Latkany - The dry eye remedy: the complete guide to restoring the health and beauty of your eyes

To my wife, Barbara

With thanks for putting up with all that pillow talk about dry eye

Every day is still like the first day we met.

In writing The Dry Eye Remedy, I have learned the extent to which authorship is a collaborative process, so I am pleased to be able to declare my gratitude to the many people who helped make this book possible.

First and foremost, I would like to thank my patients for indirectly encouraging me to establish myself as a dry eye specialist. The experience of treating suffering patients enabled me to perfect the detailed history, examination, and treatment regime for all types of dry eye sufferers. Dry eye is not a condition taught in medical school, and it receives little emphasis in residency training, so it is my patients who really taught me about this condition.

Thanks to Dr. Vickery Trinkaus-Randall for allowing me to be a part of her ophthalmic research team; I hope others will also benefit from such generosity. I am grateful to Dr. Celso Tello and Dr. Joseph Walsh for seeing potential in me and allowing me to train at the New York Eye & Ear Infirmary. To those who believed early on in my passion for treating dry eye, I thank Dr. Monica Lorenzo, Dr. Mark Kupersmith, Dr. Julius Schulman, Dr. Paul Finger, Dr. John Seedor, Dr. Jodi Abramson, Dr. Steven Ali, Dr. Arkady Selenow, Dr. Ann Abadir, and Dr. Robert Ritch for all their dry eye patient referrals. And I thank Dr. Mark Speaker for taking me under his wing and trusting me to pursue the never been done before career of a dry eye specialist.

I am grateful to Susanna Margolis for her editorial helpparticularly impressive for someone who started off with no knowledge of the subject matter. To my agent Sarah Jane Freymann, it was not just a coincidence that we met: I thank you for seeing the potential in this book.

I am grateful also to the folks at Hatherleigh Press for their support and for playing an active role in the books development.

I would like to thank my mother Regina and my father Robert for being there for me every day. It is unfortunate that not everyone can be so lucky as to have parents like mine. I still remember every night that they put me to bed and said pleasant dreams. I want also to thank my brother, Dr. Paul Latkany, without whose guidance and support I probably would never have been a physician. And I want my brother Joe and sisters Lianne and Lauren to know what a joy it was to be the youngest in our family. To my father-in-law Jim and mother-in-law Carolyn, I offer fondest appreciation of your encouragement and guidance.

Special thanks to my Uncle Adam, who not only introduced me to the game of golf but, more importantly, taught me the importance of generosity. I am sorry I never got a chance to say thank you, but I think about him every day since the day he passed.

To my beautiful children, Brian, Amanda, Luke, and Robbie, you bring a smile to my face whenever I see you. So please stay close by. I hope you will be as passionate about your career as I am about mine.

I f you complained of dry eye back in 2007, when the first edition of this book was published, you would have been greeted with polite but blank stares. The public at large was totally unfamiliar with the term, and only a few eye doctorsmyself includedwere interested enough in the condition to research its etiology and treatment, much less to specialize in it.

What a difference a decade makes! Today, the term dry eye is much more well-known. You cannot turn on the television nor open a magazine nor log on to a website having anything to do with vision without being bombarded by advertisements for various eye drops, procedures, and even doctors promising to cure the condition. Dry Eye Centers and Dry Eye Centers of Excellence are springing up everywhere, offering the latest scientific advances to quantify your dry eye disorder and treat and/or manage it.

What happened? Two phenomena in particular have spurred this surging focus on the condition that affects tens of millions of uswomen more than men by two to oneinto what we might call the dry eye marketplace. Seeing an opportunity, pharmaceutical companies set about marketing existing eye drop products to dry eye patients, positioning the products as lubricants that could relieve the discomfort of eyes that felt dry or gritty, while at the same time they tasked their research labs to find new treatments specifically for the condition. Ads began appearing. Commercials aired on television, often in sponsorship of the national news in the evening, an advertising slot typically geared to the older audience that comprises most dry eye sufferers. Not surprisingly, the products took off, which stimulated increased profits and therefore additional advertising.

The second phenomenon was a shift in both public and private medical insurance policies that enabled reimbursement to physicians for dry eye diagnostic tests. What once was to many doctors a difficult condition to take onthere is no quick fix for dry eyenow seemed worth tackling.

Put the two phenomena together, and you have a great many more patients wondering if they have dry eye or self-diagnosing a dry eye condition and many more practitioners jumping into the business of diagnosing and treating dry eye.

In a way, this is wonderful. I have suffered from dry eye since I was in my early 20s; its the reason I became an ophthalmologist, and I have been researching the condition, thinking about it, writing about it, and treating patients for it for close to two decades, as of this writing. So to see the condition at last receiving the kind of attention I have long believed it deserves and needs is gratifying indeed.

But I have also come to see the attention as something of a two-edged sword. Testing, treatments, products, and practitioners have proliferated, but not all of them for the right reasons nor producing effective outcomes. Thats understandable, and its as normal in medicine as in any other profession. But it makes it harder for those suffering from dry eye to find the kind of help they need and deserve, harder for them to be smart consumers in what is now a bustling marketplace of possibilities.

Thats why Ive agreed to update and revise The Dry Eye Remedy. Today, more than ever, the most effective tool dry eye sufferers can bring to bear to ensure relief and eye health is knowledge. The more you understand about the disorder, its causes, the treatments available, and the things you can do on your own at home to keep the disorder at bay, the better equipped you will be to work with the right doctor to alleviate your pain and secure the health of your eyes.