Dry Eye Treatments

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.

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)

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 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.

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.