Dry Eye Developments

New Advancements And Treatments Will Let You Ditch The Drops

by Samantha K. McPherson, OD, FAAO // October - November - December 2019

Do your eyes often feel tired, scratchy, or burn? Do they seem to water excessively? Does your vision seem to blur on a whim? If so, you may be one of the estimated 20.7 million people in the United States who suffer from chronic dry eye. Dry eye symptoms can be very frustrating, especially for those who have tried a variety of over-the-counter or prescription eye drops and are still suffering from the irritation and blurred vision caused by dry eye. While it is true that there is no cure for dry eye, there are many treatment options and diagnostic tools that people may not yet be familiar with.

Do you have dry eyes because you don’t have enough tears (aqueous deficient dry eye)? Or is it because of evaporative dry eye, meaning that you may have enough tears, but they are in poor condition, so they evaporate too quickly? Just like with most things in the world today, new technology has enabled doctors to diagnosis dry eye much more precisely. We can now differentiate between various types of dry eye and tailor your treatment plan accordingly. For instance, a special infrared camera can provide us with 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 eye’s surface. Your blink rate naturally drops when you use a computer or a digital device. Compound that with poor quality blinking and the oils in your eyelids can become thickened, causing the quality of your tears to degrade dramatically. This results in fluctuating vision and red, irritated eyes. Understanding the condition of the glands and the quality of your oil layer is critical when determining your dry eye treatment.

Eye drops have been the standard in dry eye management for years. For many people, switching from an over-the-counter eye drop to a prescription version that addresses the inflammation associated with dry eye is enough to get them feeling and seeing better. But for many others, more is needed to end their dry-eye suffering. Fortunately, today, there are options that treat dry eye in non-traditional ways.

One such way is LipiFlow – a revolutionary, quick, and painless procedure that eliminates any obstructions present in the oil producing gland. Simply clearing the glands of poor-quality oils helps them to function more effectively, providing significant relief to those who have been experiencing dry eye symptoms. This one time, in-office treatment takes less than 15 minutes, and there is no downtime afterwards, so you can get back to your daily routine in no time at all.

Another advancement is Intense Pulsed Light (IPL) treatment. IPL, a light-based technology that is commonly used in dermatology to treat rosacea and other skin inflammatory conditions, is increasing in popularity as a treatment for dry eye. 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 improves your overall skin appearance, your eyelid inflammation is reduced, and the function of your oil glands will subsequently improve. These procedures are effective, gentle, safe, and also have no downtime afterwards.

If you do not produce enough tears, tear duct plugs will help to keep your tears from leaving your eye too quickly. Tears leave the eye via the tear ducts – and by partially blocking them with either silicone or collagen plugs, your tears will stay on the surface of your eye for a longer period of time. Insertion of these plugs is a very straightforward, painless procedure that can be done quickly in-office.

Persistent defects in the cornea – the front surface of the eye – are common in those with dry eye. These imperfections cause chronic irritation, blurred vision, and are often very challenging to heal with eye drops alone. Fortunately, therapeutic tissues can be placed on the ocular surface, just like a bandage to cover a cut on the skin. These tissues contain natural, therapeutic healing factors that can promote quality healing and lessen inflammation in a very short period.

Autologous blood serum drops are eyedrops that are made from your own blood. Yes, you read that right, eyedrops made from blood! I know this treatment sounds a bit crazy, but your blood serum is full of nutrients and therapeutic factors that can help your eyes to heal. This is not a new treatment for dry eye; however, cost and the difficulties associated with getting the drops previously made this an unviable option for most people. Fortunately, though, both cost and access barriers have been lessened, thanks to new technologies – so the use of autologous blood serum drops for dry eye treatment is expected to increase.

Many people discontinue contact lens wear due to discomfort caused by dry eye. However, scleral lenses are a special type of contact lens that can provide excellent vision and help to provide comfort for those suffering from it. This is due to the unique way that they sit on the eye’s surface. Rather than draping directly on top of the front surface of the eye like a soft contact lens, the scleral lens only rests on the white part – and there is a buffer of saline between the contact lens and the front surface of the eye. It is as though your eyes are taking a “bath” in moisture while the contact lenses are in.

Last, but not least, take a holistic approach to dry eye – what is happening in your body can impact what is happening in your eyes. Conditions such as lupus, rheumatoid arthritis, and Sjogren’s Syndrome can all cause dry eye. If there is any suspicion that those conditions might be present, it is important to rule them out as potential causes. Also, many medications can cause dry eye, so if finding alternative treatments is an option, those shouldn’t be overlooked.

Normal body changes come with aging … however, you do not have to merely accept dry eye symptoms as a typical part of getting older (or contact lens wear). There are many new technologies, advancements, and options that can improve eye comfort. So if you are one of those 20.7 million dry eye sufferers I mentioned earlier, and have found that 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.