Treatment: Supportive Care «

Treatment: Supportive Care

When the patient returned two weeks later, he reported that his eyes felt better throughout the day. Slit lamp examination showed less inferior corneal staining. The patient then tried several different lens types and was successfully re-fit into the lens that provided the most comfort and best quality of vision.

I instructed the patient to continue his lubricant therapies—LACRISERT^® (hydroxypropyl cellulose ophthalmic insert) in the morning with a drop of artificial tear on top, a nonpreserved artificial tear to be used as needed during the day, and a lubricating ointment at night. In addition, I counseled him on strategies to minimize or eliminate factors that have the potential to exacerbate his condition. These strategies included making a conscious effort to blink while driving and turning cooling or heating vents away from his face.

What else do you think I recommended to this patient to help improve his symptoms?

○	a. Omega-3 supplement Yes. Omega-3 fatty acids have been found to be of benefit to patients with dry eye, potentially through their antiinflammatory activities and effects on tear production.^1,2 Wojtowicz JC, Butovich I, Uchiyama E, et al. Pilot, prospective, randomized, double-masked, placebo-controlled clinical trial of an omega-3 supplement for dry eye. Cornea. 2011;30(3):308-14. Rand AL, Asbell PA. Nutritional supplements for dry eye syndrome. Curr Opin Ophthalmol. 2011;22(4):279-82.
○	b. Warm compresses This was not my recommendation. The patient had no clinically significant eyelid disorders such as MGD; there was no indication that he would benefit from warm compresses. Please select again.
○	c. Vitamin A supplement This was not my recommendation. There is no evidence that vitamin A deficiency contributed to this patient’s condition. Please select again.
○	d. None of the above I recommended one of the listed therapies to this patient. Please select again.

Indications and Usage

LACRISERT^® (hydroxypropyl cellulose ophthalmic insert) is indicated in patients with moderate to severe dry eye syndromes, including keratoconjunctivitis sicca. LACRISERT is indicated especially in patients who remain symptomatic after an adequate trial of therapy with artificial tear solutions. LACRISERT is also indicated for patients with exposure keratitis, decreased corneal sensitivity, and recurrent corneal erosions.

Important Safety Information

LACRISERT^® (hydroxypropyl cellulose ophthalmic insert) is contraindicated in patients who are hypersensitive to hydroxypropyl cellulose.
Instructions for inserting and removing LACRISERT should be carefully followed.
If improperly placed, LACRISERT may result in corneal abrasion. Because LACRISERT may cause transient blurred vision, patients should be instructed to exercise caution when driving or operating machinery.
The following adverse reactions have been reported, but were in most instances mild and temporary: transient blurring of vision, ocular discomfort or irritation, matting or stickiness of eyelashes, photophobia, hypersensitivity, eyelid edema, and hyperemia.

Please see full Prescribing Information for LACRISERT^® (hydroxypropyl cellulose ophthalmic insert).

Jack L. Schaeffer, OD, FAAO, is president, CEO, and chief of optometry at Schaeffer Eye Center in Birmingham, AL. He is a consultant for Bausch + Lomb.

Shire Test Prep