The Best Contact Lenses for Dry Eyes and Blepharitis with Dr. Davidson
Dr. Josh Davidson initially wanted to be a pilot, but quickly found out that his vision was not good enough to go into that profession. Due to his poor eyesight and great need for glasses and contact lenses, he fell in love with optometry. And because of many friends and family members with dry eye disease, he began to dive into the dry eye world. The Williamson Dry Eye Center of Louisiana is now one of the only dry eye centers in their area, and they draw from and receive referrals from at least three different states.
He also began fitting scleral lenses early in his career, and he found that they were incredibly beneficial for those with dry eye disease. Dry eye is a growing disease as our diets get worse and as we spend more time in front of screens. When you can help a patient that’s been suffering for years, it’s addictive in some respects. You know you’ve made a difference in someone’s life, and that feeling is hard to surpass.
Dry Eye Treatment Protocol
There are no two patients that are the same, and this can be frustrating for both the doctor and the patient. Just because something works for one person doesn’t mean it will work for others. When you enter Dr. Davidson’s office for your dry eye exam, you’ll first run through a SPEED test to determine your symptoms surrounding dry eye. A keratograph is used to image the upper and lower eyelids, check out the tear film, and look at the non-invasive tear break-up time. They’ll also run a TearLab, InflammaDry, and look at the eyes with dye to see how dry the eyes look physically.
If it’s found that a patient doesn’t have enough oil production, which is the most common form of dry eye disease, they’ll be directed to eyelid cleansing and warm compress eye masks. Note that when your vision is blurry after using a mask, this is a good thing! It means that you’ve liberated those stagnant oils from the glands and that the mask is working. In addition to this, dry eye is an inflammatory disease so you may be started on an anti-inflammatory medication (especially if you’ve been to many doctors with no relief). Topical steroids can be incredibly beneficial to quickly reduce inflammation.
After this, nutraceuticals will be discussed because there are a few great supplements out there that can make a huge difference for patients. Specifically, omega-3 supplements can be incredibly beneficial.
Most patients will be brought back in two weeks to assess how things are going, and at that time you may be placed on Restasis, Xiidra, or another similar medication. IPL may be considered, especially with an increase in eyelid inflammation. BlephEx and MiBoFlo are also tools that Dr. Davidson uses quite frequently on patients with incredible results. BlephEx is done first to clean up the biofilm on the eyelids, and then MiBoFlo is used to release the oils from the meibomian glands. Their practice prefers MiBoFlo over LipiFlow simply because it is much more cost effective for patients in their area.
Contact Lenses for Dry Eye
For those who wear contact lenses, you may be aware that they can contribute to dry eye disease. Contact lenses often lead to evaporative dry eye because they pull water away from the eyes into the lenses. This is why daily disposable lenses are great, as they are a new fresh lens being used every single day. If you’ve got mild dry eyes, you will likely be able to tolerate some of the great soft lenses on the market. Right now, Dr. Davidson loves Dailies Total1 for his dry eye patients. It’s a great daily disposable lens with great optics, but every single contact lens you wear will act like a sponge and soak up tears. Some people will not be able to tolerate even this one, but it’s one of the best on the market for those with dry eye disease.
Another lens he likes is Acuvue Oasys 1-Day Toric for those with astigmatism. There aren’t a ton of great options, but this one is the best he’s found for those who need a toric lens. There aren’t a ton of great options for multifocals at this time, but Dailies Total1 does come in multifocals for those who need it.
Another contact lens Dr. Davidson has used recently is the new Bausch + Lomb Infuse daily disposable lens. This lens has an aspheric back surface, which can decrease glare at night. In addition, the Infuse is a silicone hydrogel and contains ProBalance Technology. This means that the lens is infused with osmoprotectants, electrolytes, and moisturizers which all help with homeostasis so the eye and lens are in good agreement with each other. Vision with Bausch + Lomb contact lenses always tends to be pretty great, so that’s another plus of this lens.
Using Scleral Lenses for Dry Eye
This is no longer a last resort for Dr. Davidson and his patients, and he’ll reach for scleral lenses in patients if he can’t get them feeling better quickly with other treatments. He’s seen a lot of success with the use of scleral lenses in Sjogren’s syndrome patients. He often will also have these patients on autologous serum tears, which are artificial tears made from your own blood. You can learn more about those here.
In those patients who do not produce enough of their own tears, scleral lenses can be a lifeline. They are expensive, but he’s seen a ton of success with these lenses. Dr. Davidson prefers to use scleral lenses that are larger diameter, which can be difficult to put in and take out. He may start with a slightly smaller lens to get the patient acclimated to them before switching to a larger diameter lens that covers more of the front of the eye. In addition to better comfort, the vision with rigid contact lenses is often of much better quality.
As you can see, there are many different treatments for dry eye disease and each and every patient is different. By seeing a dry eye specialist, you’re giving yourself the best opportunity for eye health and comfort long into the future.
Dr. Davidson practices at Williamson Eye Center, and you can call them at 225-924-2020. Their practice has six medically-based offices around Louisiana. He runs their brand new Dry Eye Center, which has become a centerpiece of their business. At this practice, he works with both optometrists and ophthalmologists and would love to see you in his practice. If you prefer to contact him via email, you can do so at email@example.com follow him on Instagram @dryeyeod.
About Dr. Davidson
Dr. Joshua Davidson grew up in Bay City Michigan where, from the age of 11, he had his eyes set on Optometry. Dr. Davidson graduated from All Saints Catholic Central and attended The University of Michigan in Ann Arbor for undergraduate where he graduated with a degree in Biology. He went on to complete his Doctor of Optometry (OD) degree at the Michigan College of Optometry. Dr. Davidson’s clinical rotations included The William Dorn VA in Columbia, South Carolina, Anderson Eye Associates in Saginaw Michigan, and the Duane L Waters Hospital at the Michigan Department of Corrections Maximum Security Prison in Jackson, Michigan.
Dr. Davidson’s interests are in the areas of dry eye treatment, specialty contact lenses, and ocular disease. In his spare time, he enjoys CrossFit, playing softball, traveling, watching college football (his beloved Michigan Wolverines and his adopted LSU Tigers), and spending time with wife Brittney and newborn son Brooks.
In October 2019 Dr. Davidson attained the highest status in the profession of Optometry, that of Fellow of the American Academy of Optometry (FAAO). In qualifying and maintaining this fellowship, individuals are evaluated against the highest standards of professional competence.
Dr. Davidson is also proud to be a fellow of the Scleral Lens Education Society (FSLS). He is currently the only certified “expert” scleral lens fitter in all of Louisiana, Mississippi, or Arkansas. His interests lie in fitting all specialty contact lenses for high prescriptions, multifocal “bifocal” contacts, keratoconus, post-radial keratotomy, post LASIK, dry eye, amongst countless other ocular issues.
Dr. Davidson also serves on the medical advisory board of Eyevance pharmaceuticals, is on the editorial board of Modern Optometry magazine, and is a paid consultant of Glaukos corporation.