Encourage Patients With DED to Examine Their Sleep Qualit

HOT TOPIC

One of the recent reports of the Tear Film & Ocular Surface Society (TFOS) Lifestyle Workshop explored the impact of lifestyle challenges on the ocular surface. Of particular interest, this report examined the association between sleep disorders (both involving quality and quantity of sleep) and dry eye disease (DED). Referring to a systematic review and meta-analysis of 19 articles, it found that, compared with controls, patients with DED have poorer sleep quality, spend less time asleep, experience more sleep disturbances, and may have increased prevalence, incidence, and severity of sleep disorders.

This TFOS Lifestyle Workshop report also found that large, population-based studies have consistently reported an association between symptoms of DED and sleep abnormalities. A similar relationship was observed after adjusting for potential confounders, indicating the importance of correcting for associated comorbidities. Clinic-based survey and cross-sectional studies have reported similar findings; however, these studies employed subjective, rather than objective, metrics to examine sleep quality.

Although no sleep intervention studies that have explored corresponding improvement in DED metrics, there is indirect evidence that interventions that affect sleep could alter DED. With more than one-third of US adults sleeping less than the recommended 7 hours per night, it’s no wonder we’re seeing so many cases of DED!

My Two Cents

I’ve hypothesized about the connection between sleep and dry eye for quite some time. I see evidence of it in my dry eye clinic every day, and it inspired me to create the PM version of The Dry Eye Drink, which patients consume before bed to “hyperhydrate” themselves with electrolytes, vitamins, and antiinflammatories that have been proven to help alleviate symptoms of dry eye. Also, suggesting a nighttime ointment for possible nocturnal lagophthalmos (Optase Hylo-Nite Dry Eye Ointment is a personal favorite of mine) or even some goggles (eg, Eyeseals 4.0) to retain moisture is a great start.

Taking advantage of this low-hanging fruit is a great way to give our patients relief from ocular dryness and discomfort, while also helping them get a more restful night’s sleep, which will undoubtedly improve their systemic health as well.

OUTSIDE THE LANE

New Technology Allows Users to “Hear” Music via Brain

Not Impossible Labs has developed a new technology called "Music: Not Impossible (M:NI)" that translates sound onto the skin through vibration, allowing users to feel the nuances of a music-listening experience. The California-based company is a technology startup that is dedicated to engineering low-cost solutions for issues of inability or inaccessibility.

"The reality is that you don't hear with your ears; you hear with your brain,” says Not Impossible Labs' Founder & CEO Mick Ebeling. “We've developed a way to get music to the brain by bypassing the ears, and focusing on the skin."

Music: Not Impossible is a combination of wearables, hardware, software, and wireless tools. The battery-powered wireless wearables include two wristbands, two ankle bands, and a harness. Each element receives complex polyphonic musical expressions across the skin, and wearers may adjust the intensity of vibrations, which are visually represented as colorful LED lights. The vibrations are carefully calibrated to match the frequencies of the original sound waves so that the user can perceive the nuances of the music, such as the different instruments and voices. (Read more here.)

My Two Cents

I’m guilting of only being drawn to information and news stories about the eyes and visual impairment; however, I find this story heartwarming. Not Impossible Labs has found a way to let the hearing impaired not only participate in music, but enjoy it in an entirely new way that offers unique satisfaction. And honestly, I imagine there’s some potential here as well for our visually impaired patient population.

CAN YOU RELATE

Sometimes, the newest option isn’t necessarily the best option. As a “scleral lens guy,” I believe strongly in these incredible lenses to provide the absolute best vision and comfort, and to be the superior option for almost every patient—until they’re not.

For the past 3 months, I’ve had an extremely difficult scleral lens patient. He’s post-refractive surgery, and without his specialty lenses, his vision is poor, and spectacle lenses offer little in the way of assistance. The difficulty in this patient’s particular scleral fit is that no matter what I seem to do, his corneal neovascularization and injection of the conjunctiva makes the lenses unwearable—not to mention the edematous cornea that it causes. We’ve reduced central clearance, adjusted diameter, and changed lens materials and cleaning protocols, but with no luck. I’ve even gotten our corneal specialist involved to make sure I hadn’t missed anything.

Then it hit me: why not try a gas permeable lens? I fit this modality every day, yet for some reason, it had never dawned on me to have this patient give them a try. After just two lenses (one initial fit and one adjustment), he is elated with the comfort, the vision, and most importantly, how he looks cosmetically. They might not be the flashiest, newest product, but don’t forget to consider the tried-and-true gas permeable lens when you’re faced with your own difficult scleral lens patient!