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Jeffrey Sonsino, O.D., and colleagues are helping patients with chronic dry eye problems.

New VEI clinic eases pain of chronic dry eye ailments

BY: JESSICA PASLEY

8/19/2010 - Itchy, red, burning and painful eyes are the most common complaints of the patients seeking solace in the new Scleral Lens Clinic at the Vanderbilt Eye Institute.

The clinic is one of a few specialized sites in the country dedicated to chronic dry eye and irregular corneal surface ailments. Vanderbilt's program is the only sclera lens clinic of its kind in the state.

“These patients walk into our clinic with just the smallest sliver of their eyes open,” said Jeffrey Sonsino, O.D., F.A.A.O., assistant professor of Ophthalmology. “They are feeling so miserable and they have tried most everything to relieve their symptoms. Once they get to us, they are often in a very severe stage of dry eyes syndrome.”

Sonsino and his colleagues are able to assist patients with dry eyes from various ailments including Sjorgen syndrome (an autoimmune disorder), corneal irregularities following surgery and transplants, keratoconus (a genetic condition of the cornea), post traumatic injuries and Stevens-Johnson syndrome.

Patients range in age from 6 to 80 and are referred to the clinic by various specialists including cornea specialists, ophthalmologists, optometrists and authorities on autoimmune disorders. VEI staff spend hours working with each patient to ensure the measurements for the specialized contact lenses used for treatment are correct.

Scleral lenses are large, rigid gas-permeable contact lens that cover the entire cornea. They create a moisture chamber of tears by vaulting over the cornea and resting on the white part of the eye (sclera) They tend to be comfortable because they do not move as much as a traditional gas-permeable lens. This moisture chamber can be used to provide tears to dry eye patients or optical correction for severely irregular corneas.

“I have never seen such a change in a patient's quality of life,” said Sonsino. “In all of my time in practice, this is the most fulfilling clinic I have had a chance to participate in. Our patients are just so thankful and the relief they experience is life altering.”

John Miller, 71, doesn't want to look back on the days prior to entering the Vanderbilt Scleral Lens Clinic.

A cancer survivor and bone marrow transplant recipient, he developed a common side effect of allogeneic stem cell procedure called graft versus host disease that affects his eyes.

Miller, who recently moved to Nashville from Santa Fe, N.M., said he noticed his condition worsening in the often dry climates of the Southwest. He had hoped the humidity of Nashville would be of some help.

He found more than a hospitable climate — he rediscovered his life.
“I am so glad I developed a relationship with Vanderbilt,” said Miller. “I see several folks at Vanderbilt and I am so grateful.

“I am really happy with my team, especially at the eye clinic. If I didn't have their expertise, my ability to function would be reduced by 90 percent. It has been a real blessing — it gives me so much hope.”

Miller, who has had several pairs of lenses, has been able to enjoy activities that for a while he had to put aside, like reading and painting.
An avid painter, Miller is determined to continue his hobby. He currently has 14 of his paintings on display at Vanderbilt Health One Hundred Oaks.

“I could not have painted without Dr. Sonsino's help,” said Miller. “I was given my life back. Frankly, I am thrilled with Vanderbilt.”
Sonsino said the patient volume in the clinic is steadily increasing and that plans call for an expansion of the clinic's operating hours.

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