Dry eye syndrome (DES) is a chronic condition that develops when your eyes do not produce and maintain enough tears to keep the eye’s surface lubricated resulting in multiple symptoms that range from person to person. This can be due to a reduction in tear production or increased tear evaporation from a lack of lipid in the tears that stem from oil glands in the eyelids. The effects can range from minor dryness and discomfort to pain, blurred vision and frequent infections.
Symptoms of Dry Eye Disease
Symptoms of dry eye syndrome can vary depending on the severity of the condition but can include:
- Dry, itchy eyes
- Burning or stinging
- Watery eyes
- Blurred vision
- Foreign body sensation
The main function of tears is to maintain the health of the cornea of your eye by washing away foreign matter and ensuring that the surface of your eye remains moist, smooth and clear. Tears also rinse away dust particles from your eyes and contain enzymes that protect your eyes from bacteria that can cause infections. Dry eyes is a condition that develops when the amount of tears produced is not sufficient to maintain the moisture balance in your eye. This can result in that scratchy sensation, a continuous feeling of dryness, stinging and a sensation of a foreign body in your eye. Ironically in an effort to fight off the condition, dry eyes can cause you to produce excessive tears, which is why some people experience watery eyes.
Causes of Dry Eye Disease
- Medication - Dry eye may be a side effect of another medication that you are taking. Possible culprits: decongestants, antihistamines, blood pressure medicines, and anti-depressants.
- Meibomian Gland Dysfunction - The most common cause of dry eye seen in our office is when the meibomian glands produce oil of the wrong consistency, get inflamed, and/or atrophy, and no longer produce oil.
- Hormones - Pregnant women or women using oral contraceptives may be susceptible to dry eye resulting from hormonal changes. Changes to the Thyroid may also cause dry eye.
- Blepharitis - Dandruff on the Eyelashes can cause inflammation on the eyelid margin and is heavily related to meibomian gland dysfunction.
- Exposure - Long-term contact wear, extended periods spent staring at screens (computer vision syndrome), and exposure to windy and dry climates.
- Age: It is not uncommon for adults over the age of 65 to experience dry eye symptoms.
Diagnosis of Dry Eye Disease At Vision Gallery
Typically, dry eye disease can be diagnosed through a comprehensive eye exam and a description of your symptoms. On some occasions the eye doctor might decide to do a test that measures how quickly your tears evaporate from the surface of your eye. By instilling a simple dye called fluorescein (much like food coloring) the doctor is able to watch and count how long it takes the tears to start to break up after they’ve asked you to hold your eyes open after a blink. This is called TBUT or a Tear Break Up Time test. A low TBUT generally indicates a lipid (aka oil) deficiency in the tears resulting from oil glands in the eyelids not functioning properly. In another type of test, called a Schirmer test, a strip of filter paper is placed under the lid of the eye and you will be asked to close your eye for five minutes. Following the test the amount of moisture on the strip will be measured. Schirmer tests are performed less frequently than a TBUT test.
Treatment for Dry Eyes
There are many treatment options for dry eyes which are highly dependent upon the cause and severity of the condition. Many mild forms of DED can be alleviated using artificial tears or lubricant eye drops to make up for the lack of natural tears usually produced by your eyes. If over-the-counter drops don’t alleviate your symptoms, your doctor might prescribe prescription drops that actually stimulate tear production or steroids for short-term relief. Other treatments in the field include: Keratograph Dry Eye Analysis, MiBo Thermoflo Treatment, Optima IPL Treatment.
-Keratograph Dry Eye Analysis
Keratograph technology helps doctors gather essential information needed to correctly diagnose and treat Dry Eye Disease.
How does Oculus Keratograph 5m work?
The Keratograph 5m has multiple scanning capabilities that are non-invasive and go deep into the eye and eyelid. The scans that are performed include:
TF Scan also allows the doctor to assess your Lipid (oil) content of your tears, which plays a very important role in quality tears.
Assessment of the Tear Film Break-Up Time
The patient is asked to blink and hold their eyes open and the device measures automatically where the dry spots develop.
Meniscus Tear Height
Assessment of the Tear Film Quantity
This lets the doctor know how much Total Tears are on the eye at any given time.
This allows the doctor to view the Oil glands on the upper and lower eyelids. With this data, your doctor can determine if specific treatments are required to maintain or improve your gland function.
-MiBo Thermoflo Treatment
What is it?
The MiBo Thermoflo is a therapeutic medical device providing a safe and effective alternative therapy for dry eyes. It uses a heat pump to help maximize liquefaction of oils in your glands, thus improving preservation and function of the evaporative of the tear film.
How Does MiBo Thermoflo Treatment Work?
The MiBo Thermoflo supplies continuous controlled heat that is applied to the outer skin of the eye lids along with ultrasound gel for a gentle massage. The heat is absorbed deep into the tissue and breaks down the hardened lipids in the meibomian glands.
After The Treatment
Successful meibomian gland expression helps increase the quality of oil production of the glands and decrease dry eyes symptoms. Patients usually only need a single session, but you can benefit from regular treatments. Your eye doctor can diagnose if you need additional procedures. He or she can also teach you how you can do meibomian gland massage at your own home as a long-term MGD management.
-Lumenis Optilight IPL
Dry eye Rescue Providers offer a revolutionary treatment using IPL technology to eliminate the root cause of your dry eyes.
How does IPL work?
IPL stands for Intense Pulsed Light and is a light-based technology, now being used to treat meibomian gland dysfunction and dry-eye disease. During the procedure, a strategic level of light pulses is administered to penetrate the skin under the eye and target the root cause of the inflammation. IPL treatment helps to liquefy and release hardened oils that have clogged the Meibomian glands in the eyelids. IPL procedures are effective, gentle, and safe.
Improves eye comfort and vision clarity
Safe and Comfortable
Reduces your dependency on eye drops
Treats the root cause of the problem
Quick “lunchtime” treatment
During the procedure
You may experience a warm sensation as the light is applied to your skin, but the treatment is gentle, and you should not feel uncomfortable. Ultrasound jelly is used under the eye to help soothe the skin. Each session lasts approximately 15 minutes.
After the Procedure
Following treatment, your eye doctor may perform a meibomian gland expression (in this procedure, tiny “paddles” are used to compress the eyelids to squeeze out the contents of the meibomian glands.) The purpose of meibomian gland expression is to accelerate your skin and eyelid healing process and is optional but recommended.You may experience some mild redness and discomfort in the treated areas – this will usually disappear within a few hours. Most patients can resume their daily activities the same day. Sunlight should be avoided for a few days following the treatment, and sunscreen should be used.For optimal results, 4 sessions are typically recommended, with 3-4 weeks in between. Maintenance treatments, usually once every 6-12 months, are also recommended for optimal long-term results.
More severe cases of dry eyes might be treated with a punctual insert which is a tiny insert containing a slow-release lubricating substance that is placed inside the lower eyelid. Since DED is often related to eyelid inflammation known as blepharitis your doctor may prescribe a heated hot compress mask, specialty eyelid scrubs and sometimes an antibiotic ointment. Finally, punctal plugs might be recommended for severe cases which would be inserted into the tear ducts to reduce the tear drainage in your eyes to keep them from drying out.
Preventing Dry Eyes
If the cause of your dry eyes is something external or environmental, eliminating that cause may solve the problem and resolve the symptoms. Avoid dry environments, hairdryers, heaters, and fans, (particularly directed toward the eyes) and smoky environments and wear eye protection such as wrap-around glasses or goggles when in dusty or windy areas. Use a humidifier to add moisture to dry indoor air. If working on a computer or watching television, make sure to blink purposefully as our natural tendency is to reduce our blink rate when staring at a screen. Also, avoid rubbing your eyes as this can further irritate them. Staying hydrated by drinking at least 8 to 10 glasses of water per day can also help.
Dry eye disease won't have a permanent effect on your vision, but there is no reason to endure dry, itchy, and uncomfortable eyes, especially since there are so many treatment options to increase moisture and comfort. It’s also important to realize that this is a chronic disease that needs consistent treatment. Your doctor will work with you to create a long-term strategy to keep your eyes as comfortable as possible.
OptiLight, Dry Eye Management By Lumenis
OptiLight by Lumenis is a light-based, non-invasive treatment done in the area surrounding the eyes to manage dry eye. The first and only IPL FDA-approved for dry eye management.