Case Studies

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    Contact lens patient with dry eye

    David Geffen, OD
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    Hear how TearLab aided Dr. Geffen in diagnosing a patient

    History of present illness (HPI) and medications

    Icon 38 year old female
    Icon Complaints
    Foreign body sensation OU
    Dry eyes
    Reduced wearing time in CL's
    Eye Strain
    Red Eyes
    Icon Medication
    BCP
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    Examination Results

    VA: 20/20 OU

    Refraction: 3.50DS, OS: -3.75-0.50 x10

    IOP (mmHg): 12 mmHg OU

    Tear Osmolarity (mOsm/L): OD: 315, OS: 325

    Lids: clear

    TBUT (sec.): 9

    Corneal Staining: mild diffuse SPK

    Conjunctival Staining: mild

    Lens: wearing Biomedics

    Conclusion of Dr. Geffen's findings

    Contact lens patient with dry eye

    "Switched patient to daily contact lens which would wet eyes better and help her corneas heal;  After 1 week trial, eyes showed no staining and tear osmolarity at 301 and 303 mOsm/L at second visit;  Showing her these numbers, she realized the help these lenses were doing and as a result, purchased an annual supply of these lenses."

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    Contact lens patient with dry eye
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    Diagnosing meibomian gland dysfunction with significant dry eye

    Eric Donnenfeld, MD
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    Hear how TearLab aided Dr. Donnenfeld in diagnosing a patient

    History of present illness (HPI) and medications

    Icon 67 year old male
    Icon Complaints
    Foreign body sensation OU
    Fluctuation vision
    Decreased vision
    Ocular burning in the morning
    Icon Medication
    Hypertensive medication
    Icon

    Examination Results

    VA: 20/30 OU

    Refraction: +1.00 OD/ +0.75-0.50X180 OS

    IOP (mmHg): 14/16

    Tear Osmolarity (mOsm/L): 286/304

    Schirmer’s (mm): 15/12

    Lids: 3+ meibomian gland inspissation with telangiectasia OU

    TBUT (sec.): 4/5

    Corneal Staining: 2+ inferior fluorescein SPK OU

    Conjunctival Staining: 1+ nasal lissamine green staining OU

    Lens: 2+ NS OU

    Conclusion of Dr. Donnenfeld’s findings

    Meibomian gland dysfunction with significant dry eye

    "Osmolarity differential shows the patient had significant dry eye but patient was treated with LipiFlow and oral omega-3 supplements. After one month, tear osmolarity reduced to normal (288/291 mOsm/L).”

    "I believe his cataract surgery will be improved markedly thanks to the diagnosis and treatment of his dry eye disease”

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    Diagnosing meibomian gland dysfunction with significant dry eye
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    Dry eye disease patient treated before cataract surgery

    Jay Pepose, MD
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    Hear how TearLab aided Dr. Pepose in diagnosing a patient

    History of present illness (HPI) and medications

    Icon 65 year old female
    Icon Complaints
    Decreased vision and glare
    Foreign body sensation OU
    Fluctuating vision
    Moderate joint pain
    Fatigue
    Occasional dry mouth
    Icon Medication
    Artificial tears
    Celebrex
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    Examination Results

    VA: 20/40 OU

    Tear Osmolarity (mOsm/L): 328 and 316

    Shirmer’s (mm): 2

    Lids: Inspissation meibomian glands

    TBUT (sec.): 4

    Corneal Staining: Inferiorly

    Conjunctival Staining: Interpalpebral with Lissamine green

    Corneal Staining: 2+ inferior fluorescein SPK OU

    Conjunctival Staining: 1+ nasal lissamine green staining OU

    Lens: 2+ NS

    Conclusion of Dr.Pepose’s findings

    Dry eye disease patient treated before cataract surgery

    "It is important to see that the use of tear osmolarity along with other science is useful in the mangament of this patient. Cataract surgery should not be performed without treating the dry eye because the biometry measurements may be affected by the dry eye. Only after we see resolution should we trust the fidelity of the biometry measurements in the setting of cataract surgery."

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    Dry eye disease patient treated before cataract surgery
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    Tearing of both eyes (epiphora)

    Elizabeth Yeu, MD
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    Hear how TearLab aided Dr.Yeu in diagnosing a patient

    History of present illness (HPI) and medications

    Icon 72 year old female
    Icon Complaints
    Main c/o is tearing OU
    Hypertension
    Seasonal allergies
    s/p Lipiflow ou 1/12/15 by another MD, which has helped burning, but not epiphora

    Icon Medication
    Amlodipine
    Hyzaar
    Ativan qhs
    Icon

    Examination Results

    UCVA: 20/25

    Refraction: OD: +0.25 +0.25 x 161, OS: -0.50 +0.50 x 165

    IOP (mmHg): 16/15

    Tear Osmolarity (mOsm/L): 294/297

    Lids: 1+ MGD, smaller punctae ou, particularly BLL

    TBUT (sec.):  10/12

    Corneal Staining: none

    Conjunctival Staining: tr -1 + LG staining inferotemporally

    2-3+ conjunctivochalasis temporally ou

    Conclusion of Dr.Yeu’s findings

    Tearing of both eyes (epiphora)

    "The evaluation of epiphora was multifactorial - outflow issues with stenotic puncta and conjunctival chelasis (mild but present). The low tear osmolarity demonstrates that this is likely due to an outflow problem. If tear osmolarity was higher, I would be more convinced that the dry eye disease played a larger role in patient's epiphora issue."

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    Tearing of both eyes (epiphora)

Others using the product

Doctors discuss how TearLab has helped their practice

Tear osmolarity in relation to cataract surgery

Dr. Whitley explains that he begins by evaluating patients with a verified questionnaire, and uses tear osmolarity measurements to gauge the success of treatment.

Tear Osmolarity in Relation to Cataract Surgery

Video Series

Dry Eye Centers of excellence and the role of diagnostics

Dr. Marguerite McDonald from OCLI and Mark Rosenberg from BDP are interviewed by Dr. Elizabeth Yeu on best practices surrounding setting up Dry Eye Centers in two very different practices.

Video 1

Becoming a Dry Eye Center of Excellence

Video 2

Incorporating TearLab into your Dry Eye Center of Excellence

Video 3

Pearls to Becoming a Dry Eye Center of Excellence

The Importance of the Ocular Surface to Surgical Results

Dr. Eric Donnenfeld from OCLI speaks with Dr. Francesca Harman, an instructor at Hillingdon Hospital in West London, discuss the effect of increased osmolarity on the corneal surface.  Dr. Harman provides insight into managing patients with hyperosmolarity and explains the importance of testing in patients considering surgery.

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