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The Dry Eye Remedy

"The Dry Eye Remedy: The Complete Guide to Restoring the Health and Beauty of Your Eyes", by Robert Latkany, MD. 2007, Hatherleigh Press.

synopsis

Want to know my overall impression?

I think that this book should be required reading for anybody suffering from chronic dry eye, especially the newly diagnosed.

Yup, that's how much I liked it. And I am not known for being lavish with praise.

I was very anxious to get this book. I read it cover to cover within an hour or so of when my copy first arrived. By the end of the day I had put in an order for The Dry Eye Shop.

There is such a huge problem out there with the lack of good solid information about proper care of the eyes and treatment of chronic dry eye. Many people are suffering far too much for far too long when better diagnosis, treatment and management can be achieved.

As the first book in its category, The Dry Eye Remedy has the potential to do a lot of good - or not - so there is a great deal at stake. I am thankful that Dr. Latkany is truly up to the task of educating the general public about dry eye. There are many pitfalls authors of books like this fall into and I think Dr. Latkany has managed to avoid them all:

  • He provides a sound framework for understanding the nature and causes of chronic dry eye, and what to do about it, without any danger of talking over the head of the average reader or putting them to sleep.
  • He covers some of the most vital overlooked and undertreated problems - like meibomian gland dysfunction (poor oil layer) and lagophthalmos (failure of the lids to fully close) - without wandering into lunatic fringe pet diagnosis and/or pet treatment territory.
  • He is thoroughly practical in his approach; he doesn't suggest things that for whatever reason are likely to be inaccessible to the majority of the readers.
  • He manages to present an awful lot of what could be termed natural treatments (as opposed to the usual medical fare of drugs and surgery - which, for us dry eye patients, seem to usually be the causes rather than the solutions) without coming across as "alternative".
  • He manages to talk about drugs without pandering to the pharmaceuticals. You don't find yourself scanning for footnoted disclosures about who he consults for.
  • Most of all, he educates, rather than promotes or sells. You don't walk away from this book thinking you'll only benefit IF you buy his products or the products he recommends or IF you fly to New York to see him or IF you manage to talk your doctor into some off-the-beaten-path drug or treatment. You walk away with several practical things you can do right now, and several practical questions you can talk to your doctor about.

Cutting to the chase: The Dry Eye Remedy is not perfect (I never yet read a book that was). But it is engaging; readable; balanced; educational; AND contains the vast majority of the most important types of information that new dry eye patients need to know sooner rather than later.

My gut reaction on my very first reading of this book was that it is just the right thing for many of the people visiting The Dry Eye Zone for the first time. In fact, I've already had many of our members tell me that they wish they could have read this book when they first joined our online community or when they were first diagnosed, because the book contains so much of the practical facts they've learned from the community (plus, of course, a lot more) but all packed into a book, expounded on in much more detail, and, crucially, with the weight of professional expertise.

 
who should read this book?

Here are some categories of people that will definitely benefit from reading this book, roughly prioritized:

  • DESPERATE FOR HELP: Dry eye has turned your life upside down. Often it's sudden onset, sometimes it's a gradual thing, but it's escalating despite the treatment you're getting. You may have been to several doctors. You've probably tried every eyedrop on the market. You're probably still stuck in the "plug & drop" regimen (tears, Restasis, plugs) and have never been told about, much less treated for, meibomian gland dysfunction and related things like ocular rosacea. You are frustrated that while your life has been terribly impacted, your doctor doesn't seem at all worried about you; s/he just doesn't seem to "get" how much discomfort you're in.... I get calls from people like you all the time and you always seem to absolutely drink up any and all information that can help, and I feel very confident this book will help you.
  • WORK IN PROGRESS: You've graduated from desperate to 'sort of under control' but still feel you've got a long ways to go. You've learned a lot about dry eye but you've got some gaps. You've always wished someone would show you exactly how to do those lid rolls or lid massage you read about sometimes! And you'd really like to get a better sense of "the big picture".
  • NEWLY DIAGNOSED: You've recently been diagnosed with dry eye, and you're in a fair amount of discomfort some of the time but wouldn't describe yourself as desperate. You don't want to overdo the drugs and you'd really appreciate advice on safe, natural treatment. I really wish ALL of you would read a book like this because, sigh, if you don't get good advice early on you may find your condition escalating to a point from which it's more difficult to return.
  • KNOW-IT-ALL MIRACLE HUNTERS: You think you've been there and done that and tried everything available, and are convinced that nothing works, but you're still searching for that magic bullet. You'll read this book and be disappointed that it doesn't have something you've never heard of, except in the new drugs section (none of which will help you for a long time to come if ever). But, but, but, if you read carefully, you can still pick up some gems. You may be encouraged to try something again that you had tried and discarded but may not have tried long enough or carefully enough. You may discover you've been too quick to dismiss known treatments without giving them a proper trial.

I think that the book is also potentially helpful for one other crowd - if only they could be persuaded to read the relevant sections! I mean the people who do not yet have obvious symptoms of dry eye but who are at high risk. It breaks my heart to see people get the facts about this disease only after it has been allowed to progress unchecked for years.

 
Is it user-friendly?

Unequivocally, YES.

First of all, The Dry Eye Remedy is a very readable book. Unlike some consumer-oriented medical guides it is not dry as a bone nor does it read like a learned treatise artificially dumbed down for the layperson. It's chatty, and flows well, and is interspersed with anecdotes from Dr. Latkany's practice. The writing itself leaves something to be desired but I did not find that it detracted in any way from the effectiveness of the book. The feeling I get reading the book is of sitting in an armchair having a long comfortable non-technical chat with the doctor. So it's not Shakespeare, but it works, and that's what matters.

Second, it's brimming with practical, 100% accessible advice and ideas you can put into practice right now. It's not pushing some pet highly technical diagnosis that you can only get by flying halfway across the country, or some promising scientific development that won't hit the shelves for another six years if ever, or some product that isn't readily accessible - or, worse, products available only from the author, as is so often the case!

Instead, it captures and explains a great deal of what has long been gospel to the dry eye veterans in our online community, but which we had to learn the hard way. Humidification, moisture chambers (Tranquileyes, Panoptx), detailed directions for lid hygiene and meibomian gland care, what medicines to avoid, sensible pain management advice and much much more. In fact, I was very gratified to feel that our experience as a community and a lot of the things we advocate on this site were vindicated by this book.

And while Dr. Latkany offers excellent products in his own online shop - some of them innovative products he has invented for his patients - alternative products and alternative sources are presented as well. (See Resource section at the back.)

 
CONTENTS

Here's a rough overview of what's in the book:

Part I: Understanding dry eye disorders

Chapters 1-3 are an introduction to what the tear film is all about and what goes wrong with it and why; and descriptions of the exam process and basic diagnostic tests. Chapter 4 covers the use of over-the-counter lubricants.

Part II: Restoring your eye health at home

Here's the real meat. Chapters 5-7 help you review your environment, activities, lifestyle and nutrition and identify a great many ways you can better care for your eyes ranging from humidification and eyewear to nutritional supplements and a lot in between.

Chapter 8 (the "Home Eye Spa") basically amounts to detailed instructions for babying your meibomian glands on a daily basis with lid hygiene, heat treatment and so on. If you've ever wondered what the heck a "lid scrub" is really meant to be and whether you're doing it right, you'll be carrying the book into the bathroom to look at the diagrams while you get the Q-tips out.

Part III: Beyond the home eye spa

Chapters 9-12 cover drugs (Restasis in detail; then walks through all the main categories of drugs with dry eye as a side effect); hormone therapy; punctal plugs and cautery; and some surgeries.

Part IV: Finding the dry eye therapy that works for you

Chapter 13 basically sorts and labels all us dry eye patients into 6 different categories ("first-time", "stymied", "just-fix-me", etc.). I have to say it's a pretty astute description of what we're like, and most of us will easily recognize our box! Anyway, then it presents a practical treatment approach geared for each group, drawing on a variety of medical and/or natural treatments depending on the needs, preferences and tolerances of each group

Chapter 14 starts with a discussion of the need for, and signs of, increasing public awareness, and ends with a brief overview of new drugs in the pipeline and other ongoing scientific developments.

Resources

The resources section lists a number of websites, organizations, and companies useful for further research.

 
what not to expect

You'll be disappointed if you read this book expecting either of these:

Shortcuts. No free lunch, as it were. Caring for your eyes will be work, period, unless your symptoms are quite mild. And you'll still need to find a good intelligent doctor willing to really engage with your dry eye.

Scientific depth. The book is broad rather than deep in its coverage. If you have been there and done that and tried every product and experimental treatment known to man, and if your idea of light reading is Medline, don't expect to be wowed or to discover new medical secrets here. I still think you should read it though, if you are willing to consider backtracking and giving some unglamorous treatments a new try with a different twist.

 
GAPS, unanswered questions, ETC.
  • Restasis (p. 128): A very suggestive paragraph in this section: "[Restasis'] effectiveness in the case of "quieter" pictures of dry eye is limited; it simply wasn't made for these less excited-looking, if equally uncomfortable, disorders." I would have loved to see this elaborated on. Among other things, if it's true, quite a lot of people currently on Restasis cannot hope to benefit from it.
  • Bandage contact lenses: I didn't see anything, positive or negative, about the therapeutic use of soft lenses in dry eye flareups, abrasions etc.
  • Photophobia (light sensitivity): This isn't covered at all. That was surprising to me as I have always considered photophobia as a common symptom of dry eye. It's one of the reasons so many of us benefit from wraparound eyewear.
  • Over-the-counter lubricants (pp. 41-62): In a book with fewer merits, I'd probably take up this issue at length, but frankly, I'm so very pleased with the book overall that I just don't have the heart to pick this chapter to bits. So I'll just mention a couple of points: 1) Fans of research on surface wetting, oncotic pressure or osmolarity will not be impressed with the conventional but not therefore correct wisdom of "viscous = longer lasting"; and 2) the many people I know who find their symptoms worsen with too frequent use of artificial tears or with use of petrolatum/mineral oil ointments will not be impressed with the overall advice on using lubricants.
  • Heat treatment for MGD (p. 114): I know it probably isn't feasible to mention anything other than commercially available products, but as an avid Rice Baggy fan I still wish some alternative sources of heat treatment were mentioned.
  • Boston Scleral Lens (p. 155) As a user of this prosthetic device myself, I'm very keen on it and I would have liked to see more coverage given to this topic, rather than having a couple of paragraphs tucked away in the plugs chapter. This is an end-of-the-line treatment with high success rates and people who have exhausted their options need to know about it. However, I appreciate that the book is written for a broad audience rather than the most severe cases, and I'm glad the BSL was at least mentioned.
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where can I buy it and how much does it cost?

You can buy it in The Dry Eye Shop for $13.00. It is also available from all the usual suspects: Amazon ($10.85), Barnes & Noble ($14.35, or $12.91 for members) and so on.

If you've found this review helpful, I'd sure be grateful if you would consider buying it from us!

PLEASE TELL YOUR DOCTOR ABOUT THIS BOOK!

Also, after you read it, come back and post your comments about it on our bulletin board (Dry Eye Talk).

 
where can i find the products dr. latkany recommends in his book?

You can find most of them at The Dry Eye Shop, including:

  • Eye Spa Pads
  • Eyedrop coolers
  • Tranquileyes goggles
  • Panoptx glasses
  • Dry Vites salmon & flax oil (actually, this product is being discontinued but we have an even better replacement called Barleans Total Omega that we think you will like)

We have a special section in the shop dedicated to these products to make them easy to locate. If you get stuck, use the Search box.

 

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