Before we get to the topic of how to treat Dry Eye let's take a couple of minutes to learn about tears. We have two kinds of tears lubricating the front of our eyes. We have our reflex, or emotional tears. These tears are created by the lacrimal gland that sits up and above our eyes. The lacrimal gland makes the tears that we cry when we watch a sad movie, or if something gets in our eye.
It's the tears that lubricate our eyes from minute to minute that we are more interested in when we are talking about dry eye. These tears are made by different types of microscopic glands on the surface of our eyes, as well as deep within our eyelids. These tiny glands can be affected by all kinds of medical problems like arthritis, lupus, and the hormonal changes that come with getting older.
Normal tears consist of three different, separate substances. We have mucin which is created by the goblet cells on the front surface of our eyes. We also have a salt water or aqueous component created by the glands of moll and zeiss. Lastly, we have an oily substance called meibum which is created by the tiny glands that sit just inside our eyelashes on the upper and lower eyelids. These three substances are mixed together, kind of like Italian salad dressing, to form a lubricating layer between our eye and the air.
Shake up a bottle of salad dressing and let it sit for a minute or two. Notice how there is a little bit more oil on the top surface, a thicker middle layer that is a mixture of everything in the salad dressing, and then a layer on the bottom that is really thick. This is a good way to visualize our tears. We have more mucin close to the eye, a mixture or emulsion of mucin and aqueous in the thicker middle, and then a layer which is mostly oil sitting on the surface and preventing evaporation of our tears.
When our tears are healthy we have just the right amount, and we have just the right proportion of the three different components. We start to have problems with dry eye when we either have too few tears, or when the three components do not mix well. Next, we'll talk about the different types of dry. See you soon!
So you've come to Skyvision Centers with red, burning or tearing eyes. Your vision gets blurry when you look at a computer. You always feels like there's something in your eyes. How do we know it's from Dry Eye? How do we make the diagnosis?
Well, the very first thing we do is LISTEN to you! We try very hard to hear what it is that's bothering you. After that there are several tests that the technicians and doctors do to evaluate your tears, like examining your tears themselves. Both the doctors and the technicians look at your tears. Do you have a normal amount present just on viewing? Are they clear? Is there any debris, stuff like mucous or clumps of white blood cells present?
Before we put anything into your eyes we will often use a special instrument called an osmometer to check your tear OSMOLARITY, how salty your tears are. This is a very new, fully FDA approved test to evaluate whether you have a normal amount of salt in your tears. Normal is below 300 and abnormal is above 308, with the 300-308 range being relatively non-diagnostic. This test is very helpful in determining whether or not you have the most common type of Dry Eye, especially when other signs are hard to see.
The doctor will then put a vegetable-base dye called FLUORESCEIN into your tears to evaluate their function. How long does it take before they "break up"? Tears should remain smooth over the front of the eye for at least 8-10 seconds. Does any part of the front of the eye become stained by the flourescein? Dye staining is a sign that your tears do not work well enough. Finally, tiny strips of filter paper may be placed just inside your eyelids for a test of your tear production called a SCHIRMER test. This helps us know the volume of tear production.
That's how we do it! Lots of work to make the diagnosis, but heck...you're worth it! Tune in for lots of information on how we TREAT Dry Eye, coming soon.
Over on our YouTube channel we have a new series called "At the Dr. Whiteboard." Check it out! Pretty soon there'll be a video up that explains how our eyes work, and how it is that we actually see. Let's introduce that topic here and do a little review
Vision is kind of like filming a TV show. Our eyes act like the television camera, gathering images. The optic nerve works like the fiber optic cable that carries information from the television camera back to the computers in the production room. Those computers are very much like the back of our brain, the occipital cortex, where vision actually occurs.
So vision is actually a combination of three separate processes: focusing and capturing an image, changing that image into a series of electrical impulses that are then transmitted to the brain, and then processing those electrical impulses to re-create the image that we "see." Historically the majority of eye care has been dedicated to improving focusing, improving our ability to capture images. Cataract surgery, LASIK surgery, even something as simple as a pair of glasses allows us to create a sharp image.
Over time will talk a lot about these and other topics, as well as the exciting new vision processing programs like RevitalVision.
As a leader in advanced techniques for vision improvement
SKYVISIONis a certified provider for:
THE WORLD’S ONLY PROVEN, NON-SURGICAL THERAPY TO IMPROVE VISION
Have you undergone cataract surgery, LASIK surgery or would simply like to reduce your dependency on reading glasses? RevitalVision may be right for you.
Train Your Brain to See Better
RevitalVision is designed to improve the communication between your eyes and your brain to help you see better. The program uses neural training to improve your vision. Just like learning to walk, riding a bicycle and learning to swim have long lasting effects, so does RevitalVision.
About the program:
§20 training sessions completed at home on a computer
§Each training session takes 20 minutes on average
More than 3,000 customers and clinical trial participants that completed the program experienced improved eyesight and quality of life. Most customers notice results in as little as 10 sessions.These simple patterns, called Gabor patches, are optimally designed to stimulate neurons in the early stages of visual processing. They're called Gabor patches in honor of the Nobel-Prize winning physicist, Dennis Gabor, who provided the mathematical basis for this kind of filtering.Learn more about the technologyBased on science created byNobel Prize Winners, RevitalVision is supported by more than two decades of scientific and clinical research.
On average, vision improves by two lines on an eye chart after completing RevitalVision. Benefits include:
§Reading smaller print on a newspaper, menu, or computer screen
§Reading better in low light conditions
§Seeing objects better at night
§Reducing or eliminating the need for reading glasses.
Safety Extensively tested by reputable eye doctors and eye institutes in the U.S. and across the globe prior to being released for commercial use, the program is 100% natural and improves vision with:
“Headlights were less glary. Newsprint was crisper. When I sat down with a book before bed, I no longer had to hold the book at arm’s length to decipher words. And, when I went to my doctor for my final post-training exam, I could read the smallest letters on the eye chart: EDFCZP. I had gained a whole line on the eye chart! I’ve never been so happy to see anything in my life.”
Dr. White was in Pittsburgh last night speaking on behalf of Inspire Pharmaceuticals. All of the doctors at Skyvision participate in what they have termed "business process research", the evaluation of medicines, medical devices, and treatments in an effort to improve how well they work. As part of this Dr. White has been traveling a little bit over the last two years to talk about what we have all learned at Skyvision.
It turns out that there is actually a "triple sweet spot" where clinical outcomes (how the disease process turns out), patient experience (how it feels to be treated), and the running of a medical practice come together. It's not enough to think about any one of these. In fact, it's really not enough to only think of two of them. In the best of settings it's actually possible to maximize all three at the same time.
What happens when you get all three of these important things working in tune? Well, it's much more than the sum of the three! You create a "virtuous cycle", the opposite of a vicious cycle, where each success builds another success. What you get is something more like a TEN TIMES better everything! A better result with a really nice experience, all in a practice that is running smoothly and efficiently.
We call this part of our practice the Skyvision Business Lab, and we're open!
Speaking of surgery and the Surgery Center , a funny thing happened to me on the way to the operating room to do premium Lifestyle cataract implant surgery this morning. I was on my way to Berea to the Surgery Center at the crack of dawn when all of a sudden the traffic on Crocker Road came to a full and complete stop. There, 3 cars in front of me, was a goose casually sauntering across the street.
What’s wrong with this picture? Well, this wasn’t a “Make Way For Ducklings” thing, this guy was a full-grown goose. No gosling here, this fellow clearly had his pilot’s license. You’ve been here before, haven’t you? Didn’t it strike you as odd, too? A goose is a BIRD for heaven’s sake. Did he forget? Why didn’t he just fly?
Anyway, the staff at the Surgery Center was just super this morning and every patient had a great experience. Everything went off as planned. We were flying!
Although we have a very large, very beautiful main office in Westlake ( see pictures on our website) we don't have enough room to do our surgeries right there. So where does Dr. White do cataract surgery, especially surgery using all of the new Lifestyle implanst? Well, glad you asked!
For more than 15 years Dr. White has been doing lots of his surgeries at a simply fantastic outpatient center called The Surgery Center in Berea. You can find their website here. The Surgery Center has been run since it opened by a woman who is simply the best surgical administrator in America, Barb Draves! Barb was part of the original team who opened the center some 27 years ago, and it has grown into one of the busiest outpatient surgery centers in the whole country.
So why there? Why choose THIS particular outpatient center to use for our most exciting, premium cataract surgeries? In a word it all comes down to excellent patient care. The entire staff at The Surgery Center is fully dedicated to providing not only the very best care possible but also to give our Skyvision patients the best experience possible. Just like in our office at Skyvision Centers!
We couldn't be happier with the care our patients get at The Surgery Center, and we know you will be happy there if you need to have surgery!
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