Dry Eye Treatment

Dr. Kerry Salsberg, OD on Dry Eye Management


We are pleased to present Dr. Kerry Salsberg, OD speaking on EvolveDry Eye Drops' unique features, and how they can benefit patients and clinicians. Dr. Salsberg recently recorded this video for the 2021 Canadian Dry Eye Innovation Summit. 

Dr. Kerry Salsberg, OD is a Canadian Optometrist with Eyes on Sheppard in North York, Ontario. The state-of-the-art optometry clinic become one of the biggest optometric practices in Toronto. 

Transcript begins below: 


My name is Dr. Kerry Salsberg, OD and I practice at Eyes on Sheppard in Midtown Toronto. I've been interested in dry diagnosis and management for more than 20 years. Our practice has always been on the cutting edge of instrumentation and therapies to help people manage symptoms and prevent further progression of dry and ocular surface disease. 

So why is dry so prevalent? Well, over the last decade, the use of digital devices have become part of our daily routine. From toddlers to seniors, the majority of us spend hours in front of some type of screen and now with COVID screen time has increased exponentially. And this has been a big factor in the number of patients we are seeing with dry eye symptoms. Even younger patients who have been learning virtually or presenting with symptoms secondary to meibomian gland dysfunction. Mask wearing has also contributed to exacerbating underlying symptoms. 

While certain medications, systemic diseases and increasing age can result in dry eye, I think the major contributor is the amount of screentime we're spending both for work and pleasure. While dry management has historically been a niche specialty, the increased number of patients experiencing symptoms, as well as the greater awareness of dry eye disease on social media, television and print creates a great opportunity to help these patients while also bolstering practice revenues. I believe that all eye care providers need to have a good understanding of the causes, diagnostics and treatment modalities that are available. 

One of the first lines of therapy include artificial tears. This has been the hallmark of treatment for decades. Unfortunately, there's a lot of confusion when trying to determine which type of artificial tear we should be reaching for. I've always been a big believer in sodium hyaluronate based formulations, and being in Canada we are fortunate to have a variety of artificial tear products with this important ingredient, as our friends to the south don't have as many options. There are several noteworthy characteristics and benefits of hyaluronate. These include enhanced viscoelasticity, incredible water binding ability - in fact, it can bind up to 1000 times its weight in water, making a great wetting agent. It's also been demonstrated to help with wound healing abilities. This is important when dealing with epithelial healing and SPK and corneal abrasions. 

So how do we choose products containing HA? For me it comes down to many factors. One, it must be a preservative free formulation, preferably without phosphate buffers. It should have suitable concentrations of high molecular weight hyaluronate. There should be tremendous value to the patient in terms of the number of drops in a bottle. The ability to use with contact lenses, ease of installing the drops and also patient feedback. What I like about the EvolveDaily Intensive formulation is that it contains more drops per bottle than any other brand at 350 micro sized drops. The micro size dosing means that there is just enough volume to coat the eye without overflow. It's super easy to handle and squeeze so there's no wastage of drops, and there's a blue aiming tip so that the drop gets in the eye and not on your face. 

A lot of patients that suffer from dry or elderly and they have difficulty with drop installation with some of the products with more rigid bottles or pumping mechanism. It's also contact lens compatible and the bottle doesn't leak in purses or when left on its side. And for sterility, it has an anti-microbial twist cap. On a business side, Evolveis not found in chains or drugstore so patients purchase product from me and margins are healthy. 

I recommend Evolvedaily intensive drops for daily use and those who wear contact lenses. For nighttime use and those with moderate to severe dry eye, the EvolveIntensive Gel contains carbomer 980 which acts as a water holding net, and glycerol which regulates osmolarity and attracts water. This is in addition to the point 2% hyaluronate to provide longer residency on the eye. I also find this formula excellent for those patients with inadequate lid seal. Surprisingly, this formulation doesn't blur vision upon installation like other gels and ointments, and it's for that reason that you can use this successfully during the day and even with contact lenses. 

While I'm a big believer in treatments such as radio frequency IPL for meibomian gland dysfunction and inflammatory lid margin disorders, artificial tears are often needed as an adjunctive therapy. For this reason, Evolvedrops offer an excellent option for patient comfort, ease of use and value. 


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