Mechanical Dry Eye Monday

This week's #MDEMonday

Today, we will hear from Dr. Nicole Lemanski, Ophthalmologist and Corneal Refractive Surgeon from Upstate New York. Dr. Lemanski discovered MDE when she noticed that many of her patients experienced the symptoms of dry eye but were not responding to any of the conventional dry eye therapies. After examining these patients under a slit lamp, she realized these patients had redundant conjunctiva, which is Mechanical Dry Eye.

Video Library

Scheffer Tseng, MD, PhD

“Mechanical Dry Eye is a very important clinical problem.” 

Neel Desai, MD

 “We’ve all had the paradoxical patient that seems to have dry eye and typical ocular surface disease, but they simply don’t respond to all of the typical conventional therapies…there is a missing x-factor. And that x-factor is this Mechanical Dry Eye concept, or conjunctivochalasis.”

Mark Milner, MD

“Dry eye disease isn’t just simply a problem with quantitative tear film, meaning a low tear volume. Dry eye can also be from an abnormal tear film where you have tears, but they’re either unhealthy, or they’re not getting to the location that they need to, and one of the classic examples is what we call ‘Conjunctivochalasis’ or Mechanical Dry Eye.”

 

Ravi Patel, MD

“My message to my peers is simple: Look and examine your patients carefully. I wish that I knew about Mechanical Dry Eye disease even earlier than I found out about it because these are some of the happiest patients in my practice and some of our largest referral sources.”

Cliff Salanger, MD

“Mechanical Dry Eye is rampant; it’s almost ubiquitous in individuals over the Medicare age of 65, and we have to look for it. The key is making the diagnosis. I get fooled still. I look, white light shining the slit beam across, and I’m thinking to myself, ‘Oh, there’s not a whole lot of redundant conjunctiva here.’ I put the fluorescein in, I turn on the cobalt blue light, and then even better, I put a yellow filter on the other side of the microscope, and it highlights the redundant fold of the conjunctiva.”

 Steve Kane, MD

“I think that Mechanical Dry Eye is something that is very commonly overlooked, and it’s true for anything in medicine: if you don’t look for it, you won’t see it; you won’t find it. And I think it’s much more common than people understand. I think every ophthalmologist has dry eye patients that they’ve thrown the book at, and the patient keeps coming back miserable. I would challenge my colleagues to look for the Mechanical Dry Eye…”

 Kevin Baxter, DO

“…For the last several years, we’ve had no way of really treating our patients with this. We saw it, we would diagnose it, but there was no way to treat the patient. A lot of us just ignored it, but now with the surgery to treat this, it’s really groundbreaking.”

 John Belardo, MD

“When I learned about mechanical approaches such as the amniotic membrane and using the biologics to actually repair and create a new reservoir, that just revolutionized my whole approach to it. And the results with our patients were day and night. We now actually have an answer to a problem that’s been around for a long time.”

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