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Dry Eye Testing and Treatment

Dry Eye

Dry eye is one of the most common reasons why patients seek help from their eye care professional. Innovative Eyecare is a TearLab Accredited Dry Eye Center and utilizes the most advanced technology on the market to diagnose and treat dry eyes, including the TearLab Osmolartity System, Lipiscan and Lipiflow.

What is Dry Eye?

There are two main forms of dry eye, evaporative dry eye and aqueous deficient dry eye. Many people mistake the dry eye symptoms for allergies, climatic conditions or just eyestrain. While all of these may aggravate dry eye symptoms, they are not the root cause.

dryeyediagram

 

Evaporative Dry Eye Evaporative dry eye accounts for 86% of all dry eye cases and occurs when a person’s Meibomian glands are blocked. Meibomian glands are located in the eyelids and this condition of obstructed glands is known as Meibomian Gland Dysfunction (MGD). When functioning properly, the Meibomian glands create a lipid (oil) layer of tears. Without this tear film oil, an individual’s tears can evaporate four to sixteen times faster than normal causing discomfort and dryness, thus the name evaporative dry eye.

Aqueous Deficient Dry Eye Aqueous deficient dry eye occurs when the lacrimal glands do not produce a sufficient amount of aqueous (water) to keep the eyes moist. In aqueous deficient dry eye, underlying changes to these tear-producing glands result in a lower quantity of tears being made and not enough water reaches the surface of the eye.

Both evaporative dry eye and aqueous deficient dry eye can lead to damage of the eyes’ surface, which, in turn, can lead to the symptoms of dry eye. Reduced tear production over a long period of time increases the risk of permanent damage and scarring to the front surface of the eye.

What Causes Dry Eye?

Dry eye can be caused by multiple factors including:

Environmental Causes Changes in environment can cause dry eye such as hot, dry and/or windy climates, high altitudes, excessive sun exposure, central heating, air conditioning, hair dryers, cigarette smoke, air pollution, and air travel.

Medications (prescription and over the counter) Many medications can cause dry eye. These medications can include allergy medications, especially antihistamines, antidepressants, some blood pressure medications, Parkinson’s medications, birth control pills, diuretics, beta blockers, sleeping pills, many pain medications, medications which regulate heart rhythm irregularities, and decongestants.

Contact Lens Wear The simple presence of a contact lens on the eye disrupts the tear film, accelerates the progression of MGD, and aggravates dry eye symptoms. In addition, wearing contact lenses for a longer period of time than they are designed for can also cause this issue. For example, wearing a one month disposable contact lenses for three months.

Non Eye-Related Diseases Individuals with Parkinson’s disease, Sjögren’s syndrome (an auto-immune disease), Rheumatoid arthritis, Lupus, Lacrimal gland deficiency, Diabetes, Sarcoidosis, Stevens-Johnson syndrome, or Rosacea can experience dry eye.

Refractive Eye Surgery Some individuals experience dry eye after LASIK.

Hormonal Deficiencies or Changes Thyroid conditions, hormonal changes during menopause, decreased production of androgen, and estrogen supplementation can cause dry eye.

Low blink rate Blinking is critical in spreading tears over the surface of the eye and stimulating tear production. A chronic low blink rate is associated with dry eye symptoms. Computer use, reading, and watching TV are the three activities most commonly associated with a low blink rate.

Dry Eye Symptoms

Symptoms of dry eyes may include stinging, burning, foreign body sensation, sensitivity to light, tearing, tired eyes, and difficulty wearing contact lenses. In addition, many patients suffer from blurred vision which is often worse at the end of the day.

Dry Eye Diagnosis

At Innovative Eyecare we use a number of methods to diagnosis dry eye and measure it’s severity including the TearLab® Osmolarity test and the LipiScan® test.

TearLab Collage 1

TearLab

TearLab Osmolarity Test

The TearLab Osmolarity test is a painless process which tests a tiny tear sample to measure osmolarity (salt content) in the tears. Tear osmolarity has been shown to have one of the best predictive values of any single test for diagnosing dry eye disease. The test provides our eye doctors a meaningful measure of the health and stability of the protective tear film that covers the surface of your eyes.

LipiScan 1

LipiScan

LipiScan Test The device takes extremely detailed images of your eye’s meibomian glands. This non-invasive test takes less than five minutes and the patient will see their tear film as an array of colors that are reflected when a light source is directed towards the front surface of the eye.

 

Dry Eye Treatment

Innovative Eyecare offers many advanced treatments to help patients experience relief from dry eye. Our eye doctors prescribe custom therapies depending on the type of dry eye a patient is experiencing. These therapies may include lubricating the eye with topical artificial tears, a prescription eye drop, or LipiFlow treatment.

 

LipiFlow Treatment

The LipiFlow Thermal Pulsation System by TearScience® is the first and only treatment that addresses the cause of evaporative dry eye: blocked Meibomian glands. For individuals who have tried to alleviate symptoms with eye drops and warm compresses, LipiFlow treatment may be the key for sustained relief from dry eye.

Patient Using LipiFlow for Dry Eye

Patient During LipiFlow Treatment

The LipiFlow relieves Meibomian gland blockage by applying a combination of directed heat and pulsation pressure. The LipiFlow Activator (a disposable eyepiece) is inserted under the lower and upper eye lid and is shaped to prevent contact with the cornea. Once in place, the patient simply reclines in the treatment chair for the 10 minute procedure.

Think of it as a “spa treatment” for your eyes. Gentle heat and light pressure create a warm massage that stimulates the Meibomian glands’ natural lipid production and helps restore the balance disrupted by evaporative dry eye. Opening and clearing these blocked glands can allow them to resume natural production of lipids (oils) needed for a healthy tear film. Four weeks after a single LipiFlow procedure, 79% of patients reported an improvement in overall dry eye symptoms.

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