Dry Eye Care
According to the National Eye Institute, approximately five million Americans aged 50 and older are estimated to suffer from dry eye syndrome. For these people, the gritty, sensitive feeling not only causes discomfort, but it can also affect vision. All these variables add up and can severely affect quality of life – whether you’re working on the computer or spending time with family.
It is more common in women than men and tends to occur more often in middle-aged and older adults than younger people. But because dry eye has many causes, including medications and medical conditions, it can happen to almost anyone.
Oregon Eye Specialists has a full range of treatment options and a talented team of physicians who can get at the root cause of your discomfort. Read on to explore the common dry eye causes and the new treatments that presents promise for relief.
View the videos below for videos to learn about the role of meibomian glands in ocular health
Ocular surface and gland function in a healthy eye
In a healthy eye, pressure from a blink expresses a small amount of oil from the meibomian glands which is then distributed over the ocular surface as the eye opens. The ocular surface is the foundation for ocular comfort and visual quality.
Impact of blocked meibomian glands
Obstruction of meibomian glands impedes the production of oils necessary to reduce aqueous evaporation and minimize harmful friction between the eyelids and cornea.
Long-term effects of untreated MGD
If left untreated, obstructed glands will reduce oil production, atrophy, and eventually drop out. Once a gland has atrophied completely, function is lost permanently, which leads to chronic discomfort and potentially sight-threatening damage to the ocular surface.
Dry eye has three main causes:
- Your tears evaporate too fast. A layer of tears covers your eyes all the time, not just when you cry. Tears are made up of oil, saltwater, and mucus. The oil helps keep tears from evaporating too quickly. But the oil-producing glands (Meibomian glands) in the eyelids can become blocked, causing tears to evaporate, and creating dry eye symptoms.
- Your eyes don’t make enough tears. This can happen for many reasons. Common medications, such as antihistamines and hormone replacement therapy, can cause dry eye. So can certain diseases, including rheumatoid arthritis and lupus. Normal aging and hormone changes in menopause can also cause dry eye.
- Your eyelids don’t distribute tears evenly. Your eyelids distribute tears across your eyes’ surface each time you blink. Dry eye can develop if you don’t blink enough (at least six times a minute) or have a physical eyelid problem, such as an eyelid that droops away from the eye or rolls onto it.
Common symptoms of dry eye include:
- Discomfort – Your eyes might feel sandy, gritty, scratchy, itchy, or sensitive to light. You might also have burning, stinging, or pain. Wind or dry air, such as from air conditioning or a wood stove, can make discomfort worse.
- Trouble seeing – You might have blurry vision, especially at the end of the day or when you focus for a long time. It might be hard to wear contact lenses, if you wear them.
- Physical changes – Your eyes might be watery or red.
Before considering dry eye treatment, we recommend a comprehensive dry eye evaluation. Oregon Eye Specialists is proud to offer LipiView II technology to our patients; this new offering plays an integral role in accurately diagnosing the type and severity of dry eye that an individual is dealing with.
Diagnostic testing such as LipiView II allows your provider to objectively identify the cause of your dry eye by examining lipid thickness, blink rate, and meibomian gland health and structure.
The key pieces of data resulting from these diagnostic tests will allow your provider to craft a customized dry eye treatment plan for you, which may include LipiFlow or other traditional treatments for dry eye.
There are many ways to treat dry eye, and most people do best with a combination of treatments. Oregon Eye Specialists has a full range of treatment options, including the newest treatments, LipiFlow and BlephEx. Your eye doctor will create a customized treatment plan to reduce your symptoms and get you back to your favorite activities.
The newest treatment for dry eye. BlephEx is an in-office procedure that removes excessive bacteria on the eyelid causing dry eye. By keeping eyelids clean through this procedure, inflammation is reduced and symptoms can be dramatically improved. The procedure only takes 6-8 minutes, and most patients only experience a tickling sensation.
LipiFlow is a new treatment for dry eye. This type of dry eye is called evaporative dry eye, and is caused by blockage in the eyelids’ oil-producing glands, or Meibomian glands. In 2018, 96% of our LipiFlow patients experienced clinical improvement in Meibomian gland function after treatment.
LipiFlow is a 12-minute office procedure and is currently offered at our St. Vincent office. Make an appointment to learn more about how this treatment can improve your dry eye symptoms.
There are many different brands and types available without a prescription. Try several and use the one that works best for you. It is best to use a preservative-free type of you need to use the artificial tears more than four times a day – these come in individual dose vials that you can use a few times prior to throwing them away after one day of use.
These contain natural fatty acids that can help dry eye symptoms. Oregon Eye Specialists recommends Nordic Naturals ProOmega, Barlean’s Flax Oil and Barlean’s Vegan Omega Swirl. If you use omega-3 supplements, you must tell your doctor about all other medications and supplements you take, especially if you take blood thinners, because omega-3s can increase your bleeding risk.
Prescription eye drops and ointments
Restasis, Azasite, steroid eye drops and antibiotic or steroid ointments help decrease the inflammation of dry eye.
Antibiotics you take by mouth can also help decrease the inflammation of dry eye. Take these exactly as directed, tell your doctor about all other medications and supplements you take, and ask about possible side effects and ways to prevent them.
A simple procedure that closes the tiny openings in your eyelids where tears drain away. This keeps tears on your eye’s surface longer. It is performed in your eye doctor’s office.
Home care and lifestyle changes
Lifestyle changes include avoiding or wearing less eye makeup, using a humidifier, and wearing protective eyewear outside. Home care includes blinking exercises and treating your eyelids twice daily with heat, massage and cleaning.
TrueTear Intranasal Tear Neurostimulator
The TrueTear™ Intranasal Tear Neurostimulator provides a temporary increase in tear production during neurostimulation in adult patients. This state-of-the-art technology in eye care creates tiny pulses of energy to stimulate tear production. It’s drop free and drug free and well tolerated with mild side effects. TrueTear is available in the Lake Grove, Aloha and St. Vincent clinics. To learn more visit TrueTear
Oregon Eye Specialists has 10 conveniently located clinics. Find one nearby!