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Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
Training module-2013-tears again
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Training module-2013-tears again

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Tears Again training module 2013

Tears Again training module 2013

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  • 1. Tears Again Training Module 2013
  • 2. Tears Again Training Module          What are tears ? What is dry eye syndrome ? What are the symptoms ? What are the treatment options ? How does Tears Again work ? What are the benefits of using Tears Again ? PBS vs OTC. Related conditions. Tears Again test questions.
  • 3. What are tears made of?  Tears clean and lubricate the eyes.  Tears consist of 3 layers, each secreted from different glands around the eyes.
  • 4. Layers of the tear film  Mucus layer : Secreted by conjunctival goblet cells.  Facilitates an even distribution of tears across the cornea.  Aqueous layer : Secreted by lacrimal glands.  Primarily water.  Lipid layer : Secreted by meibomian glands (found on eyelid margins).  Reduces aqueous evaporation and provides lubrication between eyelid and eyeball.
  • 5. What is Dry Eye Syndrome ?  Also known as keratoconjunctivitis sicca.  Occurs when one or more layers of the tear film malfunction.  May affect up to 14% of over 40s (according to US survey).  Research has shown that 79% of dry eye patients have “evaporative dry eye” due to a malfunctioning lipid layer.
  • 6. What are the triggers of dry eye ?  Triggers can include : Aging.  Other conditions, such as Sjorgren’s syndrome and blepharitis (see later).  Arthritis.  Some medications, including antihistamines, beta blockers and contraceptive pills.  Wearing contact lens.  Eye surgery.  Environmental conditions, such as air conditioning.
  • 7. What are the symptoms of dry eye ?  Symptoms can include :     Itchy, gritty eyes. Redness. Pain. Blurred vision. Watery eyes.
  • 8. How big is the market in Australia ?  Multiple SKUs and brands.  Leading brands sell up to 500,000 units per annum.  Leaders include Systane and Poly Tears.
  • 9. Preservatives in dry eye treatments  Dry eye treatments come in 3 broad categories :1. Containing preservatives. 2. Preservative-free. 3. Ointments (for overnight use).
  • 10. Preservative-Containing Drops  Usually a multi-dose bottle.  Can use for up to 30 days after opening.  Will contain a preservative such as benzalkonium chloride, which may irritate eyes if used frequently or over a long period.  Not recommended for long-term use.  Brands include : Visine; Poly Tears; Optive.
  • 11. Preservative-Free Eye Drops     Sold in individual, single-use vials. Suitable for long-term use. Brands include Systane; Cellufresh, Refresh. Usually available either OTC or on PBS.
  • 12. How is dry eye measured / diagnosed? 1. Measure tear volume using Schirmer test :  Filter paper place on lower eyelids for 5 minutes. Filter paper is removed and amount of moisture is measured.
  • 13. 2. Measuring tear break-up time (BUT) : Tear film is stained.  Physician observes how long it takes tear to break-up when eye is left open (ie no blinking).  Any time less than 10 seconds is an indication of dry eye.  The lipid layer is the main determinant of BUT.  Unstable lipid layer = shorter BUT.
  • 14. The Principles Behind Tears Again  79% of dry eye patients lack a stable lipid layer, leading to evaporative dry eye.  Tears Again is the only dry eye treatment that works to stabilise the lipid layer.  A stable lipid layer means :    Reduced evaporation. Extended break-up time (BUT). Improved tear volume (as measured by Schirmer Test). Reduced eyelid inflammation due to improved lubrication between the eyelid and eyeball.
  • 15. What is in Tears Again?  Contains phospho-lipid liposomes.  These are the same type of lipids that make up the lipid layer of the tear film.  Liposomes are microscopic balls of oil, with an aqueous core.  The lipids in Tears Again supplement the natural lipids secreted from meibomian glands.  Since its action is purely physical, Tears Again is classified as a medical device, not a medicine.
  • 16. How is Tears Again Used ?  Spray onto a closed eyelid from 10-15cm.  Eyes can be opened immediately after spraying.  Use as often as required (since the action is purely physical).  Applying 3 times per day is normal.
  • 17. How does Tears Again work through a Closed Eyelid ?  When sprayed onto a closed eyelid, a small percentage of the spray forms on the eyelid margins.  This is where meibomian glands are located and the natural lipids are secreted.  Tears Again supplements the natural lipids and is then blinked across the eye.  The outcome for patients: stable lipid layer means extended BUT, improved tear volume and reduced inflammation.
  • 18. How Well Does Tears Again Work?  Study by Lee, Daush, Meierhofer and Dausch (2004) compared Tears Again to placebo.  Tears Again showed significant improvement in BUT, tear volume and inflammation.  95% of patients preferred the spray to previous drop application.  Other studies exist showing effective use in cases of contact lens wear and surgery-induced dry eye.
  • 19. FAQs  How can Tears Again work when sprayed onto a closed eye ? Tears Again is designed to mimic meibomian secretions. These lipids are secreted onto the eyelid margins. When Tears Again is sprayed onto a closed eye, a small percentage forms on the eyelid margins. Here, it supplements the natural meibomian secretions and is blinked across the eye.  What happens if Tears Again is sprayed onto an open eye ? Tears Again works equally well on an open or closed eye. However, spraying onto an open eye is almost impossible due to the blink reflex.  Will Tears Again ruin make-up ? No, just let the residue on the face dry naturally (approx. 30 seconds).  Can I use Tears Again if I wear contact lens ? Contact lens can physically disrupt the lipid layer and cause dry eye. All types of lens can be left in when using Tears Again.
  • 20. FAQs continued  How often should I use Tears Again ? As often as you feel the need. Since its action is purely physical there are no adverse effects from frequent use.  Can I use Tears Again and eye drops ? Yes, but use the drop first and Tears Again afterwards.  Does Tears Again contain a preservative ? Tears Again contains phenoxyethanol. This preserves Tears Again in the bottle. Being an ethanol-based preservative, it is volatile and quickly evaporates when sprayed. As such, Tears Again is designed for long-term use like a preservative-free eye drop.  What is the shelf-life of Tears Again ? Tears Again can be used for up to 3 years (expiry date) even after opening.  Why are watery eyes a common symptom of dry eye? As eyes dry out (usually due to excessive evaporation), they become irritated. This results in the lacrimal glands to produce a greater volume of tears – more than the eye can readily drain. The result is watery eyes in patients who still suffer the symptoms of dry eye.
  • 21. OTC vs PBS  Tears Again is available either OTC or with a prescription on the PBS.  For concession card holders there is a very considerable saving with a PBS prescription.  Each PBS prescription is for 2 bottles, with a maximum of 5 repeats.  Approximately 50% of Tears Again sales are via PBS.
  • 22. Some Related Condition Information
  • 23. Sjorgren’s Syndrome  Pronounced “shoh-grinz”.  Autoimmune disease in which immune cells attack and destroy the glands which produce tears and saliva.  90% of sufferers are female, mostly post-menopause.  Affects up to 250,000 Australians.  Symptoms include severe dry mouth and dry eye.  Tears Again can be used effectively to relieve the dry eye associated with Sjorgren’s syndrome.
  • 24. Blepharitis  This is an inflammation of the eyelid and is usually a chronic condition.  Symptoms include red eyes and eyelids, crusting on lid margin (especially upon waking), gritty sensation in eyes.  Blepharitis cam lead to interrupted flow of lipids from meibomian glands.  This, in turn, can lead to dry eye.  Tears Again is an ideal treatment for the dry eye associated with blepharitis.
  • 25. Test Questions All answers are included in previous pages. If you don’t know an answer, go back and re-read.  What are the 3 layers of the tear film?  How does Tears Again work when sprayed onto a closed eyelid?  Does Tears Again contain a preservative?  What is BUT?  Why do dry eye patients often have watery eyes ?  What is a liposome?

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