Mrs Elizabeth Ralph

Professional Services Consultant
Contact Lens Specialist

Contact: beth.ralph19@icloud.com

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Consultation via Webcam

Dry Eye Clinic Video

Latest News

LATEST NEWS! This column will carry the latest news for ADP-EyeCare patients and/or prospective patients. 

23/05/2020:  Dry Eye Clinic Video published - watch here.

03/05/2020:  Remote non-urgent consultations with Andrew D Price, now available 7 days/week, day or evening by phone or Webcam Consult. Send initial email to patients@adp-eyecare.co.uk  

03/05/2020: A collaborative agreement between private ophthalmology and Andrew D Price at the Dry Eye/Contact Lens Clinic of ADP-EyeCare at Focus-In Opticians of Rhyl. See more.

04/04/2020: Lipiflow page discusses treatment. See In-Practice/Clinic Professional Treatments under Dry Eyes Clinic menu-point.

25/03/2020:  New feature of the ADP-EyeCare website is the downloadable, savable, optionally printable Contact Lens Referral documents with all fields open for text. Go to ADP-EyeCare where you will find it under the Contact Lens Menu Point.

15/03/2020: Latest Covid-19 guidance for professionals and patients in regard to contact lens and spectacle wear can be fiund here https://www.abdo.org.uk/news/experts-respond-to-covid-19-contact-lens-misinformation/

22/02/2020: New feature of the ADP-EyeCare website is the downloadable, savable, optionally printable Dry/Watery Eye/Blepharitis Referral documents with all fields open for text. Go to ADP-EyeCare where you will find it under the Dry/Watery Eye Menu Point.

05/02/2020: The use of two new instruments for diagnosis and treatment of dry eye and contact lens discomfort included in appointments - Me-Check and MyMask. See Mr Andrew D Price - Portfolio.

22/01/2020 ADP-EyeCare announce a new dry eye clinic will commence in Stoke-on-Trent in the first week of March 2020, in addition to the current one in North-Wales. To find out more email Andrew D Price FBDO(Hons)CL , COA: patients@adp-eyecare.co.uk  

07/01/2020: Contact lens wearers who would like to improve their hours of comfort please see 'Clinical Trials - Can You Help?'

28/12/2019: 'Monovision' where one eye is corrected for distance and the other for near, is sometimes an option for cataract/refractive surgery. It is vital you have the opportunity to judge if this is suitable for you before surgery, this can be done easily as part of the Cataract or Refractive Surgery Referral Clinic. The 'target' prescription is then known in advance and is provided to the surgeon.

07/12/2019: Mrs Elizabeth Ralph FBDO CL joins ADP-EyeCare, providing specialist services in the East Midlands. 

28/10/2019: Do you have Colour Blindness/Colour Vision Deficiency (CVD)? A unique contact lens is available that may help you differentiate colours more easily. Read more. Email: patients@adp-eyecare.co.uk   

26/10/2019:  Wear glasses/contact lenses currently and would like to consider reducing or eliminating your need for them by refractive surgery, or you require cataract surgery and thinking of a private procudure? We can offer information and examinations to assess your sutability. Email: patients@adp-eyecare.co.uk 

 

 

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Dry Eye Drops – The What and the How!

Article borrowed from sister website!

In March 2015 a website named Eye Drops Database was launched as a rescource for Eye Care and Health Care Professionals, it was envisaged to be centred around Dry Eye drops, however it has grown to be much more than that. Not withstanding its expansion, it seemed appropriate for me to write a specific article on Dry Eye drops. It was my personal consideration of Dry Eye drops and so was not necessarily the same as other Eye Care/Health Care Professionals (ECPs/HCPs), I thought it useful to re-publish it here!

Use of Dry Eye drops

The visual and physical symptoms associated with dry or excessively watery eyes (very often these are linked) seems to be increasing, due to multiple factors such as; increased use of concentrated near tasks with computers, mobile phones, tablets etc. In addition other factors, with or without the use of these tasks, such as warm, dry atmospheres, air currents (windy conditions, fan driven air) and/or Contact Lens wear add to the eye's challenge to maintain its normal hydration. As if all these external factors weren't enough to conspire against us, increasing Dry Eye problem are seen as we age (a study showed a third of people over 40 were predisposed to Dry Eye), general health conditions also contribute, as do many medications we take. Historically the only way of managing/treating Dry Eye was through eye drops, in fact they used to be called 'artificial tears', a term not used nowadays. As clinicians we knew, as patients told us, this was only partially helpful. Nowadays many modern specific eye drops are better than ever, however a weakness of all drops is the 'residence time' of the drop on the eye's surface, they get washed away quickly! Latest knowledge of the tear film has led to the development of specific formulations with properties that re-balance and and add to tear quality, stay on the eye surface longer than older products and either indirectly or directly protect the delicate cells that line the eye's surface. Your ECP can advise you on specific products. 

How do I know if I have a Dry Eye/Watery Eye or even an Allergic Eye reaction? Quite simply - talk to a registered Eye Care/Health Care Professional, I would always suggest you initially contact the Eye Care Practitioner you last attended. Typical symptoms you may be experiencing could be dryness (although often other symptoms are more noticeable), mild grittiness, burning, stinging, fluctuating vision (better  after blinking/use of drops). Do not try to self-diagnose. In the same way there isn't a drug/medication that doesn't have a side-effect (noticeable or otherwise), there isn't a Contact Lens that doesn't interfere with the eye's tear film (noticeable or otherwise), so using specific drops with Contact Lens wear is quite normal and to a certain extent recommended. Do seek specific advice from your Contact Lens Practitioner. 

Do Dry Eye drops have limitations?

Yes, we are still working on a single drop that can be applied before Today (BBCR4) and will still be effective when Newsnight (BBC2) comes on! As described, with one or two exceptions, drops don't hang around on the ocular surface very long, they don't generally treat the condition, but rather the symptoms. Newer forms of treatment, now accepted around the world, for specific Dry Eye conditions don't rely exclusively on Dry Eye drops alone - these have very high success rates. As it's always better to at least understand the condition (Dry Eye has a number of forms), than to simply mask the condition so I would always advocate Eye Care/Health Care Professional be made aware of the problem. An important limitation of older forms of drops is that they may contain preservatives, which in themselves can cause toxic reactions on the eye surface. Newer forms have self-eliminating or no preservatives. Many drops are not Contact Lens compatible so can cause eye injury if used with lenses, check with your Contact Lens Practitioner and read all product information thoroughly, this applies to the use of all drops for everyone. Don't do what I do with flat-pack furniture, decide to read the instructions half-way through assembly!

Where should I buy them from? 

It should be remembered that not all drops, and ocular surface products are equal, some are more equal than others! Obviously the practice that recommended specific products will stock them and prefer you buy from them. However, in the same way it is not always possible by your new toothbrush from your dentist, it is not always possible buy drops from your optical practice. Many drops are available from many different sources, however the range can be bewildering, it is tempting to assume all drops are the same, and pick them up with your groceries, they are not! It is probably better order on-line than switch away from the specific advised product. 

How should I use them?

good technique

Follow the advice given to you by your ECP/HCP, perhaps bearing in mind the following points. If you are commencing Contact Lens wear it is advisable to have a bottle of Contact Lens compatible drops available from day one. Sometimes Contact Lens Practitioners advise applying a drop to the lens before placing it on the eye. Contact Lens wearer or not, your ECP/HCP can show you how to safely and effectively best instill drops, not a skill that comes naturally! Starting point - always wash your and dry hands, more eye infections, and very sadly but very rarely, permanent vision loss comes from invisible hand contamination than anywhere else. Check the bottle expiry date from first opening. Don't touch the dropper to your eye or face. Look up while pulling the lower lid down to create a 'pocket' and place the drop in it. The eye can't normally hold more than one drop so multiple drops risk over-dosing the eye, wasting money or drops draining via the eye's drainage canal into your body, normally harmless, but with certain drops possible side-effects can occur. Your ECP/HCP can show you how to instil drops and how to ensure very little drains away via the eye's canal.

Here is an excellent video related to administration of eye drops:

 

Here is another very useful video related to administration of eye drops to babies and children:

Space drops out by at least 10 minutes, if you are using a gel or ointment instill that last. Alternatives to drops are sprays, again check with your ECP/HCP that they are appropriate for you and how best to use them. If this article has whetted your interest to know more it is always best to consult your current ECP initially, or you could Email Mr Andrew D Price FBDO(Hons)CL, COA: This email address is being protected from spambots. You need JavaScript enabled to view it. to discuss further, with a view to arranging an initial appointment in my North-Wales or Stoke-on-Trent clinic or Mrs Elizabeth Ralph FBDO CL This email address is being protected from spambots. You need JavaScript enabled to view it. in the East-Midlands. 

Personal portfolios can be found here: Mr Andrew D Price FBDO(Hons)CL, COA and Mrs Elizabeth Ralph FBDO CL.

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