Dry Eye

THE UNDERLYING CAUSE OF DRY EYE SYMPTOMS

Long term effective treatment for Dry Eye symptoms has eluded many who have come to rely on short term relief from drops, various at-home symptom relief remedies or other prescribed medications. For many, managing symptoms is a frustrating process. The key to effective Dry Eye treatment is to understand the underlying cause of the symptoms.

Dry Eye is generally caused by an imbalance in the tear film that acts as a shield on the surface of our eyes. There are two primary contributors to tear film imbalance. The first is decreased tear production. In recent years, we have learned that true reduced tear production is rare. What we know now is that the problem almost always originates with blockage of the tiny Meibomian Glands in our eyelids. These glands produce essential oils that form the top layer of the tear film and are the core protective element that is essential to long-term visual comfort. 86% of all dry eye symptoms are caused by oil deficiency in the tears.

When the Meibomian glands are blocked or the glands have been compromised, the eye becomes exposed. This leads to dry eye signs and symptoms. This is known as MGD or Meibomian Gland Dysfunction. MGD is easy to diagnose and manage. The treatment of MGD is essential for the long term management of dry eye.

THE LEADING CAUSE OF DRY EYE SYMPTOMS: BLOCKED GLANDS IN THE EYE LIDS

Fortunately, most Dry Eye patients boast healthy tear production as many have a common symptom of Dry Eye, excessive tearing. As tear production is generally not the root cause of Dry Eye, Drs. Quan, Deng, or Chang will check for gland blockages and the structure of your Meibomian Glands in your eyelids. Drs. Quan, Deng, or Chang uses a camera, called Lipiview to evaluate the Meibomian Glands.

Gland blockages can occur over time from debris that is caught in the eyelids, digital device and computer usage and, for women, just putting on make-up over the course of many years. While Miebomian Gland Dysfunction, or MGD, is most often detected in adults over 40, the condition does not discriminate based on age and is often seen in kids and young adults as well. That is why checking for MGD should be a part of your regular eye exam. MGD, if caught early, is the best way to avoid chronic dry eye symptoms. More importantly, you can prevent the potential for substantial permanent gland loss.

EXTERNAL DRY EYE CAUSES

Dry Eye Syndrome and chronic Dry Eye symptoms can have significant impact on daily lifestyles and can impede on simple activities such as reading, working on a computer, enjoying the outdoors or watching a TV. Those same daily activities that are impeded by Dry Eye symptoms are also the same activities that can be contributing causes to Dry Eye.

For example, looking at computers or digital devices for long periods of time can contribute to decreased blink rates. Blinking is essential to activating the oil-producing Meibomian Glands and spreading those oils across the surface of the eye. When blink rates decrease, it impacts long term functionality of the glands and can lead to MGD or even irreversible damage if MGD is not detected and treated early. Other contributing factors that cause Dry Eye symptoms to flare up are dry climates, smoke, indoor air circulation, and wind. Some of us are just lucky with Dry Eye being a product of the aging process.

MEDICAL RELATED DRY EYE CAUSES

In addition to environmental factors that contribute to Chronic Dry Eye symptoms, there are various diseases, medications or medical procedures that can cause Dry Eye symptoms. If you are experiencing any of the below medical conditions or receiving any of these treatments, you should discuss with your eye doctor to get to the root cause of your Dry Eye symptoms. The following are common conditions or treatments that can lead to chronic Dry Eye Symptoms:

• Rheumatoid Arthritis, Sjogren’s syndrome, thyroid disease and lupus
• Medicines such as beta-blockers, antihistamines, diuretics and anxiety medications
• Refractive surgery such as LASIK surgery
• Various prescription and non-prescription medications
• Swollen, red irritated eye lids, commonly referred to as Blepharitis
• Out-turning of the eye lids (ectropion) and in-turning of the eye lids (entropion)
• Contact lens use for long periods of time

UNDERSTANDING THE TEAR FILM

The tear film is a complex structure of mucin, tears and oil that protects the surface of the eyes. When the tear film is compromised, it results in a variety of symptoms, most of which have been associated with Dry Eye and MGD (Meibomian Gland Dysfunction). Understanding the tear film is key to seeing the clear differences between tear deficiency issues and MGD, especially since MGD is more common and has greater long term impact on Dry Eye symptoms.

Mucin Layer

Aqueous Layer

Lipid Layer

What Is the OptiLight by Lumenis & How Can It Manage Your Dry Eye?

Dry eye disease is a widespread and common issue for up to 49 million Americans. This chronic condition can have a significant impact on your quality of life, causing a foreign body sensation in your eyes, pain, blurry vision, and dry or watery eyes. Untreated, it can even lead to further eye health complications.

Despite these constant detrimental effects on quality of life, many dry eye sufferers are not aware that they’re suffering from dry eye disease or that real treatments exist. Instead, they just live with the discomfort.

At Visionarium Optometry, we believe the key to managing dry eyes is understanding the underlying cause. We do this by investing in modern dry eye technology, such as Lipiview and meibomian gland evaluators.

Our team can determine the cause of your dry eyes and recommend effective treatments for your needs.

We’re proud to offer OptiLight by Lumenis to our patients, specially designed for dry eye management.

What Is OptiLight by Lumenis?

OptiLight by Lumenis is a light-based, non-invasive treatment done in the area below the eyes to manage dry eye. The first and only IPL FDA-approved for dry eye management.

The treatment is safe, gentle, and is backed by more than 20 clinical studies.

How Does It Work?

OptiLight uses precise pulses of light to reduce the inflammation that is typically associated with dry eye disease, improve tear break-up time, and increase meibomian gland functionality.

This application can significantly relieve dry eye indicators and has a multi-factorial effect, including:

• Increasing tear break-up time
• Reducing the amount of demodex mites and bacteria living around your eyes
• Eliminating blood vessels that contribute to inflammation
• Improving meibomian gland functionality

What to Expect

Before Your Treatment
There are a couple of ways you can prepare yourself for your treatment. Avoid sun exposure for a few weeks leading up to your appointment. Wear a wide-brimmed hat when outside and avoid tanning.
Ensure you shave the treatment area before your appointment. On the day of your treatment, arrive in comfortable clothing and refrain from wearing any makeup.

During Your Treatment
This treatment is fast and simple. During the treatment your doctor will apply a coupling gel on the treatment area and cover your eyes with shields.
As light is applied to the skin, you may experience a warm sensation. The treatment is gentle with minimum discomfort. The treatment itself will only take 10–15 minutes.

After Your Treatment
After your treatment, you’ll have time to recuperate. During this time, you can ask any questions you may have for your doctor.

Part of Your Custom Treatment Plan

A course of treatment depends on the specifics of your case. Your doctor will help determine the number of treatments you may need. You should see results after your second or third appointment.

OptiLight is a part of the custom treatment plan your eye doctor creates. They have several treatments they can recommend to address your symptoms. If you require additional treatments, your doctor can recommend LipiFlow, Tear Care, Blephex, and more, depending on your needs.

Will the OptiLight by Lumenis Work for Me?

While OptiLight by Lumenis is an effective dry eye management solution, we want to make sure it’s right for you. We do not recommend this treatment if you:

• Suffer from aqueous deficiency dry eye (rather than evaporative dry eye or meibomian gland dysfunction)
• Have a history of keloid scarring
• Have severe scarring around your eyes

Ultimately, our doctors can determine whether this option is right for you. During your next appointment, ask us if you are a good candidate for OptiLight by Lumenis.

You Don’t Have to Live With Dry Eye Anymore

Dry, irritated eyes can be managed with a new treatment that brings comfort and can restore quality of life. Arrange an appointment for a dry eye assessment to get an accurate diagnosis and a treatment plan tailored to your needs.

Contact your eye doctor today if you want relief from your dry eye symptoms.

LipiFlow Treatment May Be For You

For many patients, LipiFlow treatment means relief. In a recent clinical study, 79% of patients reported improvement of their overall dry eye symptoms within 4 weeks (ranging from 10% – 100%) following a single LipiFlow treatment.

So What Is LipiFlow?

The LipiFlow Thermal Pulsation System is the only FDA-approved device for treating Evaporative Dry Eye caused by Meibomian Gland Dysfunction (MGD). The treatment opens and clears blocked meibomian glands. This allows the glands to resume their natural production of lipids (oils) which helps reestablish the tear film. This improved tear film is what helps dry eye sufferers feel and see better.

How Does LipiFlow Work?

LipiFlow uses thermal pulsation which allows precisely controlled heat to reach the inner eyelid where the meibomian glands reside, while also performing mild, intermittent directional pressure. Together, the precise heat and gentle pressure help unblock and clear the meibomian glands on both the upper and lower eyelids.

The procedure utilizes a sophisticated single-use device with built-in sensors to ensure a safe, sterile treatment.

The treatment time is 12 minutes and is performed in our office. It is comfortable and patients actually compare it to a spa-like experience.

What To Expect After LipiFlow Treatment?

There is no down-time or recovery period after the procedure. Vision may be slightly fuzzy for a few minutes as your tear film recovers. Although some patients notice improvement in symptoms right away, this is not the norm. A more likely outcome will be improvement within 4-8 weeks as the ocular surface normalizes. Another study showed that 90% of patients had significant symptom relief (a 50% improvement) by their 8-week follow-up. It has also been shown that further improvement can be seen at 6 months. Although it is hopeful that everyone will see improvement, some patients with severe disease may not. With severe disease, the goal of treatment will be to stop its progression.

How can I know that this is right for me?

You can schedule what we call a Dry Eye Evaluation with Drs. Quan, Deng, or Chang. During that visit, Drs. Quan, Deng, or Chang will utilize tests and specialized equipment to examine your meibomian glands, tear layer, and eyelid structure as well as your cornea and eyeball itself.

After this evaluation, a treatment plan will be outlined that may, or may not, include LipiFlow treatment. Every patient is unique, and you will be presented with the best treatment options for you.

What is TearCare®?

TearCare® is an innovative Dry Eye procedure that targets the blocked meibomian glands in your eyelids that produce oils to keep your tears healthy. When these glands become blocked or have reduced function, your tears may evaporate more quickly. Unblocking these glands with The TearCare® System can help restore their function and stabilize the tear film. This may improve the quality of tears and reduce symptoms like dryness, gritty or scratchy sensations, blurry vision, and watery eyes.

At your appointment, we will determine whether your dry eye symptoms are caused by Meibomian Gland Dysfunction (MGD) and would benefit from the use of The TearCare® System.

Watch TearCare Video

If you have questions or want to schedule an appointment, call: (415)753-5338.