Saturday, 20 July 2013

Part 6. Immune System Gone Wild. Dr Miriam Grushka and Dr Lisa Prokopich

Dr Miriam Grushka, who is an Oral Medicine and Orofacial pain specialist, has been a long time supporter of the Sjogren's Society of Canada. Her topic was Taste and Smell In Sjogren's Syndrome.

I learned that the loss of taste that some experience with Sjogren's affects your retronasal sense of smell also. There is not much research in this area.  Yeast infections cause changes to the tongue as well as the mouth. When this infection is treated successfully, even if your tastebuds are gone they are likely to return.

Dr Grushka is also the go-to expert for burning mouth syndrome which sometimes occurs in Sjogren's.

Dr Lisa Prokopich,OD, M.Sc. spoke about "Artificial Tear Products – How To Choose?" She is Head of the Ocular Health Clinic at the University of Waterloo.
Dry eye can be episodic or chronic, and the tear supplement composition makes a difference in effectiveness. It is not really accurate to call them tears; they are really lubricants. They can help to heal the ocular surface. All are approved as over the counter (OTC) products. This is not based on clinical efficacy.
If you use artificial tears more the four times a day preservatives can be a problem. The most common one is BAK (benzalkinium chloride) and sensitivities to it are common. Some newer preservatives are less toxic.

I learned a  lot about tears, but am still not positive which is the best for me. I hear it's best not to mix brands. Here are some other comments that may be helpful.

Cellulose polymers as in Refresh and Theratears are beneficial.

Systane Ultra does help to heal your cornea. 
Systane Balance is good for meibomian gland dysfunction.
                                                                  Barbie's eye
Ointment gives more comfort than it does healing. The brands available contain mineral oil and petrolatum and are helpful to use at night.

Tears are hypertonic, a hypotonic tear is preferred. Hypotonic solutions have low osmolarity -Theratears is lowest, Hyptears, Refresh Optiva and Optive Advanced are also low. Hypertonic solutions are not for dry eyes, they can make it worse. With dry eyes we are better off with a hypotonic solution like Theratears.

She also gave us some web resources to use.

Sjogren's Society

The Ocular Surface (now owned by Elsevier- only abstracts  free)

Eye Tube OD

Dry Eye Zone  Interesting site

Links to past Sjogren’s posts:

Part 6. Immune System Gone Wild. Dr MiriamGrushka and Dr Lisa Prokopich

Part 4. Immune System Gone Wild. Dr Carl Laskin and Dr Izchak Barzilay 

Part 2 Immune System Gone Wild. Sjogren's National Conference Dr.Papas

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