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This perfectly illustrates the importance of being attentive to any new medicines when encountering an unusual patient complaint. STRATEGIES FOR SUCCESS EYELID CLEANSING TREATMENTS FOR BLEPHARITIS • Study compared “dedicated eyelid cleanser to diluted baby shampoo” • Cleaning was done BID for four weeks • Conclusion: improvements occurred with both treatments • “However, only the dedicated eyelid cleanser proved effective in reducing inflammation and was the preferred therapy.” — The Ocular Surface, October 2017 10 REVIEW OF OPTOMETRY JUNE 15, 2020 perform an appropriate and comprehensive workup prior to initiating therapy. • An internal medicine journal notes “soft drink consumption has been associated, not only with weight gain and obesity, but also with excess mortality in US studies. Associations were found for both sugar-sweetened and artificially sweetened drinks.”3 Our take: Play outside and be active. For the most part, try to eat a plant-based diet; wear your seat belts; don’t drink alcohol (or soft drinks) excessively; sleep adequately; certainly do not smoke; and if you wear contact lenses, do not sleep in them! • Presbyopia-“correcting” eye drops are coming. The bifocal market is about to take a hit! This first sentence is to get your attention; the following discussion is to explain the pharmacologic mechanisms to reduce the demand for bifocal lenses. There are two primary approaches: (1) miotic induction to create a pinhole effect in a non-dominant eye, and (2) restoration of crystalline lens intrinsic elasticity. The former approach may come to market first; however, we are excited for the latter approach. It’s a year or two too early to get into the details, but we feel an obligation to put our colleagues on notice that megachanges are coming down the road. Anticipate the emergence of these innovative drugs and how they might impact your practices.4 • Looking into resolution of congenital nasolacrimal duct obstruction, JAMA Ophthalmology recently stated, “The rate of spontaneous resolution plateaued after nine months, and initial probing success declined after 15 months.”5 Of course, different articles seem to consistently find different outcomes. This is always so frustrating. A study from the December 2019 British Journal of Ophthalmology found that “spontaneous resolution occurred in 45% of patients at a mean of 17.8 months of age.” Our take: We would recommend appropriate lacrimal sac massage for several weeks, but if treatment is not successful, we would recommend a pediatric ophthalmological consultation at about nine to 10 months of age. While we still hold to this recommendation, if the parent(s) prefer to continue to try massage up to 15 months of age, that may well be reasonable. • Blue light protection glasses. There have been a number of articles published regarding blue light protection of late. There is no consensus that such “protection” serves any humanitarian purpose, yet ignorance of the professional literature seems to fail to deter sales-centric opticals. Because blue light can modify our circadian rhythms, all of these articles advise us not to work at a screen two to three hours before bedtime, however. • In a similar vein, the alleged benefit of wearing yellow-tinted glasses to enhance contrast has been found to be a myth.6 Now, we all have patients who swear by these, and we see no practical reason to rain on their parades.
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