The Dry Eye Zone is a patient-run website about dry eye. This site is neither written nor formally reviewed by medical professionals. It contains peer-to-peer practical advice only. As with all your medical research online, use good judgment, and team up with an eye doctor who has proven expertise with dry eye and who is actively engaged with you in your dry eye journey.
by Rebecca Petris
The Dry Eye Zone website was launched in 2005. DEZ was a natural outgrowth of LaserMyEye, a website and forum I ran in the early 2000s (now long gone) as a solutions resource for people with complications from laser eye surgeries, e.g. LASIK and PRK, back in the early days when information and good care were so scarce.
I turned my eye interests into a full-time occupation when my own eye troubles were interfering too much with my previous line of work, because working for myself gives me control over my time, computer use and environment, and most importantly, it gives me more scope for what I'm passionate about.
You see, for me, dry eye all started when I had LASIK surgery back in 2001. While nothing went visibly wrong with my surgery, I was left with compromised vision, dry eye, and chronically painful, sensitive eyes. It was many years before I came to a point of feeling that I had what I needed to successfully manage those of my eye issues that I couldn't simply adapt to. Thankfully, I've been able to wear a variety of specialty lenses over the years, from sclerals to PROSE and EyePrintPro, that restore much of my vision and keep my eyes comfortable most of the day. If you’d like to read more about my personal eye history, please visit dryeyestories.com.
In the years following my LASIK procedure, I found myself more and more active in advocacy for people with complications. Many of us had (and have, for that matter) vision complications, but dry eye was the hands down winner as the most common and troubling side effect from LASIK — the hardest problem to solve and the one taking the greatest toll on quality of life. It was also something none of us felt we had been adequately warned about. Furthermore, many people undergoing LASIK found themselves with a persistent, painful, and medically puzzling version of it that did not seem to respond to treatment the way it "ought" to. (We now know that much of this was probably due to neuropathic corneal pain, but this was long, long before the ophthalmic community started a conversation about that or even had language for it.) This form of dry eye was particularly devastating when combined with vision problems. Depression and anxiety became huge issues. Shockingly, suicides were being reported regularly. I was heartbroken by suicides amongst people I knew personally. I worried a lot about the collective negativity on forums and groups whose focus was all about laser surgery complications. How could we infuse hope, and shift the focus to what we could achieve together?
This was all happening at a time when the incidence of painful dry eye in general seemed to be on the rise, particularly from medical causes such as side effects of drugs and surgeries. Meantime, resources and information for patients were scarce and the medical community was poorly equipped to answer their questions or help them with the practical impact of dry eye. I can still remember the two decent dry eye websites that existed back in 2003 — it was a very different world! Restasis had been FDA approved in 2003, but even when it became commonly prescribed, there were so many people it just didn't help. And, worryingly, patients were not getting properly diagnosed. Doctors and patients alike did not know what they needed to know about the tear system, how each part works, how dry eye happens and what to do about it beyond a small handful of conventional measures that don't work for severe cases.
I have a friend who is a pediatric ophthalmologist. One of the best things she ever did for me back then was to give me a crash course in dry eye. As soon as I had wrapped my brain around a few basics, I summarized my understanding of it an article called "Dry Eye for Dummies" and put it up on the laser site. That page was so heavily trafficked, and I got so many questions about it, that I began doing more research about dry eye. I posted more and more articles. That, in turn, led to more and more visits from people who had dry eye but not from laser surgery. Over time, it seemed the visitors to the site who had dry eye from a great variety of causes were outnumbering all others — such was the need for any kind of information that could help them on the path to getting answers and help. (Incidentally, the most current version of my original dry eye article is now Dry Eye 101 on this site.)
That's when I started The Dry Eye Company, with the dryeyezone.com, dryeyetalk.com and dryeyeshop.com sites.
My strongest memories of that period are when I was writing the original DryEyeZone site. It was a huge undertaking. I remember a veritable sea of 3x5 cards on an enormous dining room table (one of those ones that nobody ever actually eats at) in Florida where we were living at the time. I remember pushing groups of cards around and re-organizing them over and over, and then writing nonstop for about two weeks. I also started the Dry Eye Shop, and much went into that, but that's another story for another site. DryEyeTalk, our forum was a close-knit community, with many of us having come from the LASIK complications community but our ranks were swelled by people who had dry eye from auto-immune disease and a host of other causes, from Accutane to blepharoplasty.
From 2005 to 2015, I ran the websites and the business more or less solo. Every day I learned more, from emails and phone calls and research and building relationships with doctors.
Then an industry crisis that I think of as The Great Saline Crisis of 2016 swept in and changed many things, because my DryEyeShop accidentally became not just an information center but a key supplier of the preservative free salines we scleral lens users all used to fill our sclerals. This forced me into larger premises and acquiring staff. Getting from there to here, though — I spent two years trying to survive the onslaught, reshape and figure out how to finance the business, and scrape together enough hours to eat and sleep. In that time, out of necessity, I totally neglected DryEyeZone and all of the educational projects I love so dearly. Out of sheer desperation to be doing something other than retail, I did manage to squeeze in some time for newsletters, some advocacy and even some research projects, and I also had the honor of serving on TFOS DEWS II public awareness and education subcommittee, which was really important to me, but time was at an all time premium, and there was a lot I wanted to do that I just couldn't.
In 2018, I managed to wrench myself into a place where I could start devoting more of my time to dry eye research, education, tracking developments and working on advocacy projects. As I delved back in, over time I came to realize it was now, finally, time to start a nonprofit. Hence The Dry Eye Foundation was born… a work in progress! One of its first projects will be to update this site, dryeyezone.com. Back in March of 2018, I ripped up the old one and started over - I moved to different software, merged the site with the blog, and began writing new content but never got time to complete it. That’s what I’m starting now.
Hope you enjoy, and please, if you have suggestions for additional dry eye or scleral lens topics you would like to see addressed here, contact us!
Who we are & what we do
I started The Dry Eye Zone in 2005. Prior to that, I worked for a decade or so in commercial jet leasing in London and San Francisco. In my younger days worked as a teacher and translator in Thessaloniki, Greece. My interests shifted to eyes and advocacy after experiencing unexpected and hard-to-treat eye problems after LASIK surgery in 2001.
I am passionate about education, patient advocacy, helping doctors and patients understand each other better, and raising the bar in dry eye care. I love writing. I love data and databases. I am ever so excited to now be launching The Dry Eye Foundation, a new nonprofit organization.
I am married with a 16-year-old daughter and live in Poulsbo, Washington. We have a little hand-built tinyhome and some Icelandic sheep companions.
KeratoScoop is my pet newsletter, my platform for dishing out news about all things cornea insofar as they relate to dry eye and scleral lenses.
In case you're curious, I got the idea for the name from the keratoscope, which is an instrument used to assess the curvature of the cornea. It has absolutely nothing to do with dry eye. But Kerato (κερατοειδης, rather) is Greek for cornea, and dry eye is a corneal disease. Scoop, well, obviously.
The name is, I confess, a sad deviation from my principles. I have always firmly believed that names should be readily understood, spelled and pronounced by anyone 8 years or older. But it felt like a fun idea at the time, and I've been using it so long that I'm stuck with it.
Some doctors I have appreciated in my personal journey
Dr Richard Muchnick, the pediatric ophthalmologist in Manhattan who first diagnosed me CORRECTLY after my LASIK. He was blunt, but it was helpful. His diagnosis wasn't anything to do with dry eye - it was about my vision. He basically said that I had permanent damage to my central corneas; that the technology to diagnose me in sufficient detail did not yet exist, let alone the technology to fix me; and that I might as well get started trying to find some kind of specialty hard lens because that's the only way I would ever be able to see well enough to drive again. It wasn't fun, but I needed someone to level with me that bluntly.
Dr Greg Gemoules, the optometrist near Dallas who specializes in post refractive surgery complications. I met him on SurgicalEyes, which at the time was the place all us post-refractives congregated, we who were shunned by an industry that not only couldn't help us but wasn't interested. He was the first doctor to get me seeing properly again after LASIK. One of the first times he tried fitting lenses on me was in Dan Reinstein's clinic in London, with my newborn baby in my lap, but I always visited him in Coppell, TX a few times. From 2004 to 2006 I wore Macrolenses he designed for me, and I had my life back. I moved on to other lenses but then he moved on and developed his own patented lens design, and has been serving post-refractives and other patients from all over the world.
Dr Dan Reinstein, the ophthalmologist in London who worked with me from 2002-2005. He helped me, and many people that I sent to him, with dry eye back in those days when there was so little available (viscotears and cling film?), and most of all he was someone who really "got it" that I could talk to about vision and complex optics issues and about everything that was wrong with the LASIK industry. - Of which, of course, he is a part, but a brilliant and conscientious part. Dr Reinstein understands vision quality and optics. It's hard enough today to find anyone of whom that is true, but in 2002, VERY few people did. I still have vivid memories of the wavefront aberrometry but also the contrast sensitivity testing we did that actually explained a lot of what I was experiencing.
Dr Richard Hector, the ophthalmologist in Bradenton who treated me while I was living in Apollo Beach, back in 2004-2005. Dr Hector is one of the most compassionate doctors I have known. Back when I was living there, he would speak at Sjogrens Syndrome Foundation support groups, and he was kind enough to speak at the dry eye conference The Dry Eye Company held in 2006 in Tampa, which I've been wanting to replicate ever since. Dr Hector is a unique and treasured combination of compassion and savvy - at the van of new drug clinical trials while also attuned to all the practical side of managing dry eye.
The late Dr Perry Rosenthal, who founded Boston Foundation for Sight and pioneered scleral lenses for so many orphaned patients and went on to pioneer diagnosis and treatment of corneal neuropathic pain. Dr. Rosenthal fitted me with PROSE in Boston in 2006, thanks to the foresight and kindness of Mark Cohen (executive director at the time). Please take a moment to read the tribute I wrote, and if the topic of neuropathic pain is relevant to you, read Bryn Nelson's brilliant report on the topic. Perry, you did so much for us. We miss you. A lot.
Dr Paul Jenson, the optometrist in Renton, Washington who helped me for so many years. Dr Jenson has helped so many of my family members, friends and DryEyeZone buddies. He is an extraordinary man, a superior listener, an observer of patterns, attuned to so many overlooked, under-diagnosed conditions. A half hour of chat with Dr Jenson is such a treat.
Dr Roya Habibi, optometrist in Seattle, Washington - kind, caring, and so knowledgeable and savvy in dry eye and meibomian gland syndrome. Dr Habibi also fits the EyePrintPro lenses I currently wear - a brilliant technology for rapidly achieving an optimally fitting lens.
Dr Sandra Brown, pediatric ophthalmologist extraordinaire in Concord, NC, and friend of ever so many years. She is simply one of the greatest minds on earth. To say nothing of heart.