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Dry Eyes and LASIK

TheraLife Eye All-in-One Starter Kit

The Complete Solution for LASIK Dry Eyes

  • For Pre and Post LASIK
  • Heal Eye Tissues Damaged from LASIK
  • Revitalize and Restore Your Own Tear Functions
  • No More Pain, No More Drops
  • Doctors Recommended.

Testimonial

"I have been taking this product [TheraLife-Eye] for a week. I had LASIK 6 weeks ago, and I have noticed a big improvement. I no longer wake up with dry eyes. My eyes do not feel sore or gritty during the day. I consider the money I paid well spent." –T.T., McAllen, TX

*Results may vary

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Is TheraLife Right For You? Call And Talk To A Doctor- 1-877-917-1989 US/Canada

Why Theralife

TheraLife® Eye accelerates and aids the healing of damaged corneal nerves and tissue.

It contains potent anti-inflammatory agents to reduce swelling and dry eye discomfort.

It stimulates tear glands to produce balanced and normal tears.

What is the TheraLife Protocol?  

TheraLife has an oral formula that restores and revives your tear production from the inside out. It is clinically proven to work for dry eye after lasik . Targets all aspects of dry eyes, blepharitis, MGD simultaneously.

It speeds tissue recovery after LASIK

Pre-surgical care

Keep your eyes healthy before LASIK surgery to prevent you developing dry eye.

Based on the clinically proven success of TheraLife® Eye- many doctors are now recommending TheraLife® Eye as a pre-treatment for patients

Post-surgical care

Use TheraLife® Eye post-surgery to accelerate healing and prevent dry eyes.

To speed up dry eye recovery and ensure success. Prevent the development of chronic dry eyes. 

To help reduce the onset and duration of post-Lasik induced dry eye conditions.

What is LASIK Surgery for?

LASIK is the most commonly performed laser eye surgery to treat myopia (nearsightedness), myopic LASIK, hyperopia (farsightedness), and astigmatism. Like other types of refractive surgery, the LASIK procedure reshapes the cornea to enable light to enter the eye correctly focused onto the retina for clearer vision.

The word “LASIK” is an acronym for “laser-assisted in situ keratomileuses.”

Why does LASIK cause dry eye?

The most frequent complication of refractive surgery is post Lasik dry eye. Most refractive surgery patients’ dry eye conditions are not significant enough or long-lasting to cause many difficulties. Unfortunately, some LASIK patients develop long-term dry eye conditions that are very debilitating.

The LASIK procedure results in corneal nerve damage and obstruction to your tears production glands.

This corneal nerve damage and interruption of nerve impulses to the tear glands can cause fewer tears and dry eye symptoms.

The new shape of your cornea can alter how your eyelids touch your eye, affecting tear glands.

Post-surgical inflammation can further cause dry eye.

Inflammation is the body’s response to a threat, and in the short run, it can be a natural part of the healing process.

Why Is LASIK Done?

When light doesn’t focus on your retina the way it should, your vision is blurry. Doctors call this a refractive error. The basic types include:

  • Nearsightedness (myopia). You see things clearly when they’re close to you, but things farther away are blurry.
  • Farsightedness (hyperopia). You see faraway things more clearly, but more immediate things are blurry.
  • Astigmatism. Make everything blurry because of the shape of your eye.

Who is a good candidate for LASIK surgery?

To have LASIK surgery and minimize developing dry eye- you need to meet specific requirements. Here are some of them:

  • Ideally, you should be 18 years or older (over 21 years old, when vision is more likely to have stopped changing).
  • Your eye prescription should not have changed much in the last year.
  • Treatable LASIK refractive error.
  • Your corneas need to be thick enough and healthy, and your overall eye health must be generally good.
  • You need to have realistic expectations about what LASIK can and cannot do for you.

LASIK Eye Surgery Benefits

The benefits of LASIK include:

  • It’s been around for over 25 years. About 96% of patients reach their vision goals afterward. An enhancement can raise this number even more.
  • There’s very little, if any, the pain involved.
  • There aren’t any bandages or stitches.
  • If your vision changes as you age, your doctor can adjust it.
  • You probably won’t need to use glasses or contacts as much, or at all, after LASIK.
  • The vast majority of people have a good outcome.

What are the side effects of LASIK?

Like any surgery, LASIK carries risks of problems or complications you should consider.

The key here is to manage the procedure with understanding dry eye symptoms.

Some people have side effects after LASIK that usually go away over time. However, in some cases, they may not go away. For example, almost everyone with LASIK will have dry eye symptoms and changing vision during the day. These dry eye symptoms usually fade within a month. However, some people may take longer to disappear, or become permanent. 

Other common complications of dry eye side effects, either temporary or permanent, could include:

Other rare risk factors include:

  • eye infection
  • worse vision than before LASIK, even with glasses or contacts (called loss of best-corrected vision)
  • blindness- vision loss
  • Your vision may end up being under-corrected or over-corrected due to refractive errors. Glasses, contact lenses, or additional laser surgery can resolve the issues. 

If you are happy wearing contacts or glasses, you may not want refractive surgery. You and your eye doctor can weigh the risks and rewards of LASIK.

How likely is post LASIK dry eye to occur?

Out of all the side effects of LASIK eye surgery, dry eye after LASIK is the most likely to occur.

Based on peer-reviewed studies, 95 percent of all patients who undergo Lasik eye surgery experience dry eye symptoms after LASIK to some degree immediately afterward. Most continue to experience dry eye symptoms after LASIK for at least a week after surgery.

In most cases, dry eyes subside after a couple of weeks, although it can last for up to a year in some cases. Eye drops or medication can manage the symptoms in nearly any circumstance, e.g., Theralife.

Most dry eye symptoms are mild to moderate and not severe enough to interfere with daily activities. Cases of dry eye lasting longer than a couple of weeks are now more common, and the condition is generally manageable.

Eye pain as a result of corneal sensation happens often. LASIK procedure requires the creation of a flap in the outermost layer of the cornea, the clear, protective covering at the front of the eye; some temporary corneal nerves damage is inevitable. This damage causes the normal nerve impulses that control tear production to be interrupted.

As the cornea heals after surgery, the nerves also heal, resulting in the resumption of the normal function of the nerves in most people.

How long do dry eyes last after LASIK?

According to peer-reviewed journals, dry eye affects approximately 50% of patients one week after LASIK, 40% one month after, and 20% to 40% six months after surgery. When doing LASIK surgery, a small incision is made, which cuts the corneal nerves, which can cause a transient ocular dryness.

Most patients say their dry eye symptoms improve between six and 12 months after their LASIK procedure.

Dry eye symptoms can be severe for some patients, especially if the patient has high-risk factors (see below).

Dry eye symptoms will reduce over time as the eye heals and begins to make more tears for lubrication.

During this time, the nerves in the eye also regenerate the cornea. The corneal sensation should improve.

Who is at Risk

The clinical signs and risk factors for developing dry eye after Lasik are:

High degrees of myopic (nearsightedness) have a greater risk of dry eye after LASIK than people with lesser degrees of nearsightedness before surgery. Myopic LASIK is a higher risk.

Other factors that cause post LASIK dry eye syndrome include:

  • Pre-existing dry eye is a significant risk factor, especially chronic dry eye.
  • Older age, particularly females who have undergone menopause, is at higher risk.
  • Allergy medications (antihistamines), certain blood pressure medications, and anti-depressants can decrease eye moisture.
  • Autoimmune diseases such as Sjogren’s syndrome.
  • Live in arid climates or environments, such as a highly heated or air-conditioned room.
  • Females have a higher potential for developing dry eyes.
  • Contact lens use.
  • Require adjustments during surgery related to the depth of the eye or alterations to the flap
  • Have diabetes
  • Unusually shaped or thin corneas
  • Ocular herpes, an ocular surface disease caused by the herpes simplex virus (HSV)
  • Were extremely nearsighted before your LASIK surgery
  • Asian descent
  • Ocular surface diseases

What are the symptoms of dry eye after LASIK?

Other than the dry eye, dry eyes after Lasik have other symptoms include:

  • Burning or stinging sensation in the eyes
  • Excessive tear production (a sign of the eyes overcompensating for the dryness)
  • The collection of mucus around the eyes
  • Eye fatigue- extremely common
  • Discomfort that occurs due to the slightest exposure to wind
  • Blurry vision

Dry Eye Screening for LASIK Candidates

To minimize post-LASIK dry eye, your eye surgeons will perform a series of dry eye screening to rule out high-risk factors to prevent dry eye after LASIK.

The quality and quantity of tears you produce are factors in developing dry eyes, which can also affect healing after surgery.

Because eye surgeons now increasingly recognize that the best LASIK patient satisfaction depends on controlling dry eye, you probably will undergo screening in advance to ensure you have tear stability to minimize your tendency of developing dry eye.

Various tests for dry eye symptoms and tear film stability include:

  • Schirmer’s test. is A thin strip of paper placed under the lower eyelid to measure tear production.
  • Tear breakup time. Place a small amount of dye on the eye’s surface to monitor how tears are distributed and when they “break up” on the eye’s surface.
  • Imaging. Keratometers or other instruments view the tear film without touching the eye’s surface.
  • MMP-9 Testing. To perform a painless test, your doctor will collect a small sample of your tears from the inside of your bottom lid. Within minutes, you’ll know whether you have high levels of protein that can cause you to struggle with inflammatory dry eye after LASIK.

Your eye doctor will determine if you have an underlying condition that might be causing dry eye. As a part of the assessment, you are a possible candidate for the LASIK procedure. 

Conventional Dry eye treatment options Before and After LASIK

Even if you do have a pre-existing dry eye condition, your eye surgeons may consider treating you for dry eye symptoms before LASIK rather than automatically eliminate you as a candidate.

Your eye doctor may also treat your dry eye symptoms before a LASIK procedure as a precaution, even if your tear production ordinarily is normal.

Advice will be to take flaxseed oil or fish oil orally for several weeks before the Lasik procedure to improve your tear film. You also need to use lubricating eye drops before and after a LASIK procedure.

Your eye doctor might recommend topical cyclosporine such as Restasis or Xiidra to reduce inflammation and help your body formulate more tears.

Other common dry eye remedies include punctal plugs, which block tear drainage channels to increase moisture on the eye, and anti-inflammatory medications such as corticosteroids.

Preventing Dry Eyes After LASIK

When meeting with your eye doctor, make sure you mention any eye symptoms. Such as dry eye syndrome, foreign body sensation, or eye irritation.

Excessive tearing can indicate that you have chronic dry eye.

Peer-reviewed studies indicate that taking omega-3 fatty acid supplements and eating food containing these good fats, such as salmon, can help maintain a healthy tear film. Drinking plenty of water can help keep your body and your eyes adequately hydrated.

Make sure you discuss the possibility of developing dry eyes with your eye doctor following a procedure. Ask what specific steps can restore the eye’s tear film and comfort until healing is complete.

Some LASIK patients have reported severe and ongoing dry eye syndrome, which may reflect improper screening.

How is LASIK surgery performed?

First, your LASIK surgeon will create a very thin, superficial flap in your cornea (ocular surface) with a small surgical tool called a microkeratome or with a femtosecond laser.

The surgeon then folds back the hinged flap to access the underlying cornea (called the stroma) and removes some corneal tissue using an excimer laser.

Excimer lasers create a cool ultraviolet light beam to remove (“ablate”) microscopic amounts of tissue from the cornea. Reshaping it, so light entering the eye focuses more accurately on the retina for improved vision.

For nearsighted people, the goal is to flatten the cornea. With farsighted people, a steeper cornea is desired. Excimer lasers also can correct astigmatism by smoothing an irregular cornea into a more normal shape.

After the laser ablation reshapes the cornea, the flap is laid back in place, covering the area where the corneal tissue was removed. The flap seals to the underlying cornea during the healing period following surgery.

LASIK laser eye surgery requires only topical anesthetic drops, and no bandages or stitches are needed.

What to expect during LASIK surgery

Most of the procedure to reshape your ocular surface is automated.

Before your LASIK surgery begins, numbing eye drops are applied to your eye to prevent any discomfort during the procedure. Your doctor may also give you some medication to help you relax.

LASIK needs a large opening to enable the excimer laser to reshape the underlying cornea.

Your eye will be positioned under the laser, and an instrument called a lid speculum is used to keep your eyelids wide open.

The surgeon uses an ink marker to mark the cornea before creating the flap. A suction ring is applied to the front of your eye to prevent eye movements or loss of contact that could affect flap quality.

After the corneal flaps is created, the surgeon then uses a computer to adjust the excimer laser for your particular prescription.

You will be asked to look at a target light for a short time while your surgeon watches your eye through a microscope as the laser sends pulses of light to your cornea.

The laser light pulses painlessly reshape the cornea, although you may feel some pressure on your eye. You’ll also hear a steady clicking sound while the laser is operating.

LASIK is performed on each eye separately, with each procedure taking only about five minutes.

Refractive errors do happen, not very often.

What to do after LASIK surgery

Upon completion of your laser assisted LASIK procedure, your surgeon will have you rest for a while. You may feel a temporary burning or itching sensation due to corneal sensation immediately following the procedure.

After a brief post-operative follow up appointments, someone can drive you home. (You cannot drive after LASIK until your eye doctor sees you the following day and confirms your uncorrected vision meets the legal standard for driving.)

You should expect some blurry vision and haziness immediately after surgery; however, clarity should improve by the very next morning.

Your eyesight should stabilize and continue to improve within a few days, although in some cases it may take several weeks or longer. For most people, vision improves immediately.

You may be able to go to work the next day, but some doctors advise at least one day of rest.

It is recommended that you refrain from any strenuous exercise for at least a week, since this can traumatize the eye and affect healing.

Generally, you will return to see your eye doctor or your LASIK surgeon the day after surgery.

At this initial check-up, your visual acuity will be measured to make sure it is safe for you to drive without glasses or contact lenses. In most states, this requires visual acuity of 20/40 or better.

As with any other surgery, it’s very important for you to follow your doctor’s instructions and take any medication prescribed to reduce risk factors.

Avoid rubbing your eyes, as there’s a small chance you could dislodge the corneal flap if you rub your eyes vigorously before the flap has securely reattached to the underlying cornea stroma.

Some people have more corneal sensitivity than others.

What to expect with LASIK

Before the laser eye surgery

You and your eye surgeon will discuss your vision needs based on your lifestyle. For example, if you play sports, you may be seeking clear distance vision from surgery.

You and your eye surgeon should discuss your expectations for LASIK. People who have LASIK to achieve perfect vision without glasses or contacts run the risk of being disappointed. This laser eye surgery allows people to do most of their everyday tasks without corrective lenses. However, you might need to wear glasses for certain activities, such as reading or driving at night.

Your eye surgeons will thoroughly examine your eyes and make sure you are a candidate for LASIK. Here is what he or she will do:

  • Test your vision  to make sure that your vision has not changed. It also shows how high your refractive error is and whether LASIK can be used to correct your vision.
  • Check for other eye problems. Your ophthalmologist will make sure that you do not have eye problems. This is because other problems could affect your surgery, or LASIK could make those other problems worse. For example, if you have pre-existing dry eyes, they may worsen after LASIK.
  • Measure and map the surface of your cornea. Your eye surgeon will check the thickness of your cornea and make precise measurements of the cornea’s surface. Your eye surgeon uses these measurements to program the computer-based laser used during surgery.
  • Measure your pupil size. They will also measure the size of your pupil. If your pupil is very large, you could see halos (light rings) at night after LASIK.

During LASIK

This laser eye surgery is done in an outpatient surgery center or your eye surgeon’s office. Your eye surgeon uses a laser to reshape your cornea. Here is what to expect:

  • Your eye will be numbed with eye drops.
  • Your eye surgeon will place an eyelid holder on your eye to keep you from blinking. They will also place a suction ring on your eye to keep it from moving. You will feel pressure like a finger pressing firmly on your eyelid. At this point, your vision will go dim or black.
  • Using either a device called a microkeratome or a laser, your ophthalmologist makes a paper-thin flap in the cornea tissue. Then they lift and fold the flap back.
  • You stare at a target light so that your eyes will not move. The eye surgeon then reshapes your cornea using a laser. The laser is a special instrument programmed with measurements for your eye.
  • While your eye doctor uses the laser, you will hear a clicking sound. After reshaping the cornea, your eye surgeon folds the flap back down into position and smoothes the edges. The flap attaches on its own in 2–3 minutes, where it will heal in place.

After LASIK

  • The ophthalmologist may place a see-through shield over your eye or ask you to wear a guard while sleeping for a few days to help protect your eye while it heals.
  • You should plan to go home and take a nap or relax after the surgery.
  • For a few hours, your eyes may feel scratchy or feel like they are burning. Special eye drops to reduce dryness and help your eye heal.

Vision after LASIK

About 9 out of 10 people (90%) who have LASIK have vision between 20/20 and 20/40—without glasses or contact lenses.

It is important to know that LASIK cannot correct presbyopia, the normal, age-related loss of close-up vision. With or without refractive surgery, almost everyone with excellent distance vision will need reading glasses after age 40.

To help with presbyopia, some people have LASIK to get monovision. Monovision is not for everyone. One eye is left slightly nearsighted and the other is for distance vision. The brain learns to adapt so that the nearsighted eye is used for close work while the other sees distant objects. To see if you can adapt to this correction, first try monovision with contact lenses.

Tips for Preventing Post LASIK Dry Eyes

Since the FDA first approved it in 1999, almost 10 million Americans have requested LASIK surgery at the rate of 700,000 LASIK surgeries each year. If you’re part of the 95% that experiencing dry eye symptoms after LASIK, here are a few options that can help. Add a little moisture to your eyes and start seeing 20/20 vision with these tips.

Follow your eye doctor’s instructions.

1. Drug Store artificial tears

Search for lubricating eye drops. One of the most common solutions for LASIK dry eyes is drugstore drops. You’ll find several options ranging from drops to specialized medicated options. You might also need a “high performance” option to make sure your dry eyes receive the highest form of relief.

After your LASIK surgery, make sure to speak with your eye doctor regarding your symptoms. They might have a few recommendations. Then, use your eye drops every hour for the first few days after the procedure. As the days pass, you can cut back on how often you use the drops.

Preservatives extend a product’s shelf life. However, those same preservations can cause eye irritation. It’s essential to check for preservatives before purchasing drops from a drugstore. Prioritize a preservative-free lubricating eye drop or artificial tears during your search.

2. Medicated Drops

If your LASIK dry eye symptoms persist, you might need something more substantial than drug store products. Your eye surgeon can recommend a medicated eye drop. Some of these products contain corticosteroids. While providing short-term relief, this option isn’t ideal for long-term treatment. If eye drops aren’t enough to relieve your dry eyes after LASIK surgery, speak with your doctor. They might even suggest a minor surgery.

3. Collagen Punctal Plugs

Punctal occlusion involves blocking the tear ducts drainage, keeping tears on the surface of your eyes for a more extended amount of time. Collagen punctal plugs are a non-permanent option. These plugs will block the tear ducts drainage for about four days. Then, they’ll completely dissolve after ten days. Collagen punctal plugs are ideal right after your surgery. During this time, your dry eye symptoms will likely feel at their worst. A common complication of punctal plugs is eye infection.

4. Silicon Punctal Plugs

Silicon punctal plugs are an ideal semi-permanent solution for your post-LASIK dry eye. Unlike collagen punctal plugs, silicone punctal plugs won’t dissolve right away. Instead, they’ll stay in indefinitely.

5. Scleral Contact Lenses

Are you experiencing dry eye after LASIK surgery? These contact lenses can provide you with the necessary relief. These contacts are larger than regular contacts. By covering more of your eye can keep a layer of tears between the lens and your cornea. These lenses are made from a permeable material. In addition to providing comfort, these contact lenses will keep the tears your body produces in constant contact with your eye. As a result, the dryness, burning, and irritation dry eye symptoms you’re experiencing should fade.

6. Make Sure You’re Hydrated

Make sure to drink plenty of water after your LASIK surgery. Keeping your body and eyes hydrated will help prevent your eyes from drying out. Try to use one of the tips for preventing dry eyes above, in addition to drinking plenty of water every day.

7. Change Your Diet

Minor changes to your diet can help as well. Try to add more omega-3 fatty acids to your food. If you’re not a fan of fish, like salmon, you can take omega-3 fatty acid supplements instead.

Don’t let dry eyes after LASIK surgery slows you down. Instead, start seeing the solution. See all the beauty our world has to offer in sharper focus than ever before! You can enjoy your renewed eyesight.

Contact TheraLife for any questions, call 1-877-917-1989 US/Canada.

To learn more – click here

References

  1. The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop. Ocul Surf. 2007;5(2):75–92.
  2. Sutton GL, Kim P. Laser in situkeratomileusis in 2010 – a review. Clin Experiment Ophthalmol. 2010;38(2):192–210.
  3. Yu EY, Leung A, Rao S, Lam DS. Effect of laser in situkeratomileusis on tear stability. Ophthalmology. 2000;107(12):2131–2135.
  4. McGhee CN, Orr D, Kidd B, Stark C, Bryce IG, Anastas CN. Psychological aspects of excimer laser surgery for myopia: reasons for seeking treatment and patient satisfaction. Br J Ophthalmol. 1996;80(10):874–879.
  5. De Paiva C, Chen Z, Koch D, et al. The incidence and risk factors for developing dry eye after myopic LASIK. Am J Ophthalmol. 2006;141(3):438–445.
  6. Melki SA, Azar DT. LASIK complications: etiology, management, and prevention. Surv Ophthalmol. 2001;46(2):95–116.
  7. Hovanesian JA, Shah SS, Maloney RK. Symptoms of dry eye and recurrent erosion syndrome after refractive surgery. J Cataract Refract Surg. 2001;27(4):577–584.
  8. Battat L, Macri A, Dursun D, Pflugfelder SC. Effects of laser in situkeratomileusis on tear production, clearance, and the ocular surface. Ophthalmology. 2001;108(7):1230–1235
  9. Toda I, Asano-Kato N, Komai-Hori Y, Tsubota K. Dry eye after laser in situkeratomileusis. Am J Ophthalmol. 2001;132(1):1–7.
  10. Solomon KD, Holzer MP, Sandoval HP, et al. Refractive Surgery Survey 2001. J Cataract Refract Surg. 2002;28(2):346–355.
  11. Schiffman RM, Walt JG, Jacobsen G, Doyle JJ, Lebovics G, Sumner W. Utility assessment among patients with dry eye disease. Ophthalmology. 2003;110(7):1412–1419.
  12. Buchholz P, Steeds CS, Stern LS, et al. Utility assessment to measure the impact of dry eye disease. Ocul Surf. 2006;4(3):155–161.
  13. Brown MM, Brown GC, Brown HC, Peet J, Roth Z. Value-based medicine, comparative effectiveness, and cost–effectiveness analysis of topical cyclosporine for the treatment of dry eye syndrome. Arch Ophthalmol. 2009;127(2):146–152.
  14. Levinson BA, Rapuano CJ, Cohen EJ, Hammersmith KM, Ayres BD, Laibson PR. Referrals to the Wills Eye Institute Cornea Service after laser in situkeratomileusis: reasons for patient dissatisfaction. J Cataract Refract Surg. 2008;34(1):32–39.
  15. Jabbur NS, Sakatani K, O’Brien TP. Survey of complications and recommendations for management in dissatisfied patients seeking a consultation after refractive surgery. J Cataract Refract Surg. 2004;30(9):1867–1874.
  16. Stern ME, Beuerman RW, Fox RI, Gao J, Mircheff AK, Pflugfelder SC. The pathology of dry eye: the interaction between the ocular surface and lacrimal glands. Cornea. 1998;17(6):584–589.
  17. Shin SY, Lee YJ. Conjunctival changes induced by LASIK suction ring in a rabbit model. Ophthalmic Res. 2006;38(6):343–349.
  18. Rodriguez AE, Rodriguez-Prats JL, Hamdi IM, Galal A, Awadalla M, Alio JL. Comparison of goblet cell density after femtosecond laser and mechanical microkeratome in LASIK. Invest Ophthalmol Vis Sci. 2007;48(6):2570–2575.
  19. Rodriguez-Prats JL, Hamdi IM, Rodriguez AE, Galal A, Alio JL. Effect of suction ring application during LASIK on goblet cell density. J Refract Surg. 2007;23(6):559–562.
  20. Konomi K, Chen LL, Tarko RS, et al. Preoperative characteristics and a potential mechanism of chronic dry eye after LASIK. Invest Ophthalmol Vis Sci. 2008;49(1):168–174.

Testimonial

"I am 6 months post LASIK. I was diagnosed with dry eyes and MGD. My eyes are red, inflamed with mucus. I can not begin to tell you how much Theralife has made a difference for my eyes! I'm still currently using 3-4 capsules twice daily, along with fish oil, warm compresses and daily eye hygiene with lid scrubs. My eyes have been feeling great! Thank you so much for caring. " Sincerely, Elise, , United States *Results may vary

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