Ditch The Drops

What's New In Dry Eye Diagnosis And Treatments

by Samantha K. McPherson, OD, FAAO // July - August - September

Are you one of the estimated 20.7 million people in the United States who suffers from chronic dry eye? If the answer is yes, then you know all too well how frustrating it can be to deal with burning, itchy, and scratchy eyes. People with dry eye often feel that there is no hope because they have tried a variety of over-the-counter or prescription eye drops and are still suffering from the irritation and blurred vision caused by it. While it’s true that there is no cure, the field of dry eye is exploding and there are many new diagnostic tools and treatment options that are now available.

Is your dry eye aqueous deficient dry eye, meaning that you do not have enough tears? Or is your dry eye evaporative dry eye, meaning that you may have enough tears, but they are in poor condition so they evaporate too quickly? Or do you have dry eye symptoms, but actually have an entirely different condition? The precision of dry eye diagnosis has improved with new technology. We can now differentiate between various types of dry eye and tailor your treatment plan accordingly. A special infrared camera provides a wealth of information that was previously not visible during standard examination. We can now clearly see the structure of the small oil producing glands in your eyelids, measure the thickness of the oil layer in your tears, observe the stability of your tear film, and monitor how effectively you blink. Blinking is essential for activating the small oil producing glands in your eyelids and spreading those oils smoothly across the surface of your eye. When you use a computer or a digital device, your blink rate naturally drops. If you compound that with poor quality blinking, the oils in your eyelids can become thickened, causing the quality of your tears to degrade dramatically, resulting in fluctuating vision and red, irritated eyes. Knowing the condition of the oil producing glands and the quality of your oil layer is critical when developing the course of your dry eye treatment.

An instrument can tell us how concentrated your tears are by measuring a very small sample of them, right in the office. The more concentrated your tears, the more likely you are to have dry eye. If your tears have normal concentration levels but you have a lot of dry eye-like symptoms, then you may be dealing with a condition that mimics dry eye, but requires a completely different type of treatment. The most common examples of this would be ocular allergies or an irregular ocular surface.

Eye drops have been the mainstay of dry eye management for years. For many, switching from an over-the-counter eye drop to a prescription one that addresses the inflammation associated with dry eye is enough to get them feeling and seeing better. For many others, they need more. Fortunately, there are many new options that treat dry eye in non-traditional ways.

LipiFlow is a revolutionary procedure that eliminates any obstructions present in the oil producing glands in a very quick and painless way. Clearing the oil glands of poor quality oils helps them to function more effectively, bringing significant relief to those who have been suffering from dry eye symptoms. This is a one time, in-office treatment that takes less than 15 minutes. There is no downtime afterwards, so you can get back to your routine in no time at all.

Intense pulsed light (IPL) treatment is another treatment option increasing in popularity as a dry eye treatment. IPL is a light-based technology commonly used in dermatology to treat rosacea and other skin inflammatory conditions. During the procedure, a strategic level of light pulses is administered to penetrate the skin under the eye and targets the root cause of the inflammation. As the IPL treatment treats your overall skin appearance, your eyelid inflammation is reduced and the function of your oil glands will subsequently improve. IPL procedures are effective, gentle, and safe and also have no downtime following.

Persistent defects in the cornea – the front surface of the eye – are common in dry eye. They cause chronic irritation, blurred vision, and are oftentimes very challenging to heal with eye drops alone. Now we have therapeutic tissues that we can place on the ocular surface like a bandage. These tissues contain many natural, therapeutic healing factors that can promote quality healing and lessen inflammation in a very short period of time.

One of the newest innovations in dry eye treatments is a device that uses state-of-the-art technology – neurostimulation – to help your eyes temporarily make more of your tears. This is an ideal option for those who prefer a drug-free, drop-free treatment option. The device is portable (smaller than a cell phone) so you can create tears essentially on demand, anytime of day. Neurostimulation is a proven technology that uses tiny pulses of energy to stimulate the nerves that act on the tear glands to produce more of your own tears.

You do not have to merely accept dry eye symptoms as a normal part of aging or contact lens wear. Many new options are available to improve the comfort of your eyes. If dry eye treatments in the past have left you disappointed, don’t give up. Discuss your symptoms and concerns with your eye doctor, who will be your best resource for determining if you are a good candidate for any of these new treatment options.

Samantha K. McPherson, OD, FAAO

Founder of Dry Eye Center of NC, a subspecialty clinic of McPherson Family Eye Care.