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Dry Eye Disease

What is Dry Eye Syndrome?

Dry Eye Syndrome (DES) is the most common eye condition worldwide.1 Dry eye is a chronic condition where the eyes do not produce enough tears to maintain healthy moisture in the eyes. The most crucial components to examine are the tear film and the meibomian glands in the eyelids. When these layers are not balanced, dry eye occurs. Symptoms can range from mild to severe and can be present occasionally or continuously.

What causes dry eye?

The most common causes of dry eye can include:

  • Tear insufficiency or poor tear quality
  • Staring too long while reading or at the computer/phone
  • Allergies and your environment (wind, smoke or dry air)
  • Hormonal changes in women including pregnancy and menopause
  • Aging; more common in women than men
  • Systemic disorders including auto-immune diseases, endocrine disorders, diabetes and rheumatoid arthritis
  • Certain medications like antihistamines, acne medications, hormonal medications and depression/anxiety medications
  • Poor lid closure (Lagophthalmos aka “lid lag”)
  • Some refractive surgeries most commonly including LASIK®

What are the most common symptoms of dry eye?

  • Excess tearing
  • Redness
  • Discomfort such as itching, burning or light sensitivity
  • Blurred vision or fluctuation in vision when blinking
  • Tired or fatigued eyes, especially at the end of the day
  • Contact lens discomfort
  • A foreign body sensation or feeling of “stringiness” in the eyes

How is dry eye diagnosed?

There are two types of dry eye: evaporative dry eye and aqueous dry eye. Evaporative dry eye affects about 86% of all dry eye cases. Evaporative dry eye results from a blockage in the meibomian glands on your upper and lower eyelids, commonly known as meibomian gland dysfunction (MGD). With this blockage, the meibomian glands will not secrete enough oil into the tears to keep them balanced.

Less common among patients is aqueous dry eye, which occurs when the lacrimal glands fail to produce enough fluid to moisturize the eyes. This type of dry eye can point to an autoimmune disorder such as Sjögren’s. Please let your provider know if you have a family history of Sjögren’s and/or symptoms of dry mouth, joint pain, and fatigue.

Your doctor will conduct a few simple, non-invasive tests to evaluate:

  • Tear production
  • Salt content of the tears
  • Health of your meibomian glands
  • Inflammation in the lids
  • The surface of the eye
  • Your eyes’ response to 60 local environmental allergens

What are the treatment options for dry eye?

Your doctor will identify how and why the tears may be imbalanced and then determine best treatment plan to manage your symptoms so you can feel relief from the discomfort of dry eye.

Self-care at home

The most common treatment is using artificial tears or preservative-free tears to keep the eye surface moisturized. Your doctor may also recommend a lid scrub and lid cleanser as well as warm compresses using the Bruder® Heat Mask. If the above methods are not enough to alleviate symptoms, your doctor may prescribe Restasis® or Xiidra®. These prescription eye drops are specially formulated to help increase the natural tear production in the eyes. Xiidra is the only drop approved to treat both types of dry eye. Contact lens wearers should remove contacts and give the drops at least 15 minutes before re-inserting your contacts.

In-office treatments and procedures

LipiFlow® and BlephEx®

Punctal plugs and probing and irrigation (P&I)

PROKERA®

Punctal plugs and probing and irrigation (P&I)

Punctal plugs are placed in the tear ducts to help maintain moisture in the eyes by blocking the tears from draining into the ducts. P&I’s are performed when there is a blockage in the nasolacrimal ducts. Your doctor will dilate the punctum (small openings on the upper and lower eyelids that act as drainage ports for tears) and insert a tiny metal tube to flush out the blocked drain with a sterile solution.

LipiFlow® and BlephEx®

For treatment of dry eye and/or blepharitis, we also offer the LipiFlow® or BlephEx® treatments. These treatments are performed by our team of certified technicians. Your doctor will check your eyes immediately after treatment and again 2 months post-treatment to see how your eyes responded to the treatment. Your doctor may also perform a meibomian gland expression to help clear any clogged oil glands in the eyelids.

PROKERA®

PROKERA® is an alternate treatment for the cornea. Made from amniotic membrane, which has natural anti-inflammatory and anti-scarring properties, PROKERA® is the only FDA cleared therapeutic device used by eye care practitioners to provide quick symptom relief and reduce inflammation associated with ocular surface disease.

Tips to help prevent dry eye

  • Choose a diet filled with anti-inflammatory foods and vitamins, like Omega-3 or fish oil.
  • Drink plenty of water to stay hydrated throughout the day.
  • Wear sunglasses while outside or driving to help with light sensitivity.
  • Using the 20/20/20 rule while using the computer for hours at a time while at work. Every 20 minutes, take a 20 second break from your work, focusing on something in the distance about 20 feet away and blink.
  • Practice “blink exercises” throughout the day.

Daily Maintenance

Following an in-office treatment, we recommend applying warm compresses to your eyes a few times a day for about 10-15 minutes, using lid scrubs and cleansers every morning and night, and using artificial or preservative-free tears throughout the day to help prolong your results. If you wear contact lenses, your doctor may suggest switching to a new type of lens or taking breaks from wearing contacts to increase oxygen flow to the cornea.

Dry Eye Disease can be stressful, let us help.
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The material contained on this site is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider. Section 1557 – Affordable Care Act (ACA)

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