Eye Conditions & Treatment:  

What is Dry Eye Syndrome?

Today there are more alternatives available to help treat this very common condition, which occurs because the eye is not receiving enough moisture. We offer the latest treatments to bring you the most comfort.

The name “dry eye” can be a little confusing since one of the most common symptoms is excessive watering! It makes more sense, though, when you learn that the eye makes two different types of tears.

The first type, called lubricating tears, is produced slowly and steadily throughout the day. Lubricating tears contain a precise balance of mucous, water, oil, nutrient proteins, and antibodies that nourish and protect the front surface of the eye.

The second type of tear, called a reflex tear, does not have much lubricating value. Reflex tears serve as a kind of emergency response to flood the eye when it is suddenly irritated or injured. Reflex tears might occur when you get something in your eye, when you’re cutting onions, when you’re around smoke, or when you accidentally scratch your eye. The reflex tears gush out in such large quantities that the tear drainage system can’t handle them all and they spill out onto your cheek. Still another cause of reflex tearing is irritation of the eye from lack of lubricating tears. If your eye is not producing enough lubricating tears, you have dry eye.

Symptoms of Dry Eye:

• Watery eyes
• The feeling that there’s sand in your eyes
• Eyes that itch and burn
• Vision that becomes blurred after periods of reading, watching TV, or using a computer
• Red, irritated eyes that produce a mucus discharge

What Causes Dry Eye:

• Age: As we get older, glands in the eyelid produce less oil. Oil keeps tears from evaporating off the eye. Decreased oil production allows tears to evaporate too quickly, leaving the eye too dry.
• Diseases including diabetes, Sjogren’s and Parkinson’s
• Hormonal changes, especially after menopause
• Prescription medications: These include some high blood pressure medications, antihistamines, diuretics, antidepressants, anti-anxiety pills, sleeping pills and pain medications. Over-the-counter medications including some cold and allergy products, motion sickness remedies, and sleep aids can also cause dry eye.
• Hot dry or windy conditions: High altitude, air-conditioning and smoke can also cause dry eye.
• Reading, using a computer or watching TV
• Contact lenses
• Eye surgery: Some types of eye surgery, including LAHayeSIK™ can aggravate dry eye.
• Inflammation: Recent research suggests that dry eye may be caused by inflammation due to an imbalance of “good” fats and “bad” fats.

Diagnosing Dry Eye:

Your eye doctor can check for dry eye by examining your eyes with magnifying instruments, measuring your rate of tear production and checking the amount of time it takes for tears to evaporate between blinks.

The doctor can also check for pinpoint scratches on the front surface of the eye caused by dryness using special, colored eye drops call fluorescein or Rose Bengal.

Treatment for Dry Eye: MeiboTherapy™

MeiboTherapy™ is a novel multifaceted approach to treating Dry Eye Syndrome (DES) or properly called Dysfunctional Tear Syndrome (DTS). 

Persons affected with DTS commonly suffer with symptoms including burning, itching, tearing, foreign body sensation, light sensitivity, blurred vision, and tired, dry, and red eyes. Mild DTS has been estimated to affect up to 20% of the United States population, and moderate DTS affects 15% of those aged >65 years. Moderate-to-severe DTS is more common in women than men aged >50.

There are two types of DTS; with and without lid margin disease.  Blepharitis is a type of DTS with lid margin disease. Blepharitis refers to inflammation of the glands and lash follicles along the margin of the eyelids, hence the use of “lid margin disease” to describe the condition. 

Not to get to confusing but lid margin disease can be further divided into anterior and posterior disease. Anterior blepharitis can be either infectious or seborrheic, whereas posterior blepharitis affects the meibomian glands, which play a critical role in tear film integrity. Anterior and posterior Blepharitis together account for the majority of problems associated with DES. 

DTS is a chronic multifactorial condition which must be well understood by those affected to prevent frustration after a long treatment period. When lid margin disease is treated, the dry eye symptoms improve dramatically; when only the ocular surface is treated the condition can actually worsen. To confuse things further excessive teary watery eyes can be the result of DES.

To understand DTS one needs to understand what constitutes tears. Three layers comprise the tear film: a thin surface lipid layer (0.1–0.2 µm) produced by the meibomian glands, a thick middle aqueous layer (7–8 µm) produced by the lacrimal glands, and an inner mucus layer (1 µm) associated with the corneal epithelial cells and produced by goblet cells in the cornea and conjunctiva.  Even minimal disruption of the tear film on the ocular surface can severely degrade visual acuity but more importantly cause all of those aggravating symptoms!

Meibomian glands, which are found in the lids and have orifices at the lid margins, secrete the lipid species in the outer lipid layer. The lipid layer reduces evaporation of the aqueous component of tears to 5% to 10% of the tear flow and is a viscosity-increasing agent that provides lubrication during the blink cycle when the secretions are released. Obstruction of meibomian gland ducts or disease/infections of the actual gland reduces the amount of lipid secreted, which can result in increased evaporation of the aqueous component. With a poor or inadequate lipid layer the breakdown of tears occurs losing the protective ability to keep the surfaces of the eye moist and healthy thereby causing symptoms of DTS.

Most therapy for dry eye may include some or all of the following; a long list of tear substitutes, hyperthermia and massage, topical antibiotics and steroids, oral tetracycline (doxycycline 20 mg twice daily for 4 weeks and perhaps 20 to 40 mg a day for a few months in highly symptomatic patients) especially when rosacea is present, nutritional supplementation of flaxseed oil, topical cyclosporine A, and topical azithromycin. 

The difficulty and problems with these treatments is that they are not very effective at targeting and getting to the bottom of the meibomian glands. The meibomian glands normally produce a lipid lubricant that floats and protects the aqueous and mucin layers slowing tear evaporation and providing soothing lubrication to eyes. There is really no manmade substitute for ones own meibomian gland lubrication. 

MeiboTherapy™ was developed and pioneered by Leon C. LaHaye, MD to specifically treat lid margin disease and rejuvenate healthy meibomian function. MeiboTherapy™ is effective for both types of DTS but more specifically when lid margin disease is involved will the best results be obtained.   

MeiboTherapy™ achieves results from a multifaceted approach including destroying the bacteria in the meibomian glands and lids, reducing the associated inflammation, lowering the viscosity of the lipid layer, and expressing and unplugging of the meibomian glands allowing for an improved production and secretion of a healthy lipid component of the tear film. This in turn promotes better natural lubrication and moisture available to the eye surface tissues reducing symptoms. 

Depending on the extent and severity of one’s DTS, MeiboTherapy™ initially involves several treatment sessions delivered over several months. 

MeiboTherapy™ is target specific, safe, and effective at treating the underlying causes of DTS with lid margin disease.

For more information or second opinion on your dry eye condition don’t hesitated to call us and schedule your evaluation.