Solving the problem

 

Dry-Eye Syndrome is a chronic and progressive condition.

 

Depending on the cause and severity, it may not be completely curable. Dry-eye can be managed successfully, which usually results in noticeably better eye comfort, fewer symptoms, and in a lot of cases, sharper vision. 

 

Successful treatment of Dry-Eye requires that we address all aspects of the wetting system of the eye. This includes looking at the oil layer, the aqueous (water) layer, and excluding external factors such as allergy and inflammatory processes. Using proven methods and products has shown to improve the wetting system of the eye.

 

The first step in finding the solution is finding the cause! (See Keratograph 5M)

 

SOLUTIONS MAY INCLUDE

Nutritional supplements are recommended as part of the Dry-Eye management plan. Studies have found that supplements containing Omega-3 fatty acids can decrease Dry-Eye Symptoms.

 

Lubricating Drops

Cushioning drops contain bulking agents – typically methyl cellulose derivatives are designed to cushion the tears and action of the lids. Products like Allergan’s Refresh® and Optive® are popular and useful for some, however, these generally older formulations have been largely superseded my modern targeted formulations.

 

Advanced formulations include drops that mimic the function of tear components – in some cases nearly as effectively as natural tears.

 

NB ! Because dry-eyes are also sometimes red eyes, some patients are tempted to use drops aimed at reducing redness. Do not use drops intended to whiten the eyes. They typically contain ingredients that can worsen Dry-Eye by disrupting the normal balance of the tears and irritating the ocular surface.

 

Lid Hygiene

Healthy lids are critical to managing dry eye and ocular surface disease. The lids contain the critically important meibomian glands which help support a healthy and stable tear structure. Bacterial overpopulation of the lids is extremely common and requires aggressive management.

Treatment for meibomian gland dysfunction (MGD). 

There has been a veritable renaissance of thinking regarding dry-eye in recent years. MGD has increasingly been recognized as a primary cause of dry eye disease. Treatment for MGD has typically consisted of warm compresses performed at home with lid massage to express the meibomian glands. In office treatment has centered around manually expressing the meibomian glands to clear blockage. These approaches are still performed; however, new research has suggested that vigorous massage of the eyes after warm compresses can cause permanent distortion and negatively impact vision, so this is no longer recommended.  Office gland expression remains a helpful technique, but usually needs to be repeated frequently and can be uncomfortable.

 

Medications for Dry-Eye.

Currently the only medication indicated and approved by the FDA for treating the signs and symptoms of dry eye in the United States is Shire’s Xiidra™. Allergan’s RESTASIS® is approved for increasing tear production. 

These products are used in conjunction with an ophthalmologist and only when needed and when available locally.

 

Tips to do at home to assist with the prescribed management plan:

  • Drink more water
  • Blinking more frequently
  • Take frequent breaks during computer work
  • Remove eye make-up thoroughly
  • Wear good quality sunglasses.