Dry Eye Treatment
in Winchester VA
What Is Dry Eye Syndrome?
Chronic Dry Eye, also known as Dry Eye Syndrome, is a medical condition that results from the eyes’ reduced ability to produce tears of the normal quantity or quality. Recent studies show that this condition affects more than 3.2 million Americans. Tears are surprisingly complex in nature, being formed by several different types of glands on the outer surface of the eye, the inner surface of the eyelids, and special glands deep within the skin of the eyelids. And so, a problem with any of several of these components can lead to inadequate tear formation.
Dry Eye Symptoms
Dry eye symptoms are most common in people ages 50 and older, however, they can result from medical injuries or certain medications. They can also occur in women who experience the change in hormones from pregnancy. The most common causes of dry eye include the following:
- Blood-pressure medications
- Eye injury
- Thyroid disease
What causes dry eye?
In Virginia, especially during our humid summers, it could seem difficult to develop dry eye, but the causes are actually mostly internal. As we age, we naturally create fewer tears. This is especially true of women due to hormonal changes. While both men and women get dry eye, is it more common in women who have been through menopause.
Dry eyes can develop when the tear ducts are not producing a sufficient number of tears. Or the condition can be due to a chemical imbalance in the tears themselves. Natural tears require a particular chemical balance to lubricate the eyes efficiently. Sometimes, your eyes are actually overproducing tears due to the irritation in your eyes, but the tears aren’t the right consistency to help.
Dry eyes can be chronic or tied to circumstances, such as allergy season. Chronic dry eye is usually the result of dysfunction in the tear-producing areas of the eyes, often with the Meibomian glands. If clogged glands are behind your chronic dry eye, changes in conditions, such as the end of allergy season, will not help.
Beyond aging and hormones, there are a variety of causes of dry eye:
- Clogged Meibomian glands
- Entropion (eyelids turn in) or ectropion (eyelids turn outward)
- Certain diseases, such as rheumatoid arthritis and thyroid disease
- Long periods looking at a computer screen or reading, without blinking frequently enough
- Long use of contact lenses
- Being in smoke, wind, or very dry climates
- Having refractive eye surgery, such as LASIK or PRK
- The side effect of certain medications, such as diuretics, allergy/cold medicines, sleeping pills, anti-anxiety and anti-depressives, heartburn medicines, and beta-blockers
Dry Eye Treatment Options With Dr. John Stefano
Dry eye can have different causes in different patients, so there are a variety of treatment options that we may use at Shenandoah LASIK & Cataract Center. Dr. Stefano first rules out causes such as reactions to certain medications the patient may be taking, inherent eyelid problems such as entropion or ectropion, or even a side issue of other diseases.
The first treatment options usually involve medications for dry eye. These may be eyedrops to control corneal inflammation or to reduce eyelid inflammation. Eye inserts made from hydroxypropyl cellulose may be inserted. These slowly dissolve and release lubricating substances. Certain drugs called cholinergic increase tear production.
From there, treatment could involve minor surgery to insert punctal plugs into the tear ducts, opening blocked oil glands, and even prescription of new contact lenses called scleral lenses that trap moisture on the eye. Lipiflow is a treatment that addresses blocked Meibomian glands.
Here’s additional information on these treatment options. View Video
Artificial Tear Replacement At Shenandoah Lasik & Cataracts Center
Frequently, artificial tear supplement drops are a first treatment regimen. There are many different brands and forms of ocular lubricating drops available, each with their own components that target some or all of the three layers of a normal tear film. They can be used to relieve burning and irritation for a limited period of time. Artificial tear ointments can be useful for longer periods, especially overnight. Recent studies have determined that there is frequently an inflammatory component to dry eye. And sometimes a mild steroidal eye drop is useful.
Tear Stimulant Drops
Prescription medications in drop form (RestasisTM and XiidraTM) are now available which act to stimulate increased production of tears by the eye itself.
A normal healthy tear film will wash the surface of the eye and flush dirt, bacteria and other debris into small “drains” (called lacrimal puncta) located on the inner corner of our eyelids. So one way to prevent excess loss of tears is to occlude or “plug” those puncta. Punctal plugs are tiny, biocompatible devices inserted into tear ducts to block drainage.
Nutritional Supplements We Offer In Winchester, Virginia
Ophthalmologists will suggest taking natural supplements such as fish oil, flax seed oil and vitamin E — a combination can be found in TheraTears Nutrition capsules with Omega3.
Doctors are moving from simply rescuing dry eye patients to prevention. 86% of dry eye patients suffer from Meibomian Gland Disease (MGD). Much of the movement to include prevention is being driven by the ability to image the glands enabling the doctor and the patient to see gland damage much earlier than was previously possible. Lipiflow helps with this dysfunction to get your glands producing tears again. Sadly, gland loss is permanent. Therefore, it is important to identify non-functioning glands and treat them (by removing the obstruction) as soon as possible.
What is the Lipiflow procedure?
Lipiflow is a dry eye treatment that uses thermal pulsation to clear blocked Meibomian glands. The unique combination of heat and massage pressure increase lipid production and the quality of the patient’s tears improves significantly.
The procedure is simple. Lipiflow uses a device that consists of a small piece that looks like a scleral contact lens attached to an arm. This slides beneath the eyelids and over the globe of the eye. For patient comfort, we usually place a couple of drops of anesthetic eye drops in each eye prior to treatment. The lens-like piece emits heat outward to the eyelids while protecting the eye itself from the heat. The second part of the device, which is connected to the shield, sits outside the eye on the lids and provides a pulsing squeezing of the lids to open the glands and allow the lipids to exit normally. The applied heat makes this massage function more successful at opening the clogged glands. Lipiflow is an in-office procedure that patients describe as “relaxing.” We can treat both eyes at the same time and a Lipiflow treatment takes just 12 minutes.
Is Lipiflow safe?
This is a completely non-invasive treatment. The piece that inserts under the eyelids applies heat outward and it protects any of that heat from going onto the eye. The massage function simply squeezes the eyelids lightly to free the clogged glands. The heat and subtle pulses work together to open the clogged Meibomian glands.
Are there side effects with Lipiflow?
These treatments are easily tolerated by our Shenandoah patients. The only issue at all is some minor irritation from the Lipiflow device, but this usually passes in an hour or less time.
Who is a good candidate for Lipiflow?
If clogged Meibomian glands are the cause of your dry eye, Lipiflow is an excellent treatment option. If your dry eye is temporary, possibly linked to smoky, dusty conditions, an eyelid infection, or other causes, Lipiflow won’t help. This treatment targets clogged Meibomian glands. Dr. Stefano will diagnose your dry eye to see if the Meibomian glands are behind it.
How does Lipiflow work?
Lipiflow combines heat and physical pressure to the clogged Meibomian glands in the patient’s eyelids. This combination is very effective, more so than heat or pressure in isolation. The heat delivered upward from the device placed under the eyelids warms the Meibomian glands, making debris, hardened oils, or other blockages easier to remove. Then the massage pressure applied to the eyelids and the glands pushes these blocking materials out and opens the glands, allowing lipids to flow and contribute to tear production.