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Mary E. Kutch, O.D. MaryK@OlympiaVision.com WEBSITE Appointments 6125 Cooper Point Rd SW Olympia WA 98502 Tel: 360-357-6683 Fax: 360-754-0482
Biographical information Certified by the American Board of Optometry? Yes Medical school: Indiana University (grad. 2007) Residency - Ocular Disease and Surgical Comanagement at PCLI, Kennewick, WA (2008) Primary Care at Jonathan M. Wainwright VAMC, Walla Walla, WA (2008) Primary Care (patient care in Spanish), Indiana University - Guanajuato, Mexico extension clinic (2009)
Approx. percentage of practice dry-eye related: 20-25%
Opinion What is the most frequent cause of dry eye amongst patients you have treated? The most common cause of dry eye amongst patients I've treated in the Northwest is meibomian gland dysfunction. In my former practice setting, MGD was a common contributor to the condition, but environmental factors and other ocular surface disease components, such as pterygia, exacerbated the condition. What advice do you most frequently find yourself giving to dry eye patients? I most commonly find myself giving dry eye patients a stepwise approach to treatment - beginning with the simplest recommendations. Artificial tears are a mainstay, as well as warm compresses (if there is gland congestion) but there are often many simple environmental modifications which can be very effective and complementary to treatment. Do you have a dry eye "hot button"? Two "hot button" issues come to mind. Firstly, I feel that punctal plugs are sometimes used too soon. They need to be reserved for once the tear film is healthy. Retaining poor quality tears and debris on the ocular surface does not improve comfort. Secondly, I tend to reserve Restasis as the last effort. I feel that jumping to this option too soon may overlook simpler, effective treatment options which could be less costly to the patient. What makes you exceptionally well qualified to help dry eye patients? In my previous practice setting, I was in central Mexico (Guanajuato). The combination of living and working at a high altitude, in intense sun, dust, and windy conditions during a 9-month dry season caused discomfort and chronic dry eye in over 75% of my patient base. What are some of your favorite products for dry eye (Rx, OTC, consumer)? As a dry eye patient myself, I have come to appreciate the effects of warm compresses with a homemade rice baggy. The unit dose (preservative free) Refresh Plus drops work well when I'm wearing my contact lenses. On dryer days, Systane Ultra is a newer product that provides longer relief without blurring my vision as much as the original Systane or other higher-viscosity products. Many of my patients have been happy with these products as well as Soothe XP to augment the lipid layer of their tears and slow evaporation - and Refresh PM for those who sleep without complete lid closure.
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