Posted by: Carolinas Center for Sight in Dry Eye Treatment

According to the National Institute of Health, dry eye affects close to five million Americans over the age of 50 as well as many younger patients.  Are you one of them?  Here are some of the symptoms:  watering, burning, foreign body sensation, and intermittent blurred vision to name a few.  If you are reading this article and you are over the age of 50, there is a significant chance that you are experiencing some or all of these symptoms.  Unfortunately, most non-eye specialists are not equipped to fully diagnose and treat the cause of this serious problem. The reality is that dry eye syndrome is so prevalent that it accounts for about four billion dollars of national healthcare spending each year.  Moreover, a large quality of life survey conducted in 2011 found that having dry eyes impacts us as much as cardiac chest pain.  At first glance, that seems surprising, but if we stop and think about the number of activities that require visual focus (reading, watching television, cooking, knitting, fishing, hunting, etc.), maybe it’s not that shocking after all. 

Why is Dry Eye Sometimes so Difficult to Treat? 

For being a simple two-word phrase, “dry eye” is actually an extraordinarily complex topic.  Finding the root cause of dry eye is not always easy. We know that many factors play a role: systemic medications, autoimmune diseases, hormone imbalances, and advanced age are at the tip of the iceberg.  Even in situations where certain contributing factors are more obvious, finding an effective and lasting therapy is still a challenge for many patients. Eye care providers have battled dry eyes for decades.  You are probably familiar with the use of artificial tears and lubricating ointments.  Other approaches to dry eye include tear preservation with punctal plugs or treatment of ocular surface inflammation with topical medications such as Restasis or prednisolone.  While these treatments prove to be enough for some people, there is a growing population of patients with dry eye that is resistant to traditional therapies.  Fortunately for these patients, dry eye research and treatment has matured quite a bit over the past several years. 

Tear Film Quality and Newer Approaches to Dry Eye Therapy

In order to have a proper clinical approach to treating this condition, we must first understand what it means to have dry eye.  Dry eye can be classified into two groups:

1) Poor quantity or

2) Poor quality. The tear film is composed of oil and water, and the quality of our tears has more to do with the oil in our tear film.  

Oil is produced by 50 to 60 structures called Meibomian glands that line the edges of our eyelids.  The oil functions not only to smoothen the tear film but also to prevent tears from evaporating in between blinks. Over time, some degree of clogging of the Meibomian glands seems to be a normal process, and this is termed Meibomian gland dysfunction or MGD.  However, in many patients this happens too early and/or too much.  Clogging of glands is reversible in its early stages, but if ignored, it leads to secondary inflammation and ultimately to gland death.  Historically, the treatment of MGD has been hot eyelid compresses a few times a day to help free the oil glands.   

Unfortunately it is difficult to get enough heat to the internal parts of the eyelid by placing the hot compresses externally. So how can we treat poor quality tear film?  Two procedures have emerged in the past several years that help boost and augment the oil in our tear film: Lipiflow and BlephEx. 

Lipiflow uses a thermal pulsation system to actively express oil from clogged glands.  BlephEx uses a surgical grade microsponge to treat inflammation of the eyelid margin that would otherwise lead to breakdown of the oil layer in the tear film.  

Both treatments have demonstrated tremendous success for patients who have failed traditional therapies.  Both are also in office procedures that can be done in many instances on the same day as the in-office visit.  

To learn more about dry eyes and available therapies, contact Carolinas Centers for Sight, P.C. to schedule a consultation 843-664-9393.