Dry Eye Diagnosis and Treatment

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DO YOU HAVE DRY EYE DISEASE?

Dry eye disease is a common, chronic condition that occurs when the eyes do not have the proper tear film consistency or are lacking in lubrication.

More than 16 million Americans suffer from the irritating symptoms of dry eye disease. Even though the condition is common, you shouldn’t have to suffer—relief is available!

While dry eye disease is not usually serious on it’s own, if left untreated it can lead to long-term complications like increased risk of infections or corneal damage and scarring.

Any time your eyes are uncomfortable, we recommend a comprehensive eye exam or medical eye appointment to diagnose the problem.

How we Diagnose and Treat Dry Eye

Before initiating a treatment plan, we perform a full evaluation to determine the root cause of your dry eye. This includes identifying risk factors and a comprehensive evaluation of your eyelids, ocular surface, and tear film. Then we can determine the most effective management strategy.

Symptoms and Causes

  • Patients with dry eye syndrome typically experience some or all of the following symptoms:

    -Stinging or burning

    -Scratchy or gritty feeling—like something is in the eyes

    -Eye redness

    -Watery eyes

    -Blurred vision

    -Eye fatigue

    -Light sensitivity

    -Difficulty wearing contact lenses

  • The following factors increase the risk of developing dry eye syndrome:

    -AGE: Dry eye can occur naturally as we age. People over 65 tend to experience increased symptoms of dry eye.

    -GENDER: Women are more likely to experience dry eye due to hormonal changes from menopause, pregnancy, and birth control.

    -MEDICATIONS: Numerous medications can decrease tear production, leading to dry eyes.

    -MEDICAL CONDITIONS: Autoimmune diseases like Sjogren’s, rheumatoid arthritis, and lupus can increase your risk for dry eye, along with other conditions like diabetes and thyroid disorders.

    -CONTACT LENS USE: Certain contact lenses can interfere with tear film distribution, causing dry eye symptoms to worsen. Certain types of contact lenses can actually be therapeutic for dry eyes!

    -REFRACTIVE SURGERY: Procedures such as LASIK can disrupt ocular surface tear film, although this can often be temporary.

The two main types of dry eye are aqueous deficiency and evaporative. Aqueous deficient dry eye occurs when the eyes do not produce enough tears, and evaporative dry eye occurs when the tear consistency is compromised lacking the right mix of water, mucous, and oils. Many factors can cause dry eye, but some of the more common causes are

  • Meibomian gland dysfunction

  • Blepharitis

  • Certain medications

  • Systemic conditions, such as autoimmune or inflammatory conditions

  • Environmental conditions

  • Aging

  • Contact lens usage

  • Dietary factors

We work to determine the underlying cause(s) of your individual dry eye to tailor an appropriate treatment plan.

What Causes Dry Eye Syndrome?

Diagnosing Dry Eye Syndrome

  • We use meibomian gland imaging to view individual oil glands and identify non-functioning or atrophied glands. We also perform meibomian gland expression in office to determine the quality of oils.

  • We use anterior segment imaging to evaluate tear film quality and also generate a tear break-up time.

  • We use fluorescein dyes to identify damaged areas on the ocular surface and also evaluate the eyelid margin and conjunctival surface.

  • We use slit lamps to evaluate the eyelids looking for signs of blepharitis, demodex, or meibomian gland dysfunction.

  • We use industry-standardized questionnaires to get a better overall feel for how impactful dry eye is on our patients’ daily lives.

Treatment Options at Pelham Eye Center

  • Over-the-counter and/or prescription eyedrops are often a first line defense against dry eye symptoms.

  • Punctal plugs are tiny medical devices inserted into the top or bottom tear ducts to keep tears on the ocular surface longer. Punctal plugs are nearly invisible. The insertion process is simple and well-tolerated with minimal or no discomfort. The plugs can be temporary, slowly dissolving over time, or semi-permanent, remaining in place for months or years.

  • Meibomian gland expression is a simple in-office procedure performed alone or in conjunction with other procedures, such as intense pulsed light treatments. Gland expression helps squeeze out debris or blockages, allowing the natural oils to flow more freely.

  • Soft bandage contact lenses or hard scleral lenses are sometimes to use to minimize dry eye symptoms or aid in healing if the cornea has been compromised. Scleral lenses are filled with a viscous solution that bathes the cornea in liquid, minimizing dry eye symptoms.

  • Amniotic membranes are applied in cases of severe dry eye in which the cornea has been injured or compromised. These special membranes contain stem cells that the cornea can use to regenerate healthy tissue.

  • Lumenis OptiLight IPL is an innovative way to treat meibomian gland dysfunction and chronic dry eye. The light targets inflammation and helps to restore meibomian gland function.

Lumenis OptiLight IPL

Say goodbye to dry eyes, and say hello to an illuminating solution! At Pelham Eye Center, we offer the first and only FDA-approved IPL treatment for dry eye disease caused by meibomian gland dysfunction (MGD).

This gentle, in-office, non-invasive procedure is safe, comfortable, and supported by more than 20 clinical studies.

Let us help you get relief from your dry eyes!

How does OptiLight work?

OptiLight uses precise pulses of light to reduce inflammation typically associated with dry eye disease, improve tear break-up time, and increase meibomian gland function—in turn diminishing the signs and symptoms of dry eye.

These treatments can significantly relieve dry eye indicators with the following effects:

  • Increasing tear break-up time

  • Reducing bacterial and demodex load on and around the ocular surface

  • Eliminating blood vessels that contribute to inflammation (as seen with conditions like rosacea)

  • Improving meibomian gland function

Patients may also appreciate aesthetic benefits of OptiLight treatments, such as the reduction of fine lines, wrinkles, age spots, redness, and telangiectasia around the eyes!

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