What is dry eye disease?
Tears are a complex composition of oils, mucin, and liquids. In order for our tears to adequately lubricate the structures of our eye's they need to have the correct saltiness (osmolality), liquid, mucin and oily component. If any of these are not in the correct proportion, we may experience symptoms of dry eye disease.
How do I know if I have dry eye disease?
- Burning or watering
- Contact lens discomfort
- Dryness, redness, or irritation
- Eye fatigue
- Fluctuating vision
- Grittiness or scratchiness
- Light sensitivity
What are my treatment options?
Over-The-Counter Artificial Tears
Patients who have been diagnosed with poor tear production can be treated in a variety of ways. For patients with relatively mild dry eyes, the use of artificial tears can often relieve their symptoms. There are a variety of artificial tears that your doctor can prescribe, all of them are over-the-counter.
These can be used as infrequently as once or twice a day to as frequently as every half-hour and more often. For patients who are allergic to the preservatives in some artificial tears and for those who will be using it frequently, your doctor may prescribe preservative free artificial tears.
In addition to doing the above, your doctor may suggest occluding the tear drainage canals, punctum, in order to allow the tears you produce to linger on your eye longer instead of being drained away. There are several techniques used to occlude the punctum: some temporary and some permanent. What is best for you should be discussed with your doctor.
Autologous Serum Tears
For those patients who have moderate to severe dry eyes associated with poor tear production there is medication that can be used, such as Restasis, that has been shown to help restore tear production. In addition some patients have found relief in the use of autologous serum tears. Ask your doctor which treatment or combination of treatments is right for you.
Spivack Vision Center offers our patients the groundbreaking technology of Lipiflow dry eye treatment. Lipiflow is a procedure that has been shown to help moderate to severe dry eye patients achieve long term relief from their symptoms.
It is a 12-minute procedure that is done in our offices. A thermal pulsator is placed along the upper and lower lid of each eye. This instrument directs heat to the oil producing glands of the lids and gently massages the oil glands to allow the dried oil to be expressed. In the majority of cases, significant clinical relief is achieved that last from nine to in excess of thirty-six months.
However in order to appropriately screen those patients with the greatest opportunity of achieving these results, a comprehensive dry eye evaluation is done in our office. The oil glands are evaluated. The tear osmolality is determined. The lids and cornea are examined for disease that may contribute to the underlying dry eye disease. An instrument called a tear layer interferometer, or LipiView, is used to determine the frequency and completeness of the patient's blink as well as the depth of the tear oil level. If it is determined that you are a candidate the procedure is scheduled. See Frequently Asked Questions below for information on what you can expect post-procedure.
Frequently Asked Questions
By one month's end you should notice significant relief. You will be seen by your doctor at the one month visit. Most patients will notice relief from their symptoms that lasts from nine to twelve months. Dry eye disease is a chronic condition. Like all chronic conditions, the symptoms and the causes are addressed, but not cured in the traditional sense. The procedure may need to be repeated if and when symptoms recur. This is typically sometime between nine and excess of 36 months.