Vision

Oxnard - Port Hueneme Optometry  Dr. Don Steensma 465 W. Channel Islands Blvd, Port Hueneme, CA 93041  805/486-3585


Dry eye medications

Ocular surface disease (OSD), sometimes called dry eyes is the most common eye problem there is. There are several ways to treat OSD.  In mild cases occasional use of lubricant drops is all that is needed.   In more moderate and severe cases further examination is required in order to determine the cause and then treat that cause. Treatment could include lubricant products, eyelid cleaning products, warm compresses, eye lid scrubs, punctal occlusion and prescription medications.

Lubricating Drops

Blink Tears ®

Blink Contacts ®

Genteal ®

Refresh Tears ®

Systane Balance ®  <This is the one that I prefer in this catagory

Systane Ultra ®

Tears Naturale II ®

TheraTears v


There are some lubricant drops that contain additional ingredients in them that possibly makes them more effective.

Genteal Severe ®

Refresh Optive ®  <This is the one that I prefer in this catagory

Tears Naturale - Forte ®

Tears Naturale - Bion ®


Non-preserved lubricating drops. If drops are needed several times a day the chemical preservative in the drop can sometimes cause problems.  These medications are in single use plastic vials.  In most cases the above listed products are ok to use several times a day, but many other products and many store brands can cause problems.

Refresh Plus ®  <This is the one that I prefer in this catagory

Refesh Classic ®

Refresh Optive Sensitive ®

Systane Ultra NP ®

Theratears NP ®


Lubricating gels.  Gels provide relief for a longer period of time, but may blur vision some.

Blink Gel ®  <This is the one that I prefer in this catagory

Genteal Eye Gel ®

Refresh Liquigel ®

Celluvisc ®

TheraTears Liquid Gel ®


Lubricating ointments. In severe cases lubricant ointments are used at bedtime.  They significanty blur vision.

Refresh P.M. ®  <This is the one that I prefer in this catagory

Lacri-lube ®



Punctal occlusion is a procedure that blocks the tear drainage ducts, so the tears do not drain away as fast.  It is often very helpful


Restasis ®is a prescription medication that can help many people with moderate to severe dry eyes. Instead of providing lubrication to the eyes. It actually treats the condition by promoting better quality tears.


Lotemax ® is a steroid eye drop that may be used for a short time in very severe dry eye conditions.


Oxnard - Port Hueneme Optometry  Dr. Don Steensma 465 W. Channel Islands Blvd, Port Hueneme, CA 93041  805/486-3585

 

3D Movies

As 3D becomes more popular in movies, television, video games and in the workplace, many people will discover that they can't appreciate this new technology because of vision problems.

Years ago 3D films were created with a red filter producing a red image on one of the cameras and a blue filter creating a blue image on the other camera. The two projectors then superimposed the images on the movie screen. Your brain would then combine these two slightly different images to create the illusion of 3D. Unfortunately, this meant that old-fashioned 3D films could not make full use of color.

To get around this problem, modern 3D films use polarized light instead of red and blue light. Normal light is like a wave moving in one direction while vibrating to the side in all 360 degrees. A polarizing filter is like a slit in that it only allows vibration in one direction. A polarized light wave vibrates in only one plane.

Modern 3D movies are projected through 2 cameras with polarizing filters set 90 degrees apart. The glasses you wear when watching a 3D movie use the same polarizing filters to separate out the two images again, giving each eye a slightly different perspective and fooling the brain into seeing 3D.  This is sometimes called passive polarization.  Because one half of the total photons are blocked for each eye the resolution of the screen is lower.

3D TVs use what is called shutter glasses-type technology. Shutter glasses receive signals from the TV, and create the 3D effect by blocking one lens then the other in sync with the TV's refresh rate.  Because the refresh rate functions at between 240 and 480 times per second, it is indiscernible to the naked eye.

An estimated 3-9 million people in the United States have binocular vision problems. If you are not using both eyes together you will not see the 3D effect. If you are using both eyes together but with extra effort you may experience discomfort, dizziness, double vision and headaches.  In these cases spectacles can sometimes be prescribed that allow the eyes to work together better.

I you are having some difficulty with the 3D effect, it is best to pick a seat near the center rear of the studio.  The screen should occupy about one half of your visual field.

 

Oxnard - Port Hueneme Optometry  Dr. Don Steensma 465 W. Channel Islands Blvd, Port Hueneme, CA 93041  805/486-3585

OTC eye medications

Prescription allergy medications work better than non-prescription  (OTC) medications, but in many cases an OTC medication may be adequate.  Over-the-counter allergy medications include topical decongestants, oral antihistamines, topical antihistamine/mast-cell stabilizer combinations and topical decongestant/antihistamine combinations.

 

Topical decongestants reduce ocular injection and edema. Topical decongestants are prescribed up to four times daily, typically work within minutes and last about two hours. Chronic use of vasoconstrictors can lead to toxic, follicular reactions and or contact dermatitis.  These medications are usually reserved for acute reactions and should only be used occasionally.  If used frequently they lead to a rebound effect in which less and less relief is achieved and the eyes become more irritated.  In rare cases they can cause glaucoma, a potential cause of blindness.

Refresh Redness Relief ® (phenylephrine HCl 0.12%, Allergan)

Visine ® (tetrahydrozoline HCl 0.05%, McNeil)

Visine L.R.® (oxymetazoline HCL 0.25%, McNeil)

Clear Eyes ® (naphazoline HCl 0.12%, Prestige Brands).

 

Oral antihistamines are helpful with eye allergic sumptoms and a concurrent allergic rhinitis, but these drugs have a superficial drying effect on the ocular surface.

Benadryl ® (diphenhydramine, McNeil)

Chlor-Trimeton ® (chlorpheniramine, Schering-Plough)

Claritin ® (loratadine, Schering-Plough).   <This is the one that I prefer in this catagory

These third-generation antihistamines are generally well tolerated and non-sedating.

 

Topical antihistamine/mast-cell stabilizer combinations are all different brands with the same active ingredient, ketotifen 0.025%.

These medications work faster than oral antihistamines at relieving ocular symptoms. The antihistamine quickly relieves itching and the mast-cell stabilizer prevents itching for an extended period of time, usually 12 hours.  Dosing is twice a day.

Alaway ® (Bausch + Lomb)   <This is the one that I prefer in this catagory (The bottle is twice as big for about the same cost.)

Claritin Eye ® (Schering-Plough)

Refresh Eye Itch Relief ® (Allergan)

Visine All Day Itch Relief ®(McNeil)

Zaditor ® (Novartis).

 

Topical decongestant/antihistamine combinations include both decongestants and antihistamines. The dosing is up to four times a day during acute symptoms. Chronic use of decongestants can lead to toxic, follicular reactions and or contact dermatitis.  These medications are usually reserved for acute reactions and should only be used occasionally.  If used frequently they lead to a rebound effect in which less and less relief is achieved and the eyes become more irritated.  In rare cases they can cause glaucoma, a potential cause of blindness.

Opcon-A ® (naphazoline HCl 0.03%/pheniramine maleate 0.32%, Bausch + Lomb)

Naphcon-A ® (naphazoline HCl 0.025%/pheniramine maleate 0.3%, Alcon)

Visine-A ® (naphazoline HCl 0.025%/pheniramine maleate 0.3%, McNeil).

 


Rx medications

 

When OTC medications do not provide adequate relief, prescription medications are used. Prescription allergy medications include topical mast cell stabilizers, antihistamines, combination antihistamine/mast-cell stabilizers and mild steroids.

Topical mast-cell stabilizers block the first step in the allergic cascade. They are used for chronic mild itching such as in perennial allergic conjunctivitis. The dosing is up to four times daily during acute symptoms.  I think that an antihistamine/mast cell stabilizer is much more effective than a pure  mast cell stabilizer, so I do not use this type of medication.

Alamast ® (pemiroloast 0.1%, Vistakon Pharmaceuticals)

Alocril ® (nedocromil 2.0%, Allergan)

Alomide ® (lodoxamide 0.1%, Alcon)

Crolom ® (cromolyn 4.0%, Bausch + Lomb)

 

Topical antihistamines block histamine receptors in the conjunctiva and eyelids. This type of medication is used for short-term, acute symptoms of itching.

Emadine ® (emedastine 0.05%, Alcon),

 

Topical combination antihistamine/mast-cell stabilitizers are the preferred medications for chronic recurrent episodes of allergic conjunctivitis. This is generally defined as more than two episodes per month. The advantage of these combination medications is the quick onset of relief and the long-lasting effect of reducing redness, tearing and burning.  These medications are usually prescribed two times daily (Pataday is once a day) for relief of symptoms. These medicines may be used up to four times a day for severely symptomatic patients.

Bepreve ® (bepotastine 1.5%, ISTA)

Elestat (epinastine ® HCl 0.05%, Allergan)

Patanol ® (olopatadine 0.1%, Alcon)

Pataday ®(olopatadine 0.2%, Alcon)

Optivar ® (azelastine 0.05%, Meda)

Lastacaft ® (alcaftadine ophthalmic solution 0.25%, Allergan)  <This is the one that I prefer in this catagory

 

Mild steroids are used  with severely symptomatic patients.In severe cases a mild steroid is also used short term with the long term combination antihistamine/mast-cell stabilitizers to decrease inflammation.  Long term use of steroids can cause serious complications,

Lotemax ® (lotepredol 0.5%, Bausch + Lomb)

Alrex ® (lotepredol 0.2%, Bausch + Lomb)

 

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