The Dry Eye Zone

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Book review: Reversing Dry Eye Syndrome (by Dr. Maskin)

"Reversing Dry Eye Syndrome: Practical Ways to Improve your Comfort, Vision and Appearance" by Steven L. Maskin. 2007, Yale University Press.

SYNOPSIS

Reversing Dry Eye Syndrome is the second of two brand new dry eye books on the market this year - the only two, in fact, ever written for the general public. I am very excited about this trend and grateful to the authors. There is a great need for public education about dry eye and particularly for better resources for the many people suffering from chronic dry eye. I hope we see more and more major publications reviewing both books. I would like to urge all dry eye patients to pick up a copy of this book and to let their doctor know about it.

In Reversing Dry Eye Syndrome
, Dr. Maskin (a full-time specialist in Tampa, Florida) covers a logical sequence of topics starting with basic eye education, how the tear film works, and the many things that can cause dry eye - some discussed in depth - and goes on to discuss diagnosis, the many treatments now available, and the home remedies and strategies dry eye patients can employ to improve their eye comfort and health.

Since this book was published just after Dr. Latkany's The Dry Eye Remedy, it is inevitable that the two will be compared.

Both books contain many practical gems - things dry eye patients can do for themselves. There is of course plenty of overlap but each book offers enough unique tips and different perspectives that they are by no means redundant. I found after reading Reversing Dry Eye Syndrome that I had unwittingly formed expectations that were not met and which in retrospect I had no basis for - I guess you could say I was expecting it to be a sort of Dry Eye 201 (deeper and more scientific). But it's really an alternative version of Dry Eye 101 and as such is certainly going to be useful to many newly diagnosed patients and even veterans who want to get a broader understanding of the causes and treatments for dry eye.

CHAPTER BY CHAPTER OVERVIEW

1. What is dry eye syndrome and who gets it?
Background information on typical dry eye symptoms, people who are most likely to get dry eye, and a 10-question self-test.

2. An overview of the eye: General information on eye anatomy, refractive errors and common eye diseases.

3. The Dry Eye:
Detailed description of the tear production parts of the eye with some handy diagrams, and descriptions of what it means for the system to break down.

4. The Causes: Listing and brief discussion of a variety of causes, grouped under the general categories of behavioral, environmental, aging, and diseases/disorders.

5. Aging and Gender: Discusses hormonal, geriatric, and medicine-related causes of dry eye.

6. Allergies, Toxicities and Other Sensitivities: Discusses allergic reactions and various types of conjunctivitis; contact dermatitis; and the relationship between ocular allergies and dry eye. Includes practical suggestions, and a handy self-test to distinguish between allergies and dry eye.

7. Contact Lenses: General information on lens types and caring for lenses, and some discussion of how contact lens wear may contribute to dry eye.

8. LASIK and Other Refractive Surgeries: Information about laser eye surgeries and how they work; questions to use when searching for a surgeon; and some comments about how laser surgery may affect dry eyes.

9. The Diagnosis: Advice on finding an eye doctor, an eye history checklist, and descriptions of testing equipment and basic tests for dry eye.

10. Treatment: This chapter begins by presenting a version of the "Delphi Consensus Approach" - a listing describing 4 levels of dry eye and treatments for each, with Dr. Maskin's modifications and additions.

11. Remedies for Home and Work: This is the most practical chapter in the book, with lots of examples and checklists of things you can do to improve your eyes at home and work.

12. Twenty Frequently Asked Questions.
Nice little synopsis of general questions related to dry eye.

Glossary: From acetylcysteine to xerophthalmia and a lot of dry eye (and general ophthalmology) terms in between.

Resources: Best suited to research-oriented readers, since it consists almost entirely of a list of medical references. Two "Helpful websites" listed (Schepens and Boston Foundation for Sight), along with the helpful suggestion of Googling for Johns Hopkins and the Mayo.

HIGHLIGHTS

- Thoroughness on many topics. On issues ranging from dry eye symptoms to causes to treatments to home remedies, there are lengthy lists with a paragraph or so explanation. While few are covered in much depth, the wide range of subtopics is valuable in giving people as many ideas as possible to pursue.

- I really enjoyed the chapter on allergies, toxicities and sensitivities. Probably the chapter that I personally learned from most.

- Eye history checklist, p. 131-133. I think this would be an excellent tool for patients to complete and take to their new eye doctor for discussion and to be placed in their medical record.

- Chapter 11 (Remedies for Home and Work) - the practical bits. You may or may not need suggestions for how to consume more canned tuna, but otherwise the checklists - esp. boxes 34, 35 and 36 - for improving dry eye at home and at work are excellent. And, wonder of wonders, he mentions rice. As an avid Rice Baggy fan, I was gratified to finally see some vindication from a doctor of this simple but wonderfully effective tool for MGD.

SHORTCOMINGS

- Lack of focus. After reading this book I felt like I walked away with more of an information collection than a message. That is not really intended as criticism - after all, the point is for readers to get the information THEY need and different people need different pieces - but I felt that clearer themes holding it all together would have been valuable.

- Could have been a little more upbeat. In my experience, people with chronic dry eye often suffer from depression and/or anxiety and are in need of encouragement, reassurance and hope. I think sometimes Dr. Maskin's diligence in repeatedly emphasizing the potential seriousness of dry eye and the urgency of getting care may be a tad hard on patients who are already distressed, particularly if - as is too often the case - they have already seen several doctors without getting the answers or relief they need.

- Extraneous information. This book tries to do a little too much for too many people, and in doing so it strays into general eyecare topics with distracting frequency and duration. For example, there is an entire chapter dedicated to refractive surgery (e.g. LASIK) full of general information. Similarly, I had been looking forward to the chapter on contact lenses, but the majority of it was very basic information about contacts and how to take care of them. On these and other general eyecare topics, I found nothing I couldn't easily find on about a gazillion websites.

- Style. It's a hazardous area to comment on since this is strictly a matter of personal taste and I don't want to put anyone off buying it because there really are many gems throughout the book. Personally, though, as a picky critic I found that the writing style detracted from my enjoyment of this book, particularly on a first reading. It was kind of slow going, a bit self-conscious, and at times comes across as somewhat condescending. Every now and then I found myself sighing over exasperatingly self-evident comments. Perhaps I'm overestimating the healthcare-book-reading general public, but I don't personally think people these days need to be told that if they get a piece of glass in their eye, they should go see a doctor, or that smoking is damaging to their general health, or that they should not put contact lenses in their mouth.

WHERE TO BUY, HOW MUCH IT COSTS

It's sold for $11.56 on Amazon, and you can purchase it together with The Dry Eye Remedy for about $22.

We don't have it in The Dry Eye Shop yet but we may at some point.

Please consider NOT ORDERING this book on Amazon. Instead, go to your local B&N, Borders or whatever, and if they do not have this book already in stock, ask them to order it. Seriously, the more copies of dry eye books around, the better for all of us - it will help raise awareness of this challenging condition.

After you read the book, come back and post your comments about it on our bulletin board (Dry Eye Talk). Also, don't forget to tell your doctor about the book if you find it helpful! You have more influence on your doctor than you think. What you share with him/her may prove helpful to other patients.
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