The Tatum Eyecare Dry Eye Clinic is dedicated to helping patients manage their lifetime battle with dry eye by reducing the day to day discomfort and visual fluctuations dry eye causes.  You cannot cure dry eye but you can certainly manage and reduce its effects on your everyday life! If you feel your dry eye is affecting your quality of life, then please schedule an appointment with our Dry Eye Clinic.  We will perform a Dry Eye evaluation, discuss your particular diagnosis and thoroughly go over your treatment options.

Dry eye symptoms include:

  • Burning
  • Redness
  • Watering (yes, really)
  • Light sensitivity
  • Gritty or foreign body sensation
  • Blurred or fluctuating vision
  • Decreased contact lens comfort
Dry eye symptoms
Types of Dry Eye

Types of Dry Eye

There are 3 layers to your tear film, the mucin, aqueous and lipid layer.  Dry eye is generally classified into two types depending on what layer of the tear film is deficient.  Aqueous Deficiency is a reduction in the production of the aqueous layer.  Evaporative dry eye is caused by a poor oil layer.  This allows the aqueous layer to evaporate.  Aqueous deficiency is relatively rare when compared to evaporative dry eye in that 85% of dry eye is classified as evaporative.

Aqueous Deficiency Dry Eye

Aqueous deficiency is caused by a failure of the lacrimal gland(s) to produce enough tears.  The aqueous layer is the largest component of the tear film.  Common causes include, autoimmune diseases such as Sjogrens, inflammatory diseases, hormonal changes and medications such as antihistamines.  Treatment of the underlying condition is important in making an aqueous deficient patient more comfortable.  Ocular treatment options include anti-inflammatory topical medications, artificial tears and punctal occlusion.

Evaporative Dry Eye

Evaporative dry eye is caused by Meibomian Gland Dysfunction.  The meibomian glands (around 30 top and bottom adjacent to the eyelashes) are located in the lids and secrete an oily substance that sits on top of the tears.  This thin oil layer is protective against the aqueous tear layer evaporating.  When the glands are not functioning correctly they are unable to produce either the right consistency of oil or any oil at all.  This results in rapid evaporation of the tears and that dry eye feeling.  Those patients living in dry, arid climates like Arizona are much more susceptible to evaporative dry eye to begin with.  Meibomian Gland Dysfunction can be caused by excess bacteria around the lashes, autoimmune disease, inflammatory disease like rosacea or lupus, and Demodex (lid mites).  The incidence of Meibomian Gland Dysfunction increases with age.

Healthy

Treatment Advances

There has been an explosion in new dry eye treatments over the last 5-10 years.  Your eye doctor has more treatment options available now than ever before.  Many of these advancements aim at treating the root cause of dry eye instead of just masking it with artificial tears.  Current treatment options include, advanced pharmaceuticals, pulsed light, radio frequency waves, punctal occlusion, bacterial bio film removal and thermal pulsation of clogged oil glands.

Treatment options we offer at Tatum Eyecare

  • Prescription topical drops including Restasis, Xiidra and Cequa
  • Non-prescription therapeutic drops
  • Non-prescription supplements
  • Topical and oral antibiotics
  • Temporary collagen and permanent silicone punctal plugs
  • Blephex eyelid debridement and bio film remover
  • iLux2 meibomian thermal gland expression
Treatment
Punctal Plugs

Punctal Plugs

Punctal plugs are small plugs made of either collagen or silicone which are placed into the tear drainage canal to slow down the body’s normal removal of tears.  There is one punctum in the nasal corner of each of the four eyelids.  Generally we only need to block the two lower lid punctum to obtain the desired effect.  By doing so, the tears that we naturally produce or the artificial tears that we add, will stay on the ocular surface longer before being drained away.  This is a quick 5 minute procedure and there is no awareness to the patient of the punctal plugs.

iLUX2

The iLux2 is classified as a thermal pulsation device. It is a hand held instrument that warms up the lids and the meibomian glands to a temperature where the oil inside can flow more easily. The instrument then gently massages the heated lids to express the oil out, opening any clogged glands. This oil is then free to spread out over the aqueous tears preventing evaporation.

iLUX2

Blephex

The Blephex treatment is a relatively simple procedure with fast results.  The Blephex tool has a high speed rotating sponge that exfoliates the skin at the base of the lashes.  This removes debri, dead cells and bacterial biofilm from the area around the meibomian glands making the lid and the glands healthier.

Blephex

Insurance and Pricing

Unfortunately, most insurance plans do not appreciate the negative impact dry eye has on a patient’s quality of life and do not cover most procedures.  Insurance will cover the diagnostic exam and follow up visits but stop short of paying for the procedures themselves.  Most of these in-office treatments will be out of pocket with the exception of punctal plugs.  Most insurances will cover punctal plugs.

Annual Dry Eye Evaluation (usually covered by insurance)

Procedure Insurance No Insurance
Previous Pt. Medical Eval. Can bill $95
New Pt. Medical Eval. Can bill $115
Eyelid Photography Can bill $25

****Your initial Dry Eye Evaluation will include the Medical Evaluation and Eyelid Photography.

Price List For Initial Treatment Options After Dry Eye Evaluation

Procedure Insurance No Insurance
MGD Thermal Pulsation iLux2 No Coverage $350
Blephex Eyelid Biofilm Removal No Coverage $125
Punctal Plugs Can bill $225/pair
Pharmaceuticals Insurance will cover some medications
Supplements No Insurance Coverage

Follow up Treatments over the following year if needed

Procedure Insurance No Insurance
Medical F/U Evaluation Can bill $45
Eyelid Photography Can bill $25
MGD Thermal Pulsation iLux2 No Coverage $325
Blephex Eyelid Biofilm Removal No Coverage $100

****Typical treatments with iLux2 and Blephex are every 6 mo.

****A Medical F/U Evaluation will be performed at the time of the follow up treatments

****Anterior Photography will be performed at each follow up treatment

Dr. Bryan Fuller

Dr. Bryan Fuller of Tatum Eye Care in Phoenix Arizona
Dr. Fuller grew up in Issaquah, Washington and graduated with a Bachelor’s degree in Mechanical Engineering from Washington State University. He decided to ditch the calculator and trade it in for a phoropter and slit lamp. He headed east to The Ohio State University where he received his Optometry degree in 1998. Go Bucks! Not wanting to return to the gray of Washington, after graduation, he headed southwest to sunny Arizona. Shortly thereafter he met Dr. McPhelan and they partnered up at their original location, Optical Illusions. With the success of the first location, the two doctors opened up their north location, Optique at the Ridge. After many years of operating the two locations, it was time for an upgrade. In 2016 they merged the two locations into their larger and current location, Tatum Eyecare! When not at the office, Dr. Fuller enjoys spending his free time with his amazing wife and two boys. Dr. Fuller holds the following degrees:

Ohio State University - Doctorate of Optometry
Washington State University - B.S. Mechanical Engineering

Dr. James McPhelan

Dr. James McPhelan of Tatum Eye Care in Phoenix Arizona
Dr. McPhelan grew up in Southern California and enlisted in the Army at age 17. He graduated from Southern California College of Optometry in 1976, then started practicing optometry in Arizona in 1977. Over the next few years, he grew 20/20 Eye Care to 15 offices. In 1999, he and Dr. Fuller took over Optical Illusions, then opened Optique at the Ridge. In 2016, they created Tatum Eyecare. In his spare time, Dr. McPhelan is an avid golfer, often competing in multiple tournaments through the year. Dr. McPhelan holds the following degrees:


Southern California College of Optometry - Doctorate of Optometry

Dr. Houle

Dr. Houle
Dr. Houle is following in her father's footsteps as an optometrist. She is a North Dakota native who received her Bachelor's degree from the University of North Dakota before earning her Doctorate of Optometry from Midwestern University - Arizona College of Optometry. Dr. Houle began her career in eye care more than 10 years ago, and she worked as a receptionist, optician, and technician before becoming an optometrist. She has a particular interest in the management of ocular disease including dry eye and glaucoma. In her free time, Dr. Houle is an avid baseball fan (go Twins!) and spends as much time as possible with her friends and family in both Arizona and North Dakota.

Midwestern University – Arizona College of Optometry - Doctorate of Optometry
University of North Dakota - Bachelor of Science: Biology

Dr. Kenneth O'Daniel

Dr. Kenneth O'Daniel of Tatum Eye Care in Phoenix Arizona
Dr. O’Daniel was born in the beautiful mountains of Waynesville, North Carolina and grew up in Dayton, Ohio. He attended Wright State University and graduated with his BS in Biology in 1977; shortly thereafter, beginning his Masters in BioChemistry.

Dr. O’Daniel is also a 1983 graduate of the Illinois College Optometry. He met his wife Lori during this period. Lori, a Chicago native, became an integral part of his practice (and life!) shortly thereafter.
He moved to Scottsdale in 1986 to begin practicing inside LensCrafters. In 1990 Dr. O'Daniel opened the Scottsdale LensCrafters, and he also presided as its director of Optometric services.
Dr. O’Daniel became an Optometrist because of his love and passion for photography, physics, and desire provide patients with the ability to see the world more clearly. As a licensed optometrist, Dr. O’Daniel provides complete eye care services for the surrounding communities ages seven and up.
Dr. O’Daniel has had a working relationship with both Dr. Fuller and McPhellan for over two decades. He has served as past director for the Arizona Optometric Association, and past President of the Central Arizona Optometric Society. In January, 2018 Dr. O’Daniel decided to join Tatum Eye Care, the premier Eye Care Center in Phoenix and Scottsdale.
Dr. O’Daniel’s goal is simple: Provide Excellent Eye Care, treat patients as family, and treat everyone honestly and fairly!

Dr. Christina Wong

Dr. Christina Wong of Tatum Eye Care in Phoenix Arizona
A southern California native, Dr. Wong attended UCLA where she received her B.S. in Biology. She then completed her Doctorate of Optometry at the Southern California College of Optometry. Dr. Wong moved to Arizona to complete a residency in ocular disease at Hu Hu Kam Memorial Hospital on the Gila River Indian Reservation. Following residency, Dr. Wong earned the distinction of Fellow in the American Academy of Optometry.

Dr. Wong provides comprehensive eye care to patients of all ages, from pediatrics through seniors. She has a special interest in the management of medical eye conditions including glaucoma, eye infections, dry eye and diabetic retinopathy.
Outside of the office, Dr. Wong enjoys running, going to the beach, rooting for the Bruins, and spending time with her husband and three daughters.
University of California Los Angeles - B.S. in Biology
Southern California College of Optometry - Doctorate of Optometry

Dr. Ryan Felten

Dr. Felten of Tatum Eye Care in Phoenix Arizona
Dr. Felten is a native to Arizona, and was raised in North Phoenix where most of his family still resides. He earned his Bachelor of Science in Exercise Science from Brigham Young University; then returned home to Arizona to pursue his Doctor of Optometry at Midwestern University in Glendale. While at Midwestern University, he was a member of the Beta Sigma Kappa Honor Society and was the recipient of the Clinical Excellence Award in Pediatrics and Vision Therapy. Dr. Felten enjoys working with patients of all ages and also speaks fluent Spanish. Dr. Felten holds the following degrees:


Brigham Young University - Bachelor of Science in Exercise Science
Midwestern University - Doctorate of Optometry