Dry Eye Treatments

Dry Eye Disease (DED)


DRY EYE DISEASE (DED)

DED is a common, and often chronic, eye condition resulting from insufficient or poor quality tears that are needed to protect & nourish the front surface of the eye and provide clear vision.


Layers of the Tear-Film

  • Lipid Layer: Protects tears from rapid evaporation.
  • Aqueous Layer: Lubricates, nourishes, & fights infection.
  • Mucin Layer: Adheres tears to the eye surface.

Symptoms

  • Redness
  • Gritty/sandy or burning sensation
  • Blurry vision
  • Excessive tearing
  • Light sensitivity
  • Eyestrain & increased fatigue
  • Contact lens discomfort

Risk Factors

  • Lengthy Reading or Screen Time
  • Contact Lens Overwear
  • Dehydration
  • Environment (Dry, Windy, Smoke)
  • Medications: Diuretics, Beta-blockers, HRT,Antihistamines, Antidepressants
  • Health Conditions: Diabetes, Thyroid, Arthritis, Sjogren's Syndrome, etc.

Meibomian Gland Dysfonction (MGD)

MEIBOMIAN GLAND DYSFUNCTION (MGD)

MGD is the leading cause of DED (86% of cases). It occurs when the meibomian glands (oil ducts in the eyelids) are clogged and not secreting enough meibum to form the protective lipid layer of the tear-film. This leads to rapid tear evaporation & bacteria accumulation, exposing the eye surface to inflammatory damage and infection.


MGD is commonly associated with:


  • Styes (a blocked oil gland that becomes infected)
  • Blepharitis (bacteria overgrowth on eyelids & lashes)
  • Keratitis (corneal damage from inflammation)

If left untreated, increasing loss of meibomian glands will cause MGD & dry eye symptoms to worsen.


MGD Treatment


  1. Warm Compression
    • Heat Mask, LipiFlow, Ilux, Radiofrequency
  2. Lid Hygiene
    • Tea-tree oil wipes, Hypochlorous acid spray, BlephEx
  3. Omega-3 (DHA + EPA)
    • 1000-2000 mg per day
    • Re-esterified form (better bioavailability)
  4. Lipiflow Thermal Pulsation (more information below)

Dry Eye Testing


DRY EYE DISEASE (DED)
Left: Fluorescein dye showing damaged cornea. Black areas resemble broken-up tears (arrow). Right: Cornea without dye.

Tear Film Osmolarity

  • Measures the salt concentration of your tears.
  • Higher osmolarity is associated with poor quality tears that dry up quickly & cause inflammation.
  • Used to monitor DED & assess effectiveness of current treatment.
Tear Film Osmolarity

Tear Break Up Time (TBUT)

  • Measures how quickly your tears evaporate.
  • A fast TBUT (< 8 secs) indicates lipid layer deficiency & highly suggestive of MGD.

Meibomian Gland Imaging & Function

  • Grading of gland loss
  • Grading of meibum quality & expressibility

Vital Dye Testing

  • Routinely performed for the diagnosis of corneal & conjunctival disorders.
  • Temporarily stains damaged tissue.
  • Also used to assess tear volume & stability.

InflammaDry

  • Tests for MMP-9, a specific marker of eye surface inflammation.
  • Used to help differentiate other causes of eye redness & discomfort.

Dry Eye Treatments

Dry Eye Treatments

In-Office


  • TempSure Radiofrequency (RF):
    • 2-IN-1: Reduce wrinkles and treat dry eyes at the same time!
    • Uses subdermal heat to unclog meibomian glands & stimulate collagen and elastin production for smoother, healthier skin.
  • LipiFlow:
    • A 12 min procedure specifically designed to clear blockages from meibomian glands & improve flow of healthy oils onto the eye.
    • Proven to improve the health of meibomian glands & dry eye symptoms in majority of patients.
  • Ilux:
    • A safe, quick & effective way to unclog meibomian glands.
    • Applies warmth & pressure to the eyelids.
  • BlephEx:
    • Microexfoliation for cleaner, healthier eyelids.
    • Gently removes Demodex mites, dead skin & other debris on the lid margins & eyelashes.
  • Punctal Plug Insertion:
    • Helps to increase moisture on the eye by slowing down the drainage of tears.
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