Treating Dry Eye and Meibomian Gland Dysfunction
Dr. Whitman: Hello. I’m Dr. Jeffrey Whitman. Welcome to the Key-Whitman Eye Center.
Joining me today are our Dry Eye specialists, Dr. Agnew and Dr. Colerick.
Welcome to the Key-Whitman Eye Center. If you are watching this video
it is likely you have been diagnosed or suffer with symptoms associated
with dry eye.
What is the cause of dry eye?
Dr. Whitman: Although there are many causes of dry eye and the symptoms can often vary
between just a little annoyance from time-to-time to more extreme dry
eye that can be quite debilitating to the patient. We now have several
options available to attempt to address the problem.
Who is affected?
Dr. Colerick: Patients of all age groups can have dry eye syndrome. Contact lens wearers
will have some degree of dry eye. Environmental factors and activities
of daily living, such as reading, computers and cell phone use of ten
notice problems with dry eye. Many medical conditions, such as Sjogrens
syndrome, lupus, rheumatoid arthritis and menopause may cause severe dry
eye symptoms. In addition, many different medications such as antihistamines
will also lead to dry eye problems.
How do we diagnose dry eye?
Dr. Agnew: To begin a dry eye evaluation, we need to know more about your symptoms.
We will give you a simple questionnaire that helps us understand the frequency
and severity of your symptoms. A thorough eye examination will be performed
and your Key-Whitman doctor will examine the tear film layer covering
your eye. They will perform an external examination of the eyelids and
meibomian glands at the base of your lashes. Additional testing may be
performed to measure the quality and the amount of tear film productions.
Dr. Coleric: In order to understand the impact our tear film has on clarity and comfort
of our eye, let’s briefly review what makes up our tear film. Your
tear film is made up of 3 layers and they have to be in perfect balance,
otherwise you will notice symptoms. The first layer is the mucous layer
and it sits right next to the cornea or the outer covering over the pupil
and iris. A water layer is sandwiched between this mucous layer and an
oily layer that is responsible for preventing this watery layer from evaporating
How is dry eye treated?
Dr. Whitman: When you don’t produce enough of the water layer, we first recommend
the regular use of artificial tears. If you seem to have more trouble
in the morning, we may recommend you use a more viscous drop or a lubricating
ointment at night. These may blur your vision, so that is why best to
use an ointment right before bed at night. Additionally, we may recommend
you begin using vitamins and supplements especially developed to improve
your tear production but these may take several weeks to months to notice
improvement. Punctual plugs may also be inserted in the drainage tear
ducts, which are like tiny stoppers made of silicone or collagen that
help keep the moisture from draining too quickly from the eye. Prescription
medications, like Restasis may also be used to reduce inflammation and
improve tear film production.
Dr. Colerick: The oil layer which is produced each time you blink sometimes is reduced
because the meibomian glands along the edge of your eyelids can get blocked,
not allowing this oily substance to flow freely. This contributes to the
evaporation of the water layer of your tear film. After determining if
you have a lipid deficiency by using a special diagnostic test called
Lipiview, we now have an FDA approved procedure called Lipiflow, which
treats meibomian gland dysfunction by using heat and gentle pressure to
express the blocked glands.
Dr. Agnew: Patients who’ve undergone this therapeutic treatment at Key-Whitman
have been very satisfied with the results and we anticipate that this
will be another solution for dry eyes. Depending on the severity of the
condition, this treatment can potentially last from 9 months to as much
as 3 years.
Dr. Whitman: We hope this information helps you understand more about your dry eyes
and brings you hope for both treatment and eye comfort.