Dry Eye Disease
Dry eye is a persistent condition that affects more than just the comfort of your eyes. Dry eye can cause blurred vision, make reading and computer work difficult or impossible, make dry environments, such as the inside of an airplane, intolerable, and cause infections and scarring on the eye surface. Dry eye may result from a lack of sufficient production, increased evaporation, or the incorrect consistency of the eye's tear film which is a complex mix of oils, mucins, aqueous (water), proteins, and environmental contaminants. The function of your tear film is to provide crisp clear vision, lubrication, and protection to the eye surface so any compromise can be devastating.
A consumer survey commissioned by Allergan found that approximately 48% of adult Americans suffer from dry eye symptoms. Forty three percent of adults that suffer from symptoms have difficulty reading. Sixty three percent of adults who use over-the-counter drops say the drops are not effective or only somewhat effective in managing their dry eye symptoms.
Causes of Dry Eye
The causes of dry eye are many. They may include age, sex, geographic location, medication, contact lens wear, computer or digital device use, and disease. All of which affect the many types of tear glands, decreasing their ability to produce the necessary components needed to adequately protect the eyes.
Diagnosis of Dry Eye
At First Eye Care McKinney, we perform a comprehensive eye health evaluation and utilize multiple point of care tests to assist in diagnosing and developing treatment plans for patients suffering from dry eye.
Eye mapping with our Medmont Corneal Topographer allows our doctors to identify tear consistency and break up time.
TearLab detects abnormal tear osmolarity (how concentrated tears are) and with InflammaDry, the first and only in office test that detects inflammation (swelling), our doctors look for inflammatory markers consistent with dry eye.
Dry Eye Treatments
For many, treatment begins with over-the-counter artificial tears. Unfortunately, the majority of these readily available options may do more harm than good. Toxic irritation of harsh preservatives these products often have, may disrupt what is already a fragile condition.
At First Eye Care McKinney, we recommend products that are proven to be gentle on your eyes. Our preferred products provide immediate relief to red, dry, and irritated eyes. Non-preserved tears are preferred in most cases. Most recently, the doctors at First Eye Care McKinney have begun recommending Retaine HPMC and Retaine MGD lubricating eye drops.
Retaine HPMC is a preservative free option in the convenience of a single bottle. It has a unique delivery system that prevents contamination and has three month stability after opening. We recommend you try this affordable option as a first line artificial tear.
Oasis Tears, which has a unique formula allowing it to stay on the eye for an extended period of time, is available preservative free in a more traditional single use vial form. Both preservative free options help relieve symptoms and assist in the healing of the eye surface that is suffering from dry eye.
Softly preserved artificial tears are recommended to patients that need only occasional use. The doctors at First Eye Care McKinney recommend Refresh Brand products, Blink® Tears Lubricating Eye Drops, as well as, the Systane family of products. These products have a proven record of success, but patients must be aware of the frequency of use. Because these products do contain preservatives, it is recommended that they be used no more than three or four times per day. If you find yourself needing more frequent use, trying one of the above mentioned preservative free options is recommended.
Up to 90% of individuals suffering from dry eye suffer from a disruption in the oil producing meibomian glands lining the upper and lower eyelids. These glands are responsible for producing the oily component of the tear layer which slows evaporation of the tear film. In order to have properly functioning glands, we at First Eye Care McKinney recommend a multi-step approach.
We begin with the use of a commercially available heating mask, like the MediBeads Eye Hydrating Mask by Bruder which if used daily, or as recommended by your doctor, will allow a better flow of tear oils with each blink. We couple this with cleaning the eyelids, after heating, with facial cleansersAvenova, Ocusoft lid scrubs, or Cliradex. Daily use of these products is recommended to maintain exceptional lid hygiene as well as to remove makeup and debris.
To provide the building blocks for a healthy tear film the doctors recommend that an individual suffering from dry eye increase the amount of omega -3 fatty acids into their diet. Good sources include cold water fish such as sardines, cod, herring, and salmon. Flaxseeds and flaxseed oil are plant based omega-3 sources. HydroEye by Science Based Health. HydroEye is a clinically tested proprietary blend of omega fatty acids and nutrients designed specifically to support your tear health.
Inflammation is commonly found with dry eye disease. If inflammation is present, prescribing Restasis (cyclosporine ophthalmic emulsion)0.05%
prescription eye drops or the recently FDA approved Xiidra (lifitigrast ophthalmic solution)5% eye drop is often necessary for long term control of dry eye. These medications help to increase natural tear production by decreasing inflammation, and Xiidra is the only medication currently approved for the treatment of signs and symptoms of dry eye disease.
For patients suffering from a severe lack of tears, such as those that suffer with Sjogren's Syndrome, it may be necessary to perform a procedure called punctal occlusion. This is a process where temporary or permanent plugs, about the size of a piece of rice, are painlessly inserted into the tear ducts to decrease the amount of tear drainage. This procedure is quickly done in the office and is typically covered by insurance.
Approximately 86% of patients that have dry eye complaints are suffering from a condition called meibomian gland dysfunction or MGD. The meibomian glands are the oil producing glands that line the upper and lower eyelids. Over time and with the increased use of digital devices and computer screens these glands begin to become obstructed and their production of lubricating oils slows and eventually stops. If not corrected atrophy of the glands follows along with increased symptoms. First Eye Care McKinney is pleased to offer patients the only FDA cleared treatment for MGD Lipiflow. With this 12 minuted in-office medical procedure your meibomian glands are cleared of the obstructing material allowing for the resumption of proper oil production.
If you do suffer from dry eyes, phone our First Eye Care McKinney clinic at (972) 540-2015 to schedule for a comprehensive evaluation and treatment options for this life altering condition. On-going care is a must for Dry Eye Disease and First Eye Care McKinney, McKinney's only accredited Tear Lab dry eye center, will guide you every step of the way.