Therapies

Dry Eye Therapy

Dry eye treatment begins with a thorough assessment with an optometrist or eye care professional. Once the specific nature of your dry eye condition is assessed, treatment usually falls into several key categories:

  • Artificial Tears (or Eyedrops)
  • Eyelid Hygiene
  • Ocular Vitamins
  • Immunologic Therapy
  • Heat and Light Eyelid Treatment
  • Punctal Plugs and Scleral Lenses

Artificial Tears (Lubricating Eyedrops)

 

The sheer number of eye drops available to patients is often overwhelming. We have done the research and selected several types and brands of drops that are friendly to the surface of the eye, and at the same time provide symptomatic relief and support to the ocular tissues and health. Eye drops vary in the type of lubricating agent they contain, how thick or viscous they are and their use of preservatives. Hyaluronic Acid (HA) naturally exists in our tear film and many of our products contain this important modulator: hyaluronan contributes significantly to cell proliferation and migration. Here is a list of the manufacturers we carry:

THEA LABORATORIES, CANDORVISION, IMED PHARMA, and PHYSICIAN RECOMMENDED NEUTRACEUTICALS.

Eyelid Hygiene

 

The eyelids play a crucial role in keeping the eyes moist and comfortable. It is here that the meibomian glands produce oil that coats the surface of the eye. If there is debris along the eyelashes and the margin of the eyelid, this can impede the eyes natural oil production. Keeping this area clean goes a long way to keeping your eyes moist and comfortable. Using heat or light therapies over several sessions in time can stimulate gland secretion and oil liquefaction, resulting in more stable, moisturizing tears.

Eyelid dermoexfoliation, also known as an Distal-Ciliary Cleansing System, to remove bacteria, crust and debris from the ends of the eyelashes and lid margins, thereby clearing the meibomian glands to enable increased oil secretions.  Dysfuntion of the Meibomian glands is the leading cause of dry eye. One such device that performs dermoexfoliation and cleansing of the lid margins is the AB Max™ or Blephex devices.  The former is a patented hand-held instrument that utilizes a spinning micro-sponge to clean the eyelid which can increase meibum oil secretions onto the top layer of the tear film. This can increase tear film breakup time (TFBUT) which promotes overall eye comfort due to more stable tears. 

Ocular Vitamins

Diet and nutritional supplements can affect the long term health of the eye, vision,comfort and appearance of ocular structures. When choosing a supplement, looking at the listed ingredients first is vital to getting a quality product.  All things are not created equal in this space. One must note that the supplements market is not regulated with trial outcomes and strict marketing rules like the pharmaceutical industry. Meaning, buyer beware when it comes to supplements.

Dry Eye syndrome can be a result of Meibomian Gland Dysfunction. When there is an imbalance in the ratio of healthy fats, Omega-3s and Omega-6s, the meibomian gland can become inflamed as the composition of meibum oil becomes more viscous. This thickening can result in a blocking of the meibomian glands and potentially prevent the production of the important tear film lipid layer. Without the lipid layer, the aqueous layer evaporates, causing the ocular surface to become irritated. To improve dry eye symptoms, the meibomian gland’s oils must be normalized.

STUDY:  PENETRATION OF rTG OMEGA-3 INTO THE MEIBOMIAN GLANDS AFTER ORAL ADMINISTRATION: 220 patients received a daily dose of PRN Dry Eye Omega Benefits® (1680 mg EPA, 560 mg DHA, and 1000 mg Vitamin D3) for 60 days. Patients completed ocular surface disease index survey, received slit-lamp examinations, and were tested for tear breakup time, corneal staining and tear osmolarity at baseline, 4 weeks, and 8 weeks. Compliance was monitored measuring EPA/DHA and DHA RBC saturation using an Omega-3 index, and meibomian gland secretion samples were collected at baseline and 8 weeks. 

THE RESULTS: Dry Eye Omega Benefits® showed positive clinical outcomes in 4-8 weeks.*EPA, DHA, & Omega-3 Index RBC levels increased significantly with Dry Eye Omega Benefits while arachidonic acid (omega-6) decreased significantly. Improvement in tear breakup time was statistically significant. All patients with corneal staining at baseline significantly improved and patients with hyperosmolarity (>308mOsm/ ) at baseline improved 25% after 4 weeks. Additional analysis of the meibum showed a decrease in arachidonic acid and and an increase in DHA at 8 weeks. Tear osmolarity decreased an average of 17% after 8 weeks of dosage.

Immunological Therapy

Pharmaceutical agents that act as inflammatory mediators and auto-secretagoues can be used in cases of moderate to severe inflammation that is present in some cases of dry eye disease.  It is important to reduce or extinguish the inflammation to alleviate the symptoms and end the cycle of dry eye in these cases. These drugs act to suppress the eye’s natural immune response, which actually harms the ocular tissues, causing redness, blood vessel growth and irritation. theses agents are applied topically and can actually help increase tear production. In some cases, they are pharmacologically manufactured from extracts of the patient’s own blood plasma. Two of the drugs in this class are Restasis and Xiidra; both are taken twice daily and require a prescription.

Heat and Light Eyelid Treatments

 

The eyelids play a crucial role in keeping the eyes moist and comfortable. It is here that the meibomian glands produce oil that coats the surface of the eye. If there is debris along the eyelashes and the margin of the eyelid, this can impede the eyes natural oil production. Keeping this area clean goes a long way to keeping your eyes moist and comfortable.

A LONG-LASTING SOLUTION FOR DRY EYE DISEASE USING PATENTED IRPL® TECHNOLOGY

E>Eye is the first medical device in the world using IRPL (Intense Regulated Pulsed Light) technology that has been specifically designed for the treatment of dry eyes due to meibomian gland dysfunction (MGD).

Meibomian gland dysfunction has been identified as a principle cause of dry eye disease. It results in the tear film becoming unstable, leading to an insufficient production, or an excessive evaporation of tears. It is now acknowledged that most cases of evaporative dry eye are primarily due to a compromised external lipid layer of the lacrimal film, caused by malfunctioning meibomian glands. Clinical studies show a considerable improvement in the symptoms perceived by patients, with a 90% satisfaction rate after the first 2 treatments. Treatment sessions are quick, safe, effective, and painless. 

How IRPL® Technology Works

E>Eye is a dry eye treatment that generates a new polychromatic pulsed light by producing perfectly calibrated and homogenously sequenced light pulses. The sculpted pulses are delivered under the shape of regulated train pulses.  The energy, spectrum and time period are precisely set to stimulate the meibomian glands to improve their function.

Easy to Use, Fast and with no risk for errors.

  • A treatment session can begin within a few seconds, and takes only 3 minutes to perform.
  • No pre-heating is required

Punctal Plugs and Scleral Lenses

Punctal Plugs, also known as punctal occluders or lacrimal plugs, are tiny bio-compatible devices that are inserted into the tear duct to block drainage. By blocking the tear duct, tears are prevented from draining away. This ultimately increases the volume of tears persisting on the ocular surface and therefore moisture to relieve dry eyes. This procedure is widely-performed, safe, quick, painless, and totally reversible.

They are available in permanent, semi-permanent and temporary options and come in a variety of materials and sizes.

In treating dry eye with punctal occlusion, there is often a measured improvement achieved in tear breakup time (TBUT), reduced corneal staining and improved visual acuity due to increased tear stability. Punctal occlusion has been reported to be very effective for the treatment of dry eye in relieving symptoms, while enabling patients to reduce their dependency on lubricants.

Punctal occlusion with most types of plugs have a high safety profile, with epiphora (tearing), conjunctival irritation and extrusion typically being the only complications.  They are also very cost-effective and reversible.

We also want to mention here the use of Scleral lenses in the treatment of dry eye. These lenses are larger than the diameter of the cornea, and sit on a cushion of tears along the limbal-conjunctival junction.  These lenses, when properly fitted, can benefit dry eye patients immensely as the lenses help bathe the eye in tears, provide excellent visual acuity and helps protect the ocular surface from the elements.   


What Causes Dry Eye?

Dry Eye Intensity Survey

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