Dry Eye Syndrome has become a common problem for many adults and an increasing reason for office visits. From eye irritation or gritty sand sensation to intermittent blurry vision and eye fatigue, dry eye syndrome can affect suffering individuals in a variety of different ways. Dryness can be influenced by contact lens wear, autoimmune conditions, medications, computer use, and changes in our bodies that occur with age. The symptoms can be mild and infrequent, or they can be constant and debilitating. Regardless of the symptoms, it is important to be seen by an eye care provider to determine if there is an underlying cause for the dry eyes.
Dry eye is a condition, not just an unfortunate symptom that can be experienced daily. There are two types of dry eye: evaporative dry eye and tear film insufficiency.
Evaporative dry eye occurs when tears evaporate off the surface of the eye. This happens when the layers of the tear film are not sufficiently keeping tears on the surface of the eye as long as they should.
Tear film insufficiency is due to an inadequate amount of tears on the ocular surface.
The tear film coats the eye’s outer layer. This tear film is very important for the lubrication and comfort of the eye as well as for clarity of vision. As we age, the protective film diminishes and leaves the eye susceptible to drying as a result of conditions such as wind and dust. Thus, contrary to popular belief, dryness in the eye is not a result of the eye producing fewer tears. In fact, many patients complain of excessive tearing and watery eyes because the eye is trying to compensate in an effort to replace the tear film.
Symptoms can be mild to severe and may include:
Chronic dry eye symptoms may also include the inability to cry, vision fluctuation, and difficulty focusing on small print or working in front of a computer for long periods of time.
If you are experiencing severe symptoms where your eyes continuously feel gritty, itchy, and irritated or your eyes continue to water, you could be experiencing Dry Eye Disease. Glands in your eyelids produce an oil called meibum which is spread over the eye each time you blink by a tear. Normal meibum is thin and clear, like olive oil. Over time, the meibum in the glands can become less like olive oil, and instead becomes cloudy and more solid. When this happens, the function of the glands can slow down and become blocked thus permanently stopping the production of meibum. This condition is called Meibomian Gland Dysfunction, or MGD, and studies have shown 86% of dry eye patients are affected by MGD.
Dry eyes can be caused by many different factors: age, sex, systemic conditions, eyelid morphology, medications, LASIK, hormones, our environment, the list goes on and on. As we age, dry eye becomes more common. Post-menopausal women are often affected because of body hormone changes. Oral medications can sometimes be the cause including antihistamines, antidepressants, blood pressure medications, and decongestants. Certain autoimmune conditions, such as rheumatoid arthritis and lupus, occur together with dry eyes. Because there are so many causes, stages, and treatment options for dry eye, patients often have a personalized management plan.
Dry eye therapy can include any combination of artificial tears or gels, warm compresses, eyelid scrubs, omega 3 fatty acids, oral antibiotics/anti-inflammatories, and topical anti-inflammatory eye drops. Additionally, using a humidifier at home and work can also help alleviate dry eye symptoms.
When eye drops are not effective in treating your dry eye condition, one of our eye specialists may suggest punctal plugs. These plugs are inserted inside the tear ducts to block them. The tears will drain into the nose via tear ducts and blocking this outflow is a reasonable strategy to keep the tears in the eye longer. Our doctors have had a high degree of success in treating this condition with punctal plugs.
Punctal plugs are small devices that are inserted into the tear ducts in order to block the drainage of fluid. These plugs prevent the drainage of fluid from the eye surface, helping to restore moisture to dry, scratchy eyes.
These small devices come in both dissolvable and semi-permanent forms. Dissolvable punctal plugs are often used after another eye surgery, such as LASIK, in order to ensure that the eyes remain moist in the days after treatment.
For a more long-term solution to severe dry eyes, your ophthalmologist may recommend semi-permanent punctal plugs. The plugs can easily be removed at any time should it be necessary. They come in a variety of shapes, sizes, and materials, which your eye doctor will choose to meet your specific needs and eye shape. Punctal plugs are a great adjunct to many other dry eye regimens and when used together allow for much symptomatic relief.
You might be a good candidate if you experience chronic symptoms of dry eye. Visit Milan Eye Center to learn more about these minimally-invasive devices and to find out if punctal plugs might be a good dry eye treatment for you.
As mentioned above, Meibomian Gland Dysfunction is associated with a failure of the meibomian glands to produce adequate quantities of meibum due to atrophy, inflammation, or obstruction, and is thought to be the most common case of evaporative dry eye disease. ILux is an in-office treatment which unblocks the glands by applying gentle heat and pressure to both the upper and lower lids.
This system is indicated for the application of localized heat and pressure therapy in adult patients with chronic conditions of the eyelids. Ideal candidates may be experiencing symptoms such as:
After treatment with iLux, the glands have the ability to function more effectively and produce the oil needed to keep your team film stable and healthy.
With any procedure, there are risks involved. While your eye care provider cannot tell you about all the risks, some of the most common are listed below:
On the day of the procedure, we ask that you do not wear any makeup or contact lenses. The procedure takes less than ten minutes and is conducted in the office without a sedative. After applying numbing drops, iLux is applied to each eyelid, with up to two treatments per lid depending on your needs. The gentle light-based heat warms your eyelid and softens the meibum blocking the glands. Gentle compression is applied to express the melted meibum from the gland orifices.
You may feel improvements in your dry eye symptoms almost immediately following the treatment. In an iLux clinical trial, patients experienced a significant improvement of symptoms after two and four weeks. You will also be scheduled for a follow-up visit with your physician to check the progress and set up maintenance treatments as prescribed by the doctor to ensure long-lasting results.
If you would like to find out more about dry eye treatment with iLux, please call us at 678-381-2020 to arrange an appointment.