Dry eye management
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 too quickly.
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.