Eyeworld

G ood habits for healthy eyes are import- ant for all ophthalmologists to know. In this last issue of 2018, we share thoughts on eye health from ophthal- mologists on several key issues. One of the most controversial topics in medicine is the value of oral omega-3 supple- mentation. Multiple studies document both their value and, occasionally, lack of value. Alice Epitropoulos, MD, and Michael Gross, MD, re- fer to the Tear Film & Ocular Surface Society Dry Eye WorkShop (DEWS) I and II reports, which state that nutritional therapy is listed as first-line treatment for even mild dry eye disease. Both physicians agree that a critical level of omega-3 supplementation is crucial to achieve the desired effect and that there are significant differences in the quality and therefore efficacy of omega-3 supplementation. Iatrogenic damage can significantly harm both the eyelid and the eye itself and is surprisingly common, according to Henry Perry, MD. Eye rubbing also plays a major role in allergic eye disease. It inflames the ocular surface, which can make any inflammatory ocular surface disease, such as dry eye, worse, according to Christopher Rapuano, MD. They agree that eye rubbing also plays an important role in the development of keratoconus and floppy eyelid syndrome. Getting patients to stop rubbing their eyes can be difficult but is important to eye health. Good tips include aggressively treating allergic eye disease with topical and sometimes systemic anti-allergy medications, cold compresses, non-preserved tears, and enlisting the help of family members. One of the most common eye conditions is ocular allergies, and accord- ing to Vincent de Luise, MD, they affect up to a third of the population. He noted that there are five different categories of ocular allergy and that thera- py is based on making the correct diagnosis: seasonal allergic conjunctivitis, perennial allergic conjunctivitis, atopic keratoconjunctivitis, giant papillary conjunctivitis, and vernal keratoconjunctivitis. The symptom seen in all five allergic conditions is ocular itching. According to Bennie Jeng, MD, atopic keratoconjunctivitis is the most difficult ocular allergy to control, and sys- temic therapy is often required. Clara Chan, MD, EyeWorld Cornea editor, thinks that in addition to topical antihistamines, ophthalmologists should consider topical corticosteroids and even an immunosuppressive in more severe and chronic ocular allergy. Contact lens wear is common, and ophthalmologists and optometrists who manage these patients should be aware of the challenges. According to Terrence O'Brien, MD, the majority of contact lens wearers also experience dry eye disease, which is the most common reason patients discontinue con- tact lens wear. Christopher Starr, MD, agrees that contact lens intolerance is often due to dry eye, but allergy to the contact lens wear also plays an important role. Francis Price Jr., MD, and Marianne Price, PhD, performed an important prospective trial on contact lens wearers and found that 14% of patients discontinue contact lens wear annually mostly due to the development of dry eye. In addition, they found greater patient satisfaction and fewer complications with LASIK than contact lens wear. Francis Mah, MD, also sees ocular allergy and dry eye as common reasons for contact lens discontinuation. On the subject of infections associated with contact lens wear, all of the sources agree that the greatest risk is the use of extended wear contact lenses and that these infections must be treated aggressively to prevent vision loss. EW World view Good habits for healthy eyes The news magazine of the American Society of Cataract & Refractive Surgery A S C R S December 2018 Volume 23, number 12 ASCRS Executive Director Steve Speares sspeares@ascrs.org Editorial Editor Amy Goldenberg amy@eyeworld.org Managing Editor Stacy Jablonski stacy@eyeworld.org Senior Staff Writer/Digital Editor Ellen Stodola ellen@eyeworld.org Senior Staff Writer Liz Hillman liz@eyeworld.org Production Graphic Designer Julio Guerrero julio@eyeworld.org Graphic Designer Susan Steury susan@eyeworld.org Production Manager Cathy Stern cathy@eyeworld.org Editorial Production Assistant Taylor Wise taylor@eyeworld.org Contributing Writers Stefanie Petrou Binder, MD Berlin, Germany Vanessa Caceres Bradenton, Florida Rich Daly Arlington, Virginia Lauren Lipuma Washington, D.C. Chiles Aedam R. Samaniego Muntinlupa, Philippines Michelle Stephenson Roanoke, Virginia Senior Contributing Writer Maxine Lipner Nyack, New York Sales, Sponsorships, and Special Events ASCRSMedia 4000 Legato Road Suite 700 Fairfax, VA 22033 703-591-2220 Jessica Donohoe jessica@eyeworld.org Shelly Dixon shelly@eyeworld.org Molly Phillips molly@eyeworld.org Cathy Stern cathy@eyeworld.org Anne Le anne@eyeworld.org ASCRS Publisher: EyeWorld (ISSN 1089-0084) is published monthly by ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; telephone: 703-591-2220; fax: 703-591-0614. Printed in the U.S. Editorial Offices: EyeWorld News Service, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org Advertising Offices: ASCRSMedia, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org Copyright 2018, ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055. All rights reserved. No part of this publication may be reproduced without written permission from the publisher. Letters to the editor and other unsolicited material are assumed intended for publication and are subject to editorial review and acceptance. Subscriptions: Requests should be addressed to the publisher. Annual subscription prices: Individual: 1 year, $120; 2 years, $220; 3 years, $320. Institutional: 1 year, $250; 2 years, $330; 3 years, $425. Foreign: 1 year, $240, 2 years $470, 3 years, $700 Back copies: Subject to availability. Contact the publisher. Cost per copy is $15; $30 foreign. All orders for individual or back copies must be accompanied by payment. Requests to reprint, use, or republish: Requests to reprint or use material published herein should be made in writing only to Cathy Stern, EyeWorld, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org EyeWorld reprints: To order reprints of material published in EyeWorld, contact Cathy Stern, EyeWorld, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: cathy@eyeworld.org or your salesperson Change of address: Notice should be sent to the publisher six weeks in advance of effective date. Include old and new addresses and label from recent issue. The publisher cannot accept responsibility for undelivered copies. Postmaster: Send change of address to EyeWorld, 4000 Legato Road, Suite 700, Fairfax, VA 22033. Periodical postage paid at Fairfax, VA 22033 and at additional mailing offices. The ideas and opinions expressed in EyeWorld do not necessarily reflect those of the editors, publisher, or its advertisers. P U B L I S H I N G S T A F F Eric Donnenfeld, MD, chief medical editor

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