Friday, 24 July 2015

Empower Yourself: 9th Annual Sjogren's Society of Canada Conference. Dr Rookaya Mather

The second presentation at the Conference was from Dr. Rookaya Mather. She is Associate Professor of Ophthalmology at the Ivey Eye Institute at the University of Western Ontario, specializing in Cornea and External Eye Disease, and a long time member of the Medical Advisory Board of the Sjogren's Society of Canada. 

She spoke about Understanding and Managing Dry Eye Disease, and how it affects those who live with it every day. Dry Eye Disease (DED) is the most common reason for people over the age of 40 to visit an eye care professional and may be associated with morbidity and reduced quality of life.  It is generally underdiagnosed and undertreated.

It is also a clinical challenge for the eye care professional since it is time-consuming to diagnose and manage, it is usually not curable so the patient is frustrated, there are numerous causes and exacerbating factors and the patient reported symptoms do not always correspond to the clinical signs.

Here are the symptoms of dry eye:
Foreign body sensation
Gritty or sandy sensation
Light sensitivity
Sticky or crusted lashes
Fluctuating or transient blurred vision

Dr Mather laid out the steps we need to take to be more comfortable, despite having dry eyes:

1. Tear Supplementation
2. Control of Inflammation using topical corticosteroids or systemic          immunosuppressants
3. Reduce loss of moisture through evaporation by modifying environment and   behaviour
4. Support meibomian gland function
5. Nutritional support
6. Enhance tear production: Salagen, Restasis

Dr Mather gave us advice on how to accomplish these goals, and also sympathized about the costs of the products we need. If a product has no DIN (drug identification number issued by Health Canada) it is not covered by any type of insurance. 

She cautioned us to think about blinking: Remind yourself to blink more often and try blinking up to 3 times in a row. Also, read differently. Use artificial tears before you sit down to read or use your computer.

Try to stay ahead of the dryness to make your quality of life better. You need to intervene before your eyes are in jeopardy - it's possible not to feel the effects of dryness. With uncontrolled inflammation you can develop corneal perforation.

One piece of advice for people with meibomian gland dysfunction was to use hot soaks and then wash the eye area with Spectrogel or Cetaphil.

People over 65 are more likely to report having dry eye. Since this is an inflammatory disease there is no easy cure. Anything in front of the eyes is going to help to reduce airflow across the eye surface so try to avoid airflow, especially when it is hot and dry. 

You can find a wide variety of eye protection from moisture chamber glasses to Panoptx which is wraparound eyewear  and other alternatives. Fortunately regular drugstore wraparound sunglasses which fit over my prescription glasses are enough for me so far.

Moisture chamber glasses to reduce evaporation

Sometimes you need to work on your problems related to Sjogren's Syndrome a few steps at a time. Dr Mather suggested we take our top 3 problems to the doctor each time we have a visit and work on gradually improving our situation, step by step.

You need to own your condition, so that you know how to help yourself. With a chronic disease like Sjogren's, education is particularly important to empower yourself and protect your eyes. That is one of the reasons I love to attend conferences - to learn more from experts and also from other patients I meet there.

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