Dry Eye and Treatment
What is dry eye? How is it treated?
The following is the definition of Dry Eye Disease according to 150 of the world’s leading experts in the Tear Film and Ocular Surface Society or TFOS. “Dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.”
The above definition and chart are not necessarily there for you to understand but to visualize and understand the complexity of the disease and its many different components of the disease
The basics for patients
It is multifactorial–there are a lot of factors that come into play when it comes to cause and effect of dry eye disease. Some of the contributing factors are:
Age
Sex
Environment (not enough humidity, use of fans and air conditioners or heaters)
Medications
Autoimmune Disorders
Rosacea
Contact Lens Use
Eye Surgery
Eye Injuries
Incomplete Blink
& Others
What are the symptoms of dry eye?
The usual symptoms include:
Scratchiness, stinging, or burning eyes
Grittiness or feeling like something is in one’s eye
Fluctuating vision w/temporary improvement after blinking (most common)
Stringy mucus in or around eyes and lids
Early morning mattering & blurriness
Excessive eye irritation & tearing from wind, fans or smoke
Excessive Tearing, especially while reading or prolonged staring
Discomfort while wearing contact lenses
Blur, photophobia, glare, Eye Fatigue.
Excess tearing from a “dry eye” may sound illogical, but can be understood as the eye’s response to discomfort. The eyes surface becomes rough and irritated, much like dry skin, prompting the lacrimal gland (responsible for the watery tears) to secrete an excessive amount of diluted tears onto the surface of the eye. The increased level of tears may overwhelm the eye’s tear drainage system resulting in an overflow of tears onto the cheek.
What is the tear film?
Each time you blink, a new layer of tears is released from the eyelids and spread smoothly over the eye’s surface. Without this high quality tear film, good vision may not be possible.
The tear film consists of three layers that are all crucial for vision and comfort:
An oily layer
A watery layer
A mucus layer
The oily layer is formed by the tear glands of the eyelids called meibomian glands. This is the outer most layer of the tear film, which responsible for preventing the evaporation and lubrication of ocular surfaces. The middle portion is a watery layer produced by the lacrimal and accessory tear glands. This layer represents the bulk of the tear film that is responsible for removing foreign particles and cleansing the eye. The inner most layer is the mucus layer produced by the skin of the eye. This layer allows the tears to coat surface of the eye uniformly and smoothly. Without the mucus layer the tear film would not adhere to the eye’s surface.
Frequently asked questions
I don’t have symptoms but my doctor says I have Dry Eye Disease, is this true?
Absolutely, Dry Eye Disease starts out as non-obvious, meaning you may not have symptoms but the signs are there. Many medical conditions start with no symptoms. For instance, high blood pressure. Your blood pressure can be elevated but you would still want to treat it. At Oasis Eye Care we want to discover your Dry Eyes here and treat them before you have symptoms.
The next stage is Obvious Dry Eye Disease and this is where we begin to have symptoms and the signs continue. If left untreated, patients can develop severe pain and visual decline that can be very difficult to get under control.
Can you cure Dry Eye Disease?
No we can’t. It is a chronic condition that requires daily therapies to keep the symptoms controlled and hopefully improve the signs. Our goal at Oasis Eye Care is to treat you well before your disease reaches in the inflammation stage to reduce the symptoms and reduce the risk of damage to the surface that can lead to vision loss.
How do you treat Dry Eye Disease?
There are several home therapies that you can do: artificial tears, warm compresses, blinking exercises, lid scrubs, and ocular supplements. These therapies need to be under the direction of your doctor as not all tears are good for every person. Your doctor will choose a drop that will treat the specific signs and symptoms that you have. This is the same with warm compresses, lid scrubs and ocular supplements.
There are also several in-office treatments and other prescription treatments:
Medications: Restasis, Xiidra, Azasite, Lotemax all help, but do not cure inflammation.
Punctal Plugs: plugs placed in the punctum to keep more tears on the surface of the eye; they can be temporary or permanent, silicone or collagen.
True Tear: This is a neuro-nasal stimulator, used to help create more of your own tears (use at home but requires a prescription).
BlephEx: This is an in office treatment to clean lashes and reduce the presence of bacteria using in rotating lid scrubbing device treatment. Just like seeing a dental hygienist for your teeth.
Pulse Light (IPL) with manual expression — This is an in-office procedure used to liquify the Meibomian glands’ stubborn thicken oil secretions, neutralize bacteria, and block local inflammation.
Lipiflow: This is known as thermal pulsation device used as an in office treatment that gently heats and expresses the clogged Meibomian glands and improve natural oil flow.
ProKera: a therapeutic amniotic membrane, contact lens temporarily placed on the surface of the eye to promote healing of a damaged ocular surface and stop inflammation.
Excess tearing from a “dry eye” may sound illogical, but can be understood as the eye’s response to discomfort. The eyes surface becomes rough and irritated, much like dry skin, prompting the lacrimal gland (responsible for the watery tears) to secrete an excessive amount of diluted tears onto the surface of the eye. The increased level of tears may overwhelm the eye’s tear drainage system resulting in an overflow of tears onto the cheek.
The most important person in treating Dry Eye Disease is You.
Many therapies rely on the patient to perform. You must continue the therapies even when your symptoms are improving to keep the disease process under control. Patients who follow their therapies and are diligent have better results!
At Oasis Eye Care, Optical, and Med Spa, “Our Vision is to Protect Yours” is definitely true when it comes to Dry Eye Disease. We are committed to staying at the forefront of the technological advances with diagnostics and treatment. Education is at the top of our priorities starting with our eye doctors, staff and patients. Our goal is to keep patients comfortable and their vision at their fullest potential.