Urban Optique & Eyecare

Dear Doctor,

At Urban Optique & Eyecare I treat patients with advanced chronic dry eye and ocular surface disease. In addition, I design specialty contact lenses devoted to patients whose visual needs are not met by mainstream Optometry or Ophthalmology. These services include:

• specialty contact lens fitting as Scleral contacts;

• specialty custom multifocal contact lenses;

• Myopia control or Ortho K non-surgical vision correction;

• and diagnosis and treatment of various ocular surface diseases including dry eye

I am a 1995 graduate of the Illinois College of Optometry and a member of the Arizona and American Optometric Association. Originally from Chicago, I practiced at Illinois Masonic Hospital and at an upscale optical boutique on Michigan Avenue. At a former retail office in Chandler, I was nationally chosen as Doctor of the Year. I have also participated in contact lens studies for FDA approval and I am certified in CRT (corneal remolding technology).

I would love to extend my services to your patients on a referral basis when they are in need of specialty eyecare. I have serviced the Chandler area for over 17 years and pride myself on providing the best in customer care. It would be my pleasure to assist your patients and support your care with advanced specialty eyecare.

If you’d like to correspond to discuss one of your patients, please call my office or email me. Please find our enclosed brochure outlining the services offered by specialty lens clinic along with referral forms.

Sincerely,

Sheryl Simms, O.D. sheryl@drsimms.com

Our mission is to address the needs of your patients with unique visual circumstances.

4960 S Gilbert Rd, Ste 11, Chandler, AZ 85249 | 480.802.7170 | DrSimms.com

Temperature Controlled Ocular Message Resulting in Tear Film Enhancement

MiBo ThermoFlo delivers consistent emissive heat to the meibomian glandular apparatus. Thickened lipid secretions are softened and mobilized through gentle ocular message. Liberated surfactants and improved lipid secretions create an enhanced tearfilm. Improved corneal wetting reduces or eliminates the signs and symptoms of ocular surface disease.

Evaporative dry eye is the leading cause of dry eye. Improving meibomian gland function is the mainstay of modern therapy. MiBo is a new treatment modality designed to addressed obstructed meibomian glands and foster superior lipid health and function. MiBo is comfortable, effective, convenient, and affordable.

Meibomian Duct Therapy

The MiBoFlo Thermoflo® is a new therapeutic device for the treatment of dry eye. It employs a proprietary thermoelectric heat pump designed to liquify inspissated secretions and improve meibomian glandular function. MiBo improves the evaporative component of dry eye.

The MiBo delivers an effective temperature of 108 degrees within a variance of less than 3%. The unit has an adjustable timer allowing for physician-controlled customization of therapy.

MiBoFlo ThermoFlo

Management of Dry Eye

to the appropriate tissue with exquisite microprocessor enabled temperature control. Warm compresses, because they hold limited heat, lose their therapeutic effect in less than a minute. Warm compresses, while not as effective as MiBo, have been used successfully for decades in the chronic management of evaporative dry eye. They remain an important adjunct.

Is it more effective to apply heat from inside?

Meibomian glands are closer to the inner lid by a few millimeters. MiBo’s Peltier technology generates sufficient heat to drive energy into the relevant tissue. Thermocouples placed on the tarsal conjunctiva prove that therapeutic temperatures are achieved in realtime during MiBo therapy.

Can MiBo treat both upper and lower lids simultaneously?

Yes. Sterilizable and interchangeable hand pieces coupled with a powerful thermal engine allows treatment of one lid, two lids, or in a prototype version, all four lids simultaneously. Clinicians typically treat both upper and lower lids of a single eye during a eight to ten minute session. Therapy for both eyes is accomplished in under 20 minutes.

Why does MiBo treatment require multiples session?

It is not sufficient to simply empty the clogged Meibomian glands. Rejuvenation of the body’s natural lipid secretions through multiple applications of MiBo appears to be the most effective strategy. Evaporative dry eye is a chronic condition requiring periodic but regular maintenance.

MiBo FAQ

Can MiBo effectively liquify meibomian gland secretions? Yes, this answer is supported by clinical data.

Some have suggested that MiBo is no better than warm compresses. Is that true?

No. Warm compresses can be too hot (in excess of 120ºF) and potentially damage the eyelid skin and underlying cornea, or too cold (below 100ºF) and fail to melt the thickened glandular secretions. MiBo delivers emissive heat, driving thermal energy

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“ It was soothing. I noticed less burning on my eyelids. It feels moist and clean like I just had a wonderful thing done for my eyes! My eyes feel relaxed!! I would absolutely recommend this to others.

— Tannis L.

Many people do not fit into standard contact lenses. With custom soft contact lenses, the proper curvature and diameter can be ordered specific to the dimensions of the eye. Custom contact lenses are now available to correct astigmatism including high prescriptions. Multifocal or bifocal prescriptions are also customized to fit each individual’s pupillary size.

Soft Custom Multifocal Contacts

When a prescription is required for both distance and near vision, there are a few options in contact lenses. Distance contacts with reading glasses are an option, but not most convenient. Another option is monovision, one contact lens for distance and the other for near. Many people can adapt to monovision, but the best comfort and quality of vision is obtained when both eyes work together for distance and near. Multifocal contact lenses are designed as a concentric ring pattern for simultaneous vision. Most lenses have a near zone in the middle and distance rings in the periphery. If contact lenses are designed like glasses, the distance and near correction rotates out of place. Due to our pupil changing in size as we look far away versus near, the lenses are designed so we don’t have to think about how to position our head. It naturally happens due the pupillary change.

Our pupil sizes vary so the vision may vary depending on how the lens positions on the eye. If not centered well, the lens won’t allow optimal vision. The central optical zone size in custom contact lenses are manufactured to each individual’s parameters. Custom contacts can be prescribed as a more accurate fit can be obtained. The base curve, diameter, and even the concentric ring pattern is designed specifically for each individual. If astigmatism is in the prescription, it can be included in this custom multifocal lens as well.

Corneal topography is specialized equipment to take accurate measurements for custom contact lenses and as well as checking the health of the surface of the eye. The initial pair of custom contacts are designed to begin the fitting process. Modifications can be made prior to purchasing the final prescription.

Custom multifocal contact lenses are disposable monthly or quarterly. The success rate of quality vision and comfort is very high so it an excellent option in contact lens wear.

Multifocal Specialty

Soft Custom Contact Lenses

D I N

D: Distance Zone Stabilized

I: Intermediate Zone Progressive

N: Near Zone Stabilized

What is an Ectasia?

The cornea is the clear tissue on the outermost surface of the eye covering the iris (colored tissue) and pupil. The main function of the cornea is to refract light entering the eye. A normal cornea will have a smooth shape. A cornea with an ectasia will have an irregular shape or bulge. This irregular corneal shape does not refract light correctly and will create irregular and distorted vision. Ectasias can be caused by corneal problems such as keratoconus, or may result after injury to the eye.

What is Keratoconus?

Keratoconus is the most common ectasia. The cause of the condition is not clearly known. It is a condition in which the cornea thins and bulges into a cone shape causing distorted vision. According to the Global Keratonoconus Foundation, the condition occurs in 50 to 230 patients per 100,000 and in men and women of all races.

How Do Scleral Lenses Help?

Scleral lenses can be an excellent choice for a patient with keratonconus or with corneal ectasia. Scleral lenses are designed specifically to vault over the irregular corneal shape and fit on the sclera (white tissue) of the eye while never touching the cornea.

The scleral contact lens creates a new regular surface on the front of the eye that refracts the light correctly. The result is clear, distortion-free vision!

Keratoconus/Ectasia Symptoms and Treatment*

Common Symptoms:

• 78% report moderate issues with night driving

• 77% report difficulty reading regular print

• 73% report difficulty with work or activities requiring near vision

• 59% complain of pain

Treatment Success Rates:

• 1% report significant success with soft contact lenses

• 7% report success with hybrid contact lenses

• 22% report success with conventional GP lenses

*2009 Study by the Boston Foundation for Sight

Scleral Lenses

Post LASIK, Keratoconus & Other Corneal Ectasias

The Success of Scleral Lenses:

• 78.9% report improved comfort

• 78.2% report improved visual quality

• 87.77% report improved overall satisfaction with scleral lenses

*2007 Study by Visser http://www.ncbi.nlm.nih.gov/pubmed/27224675

How Scleral Lenses Work

The Scleral lens is designed specifically for irregular corneas or those with keratoconus. The lens is made of materials that let oxygen pass through the lens and the design creates a thin vault making it very comfortable and healthy.

Scleral lenses offer three critical benefits to patients with keratoconus:

1. Creates a regular smooth ocular surface to provide clear, crisp vision

2. Fits beneath the lids and rests on the sclera (white of the eye) offering exceptional comfort and stability

3. Maintains a vault of soothing tears between the lens and cornea keeping the eye moist, comfortable and healthy

Our preferred technique employs computer based topography and which allows us to create one-of-a-kind scleral lenses to rehabilitate compromised corneas for:

• Severe dry eye

• Corneal epithelial defects

• Irregular or high astigmatism

• Keratoconus

• Post-LASIK and RK ectasias

• Even designs for healthy corneas (sports, difficult standard fits, lens rotational problems)

Scleral lens vaulting the cornea, maintaining a cushion of tears.