Dry Eye is a chronic disease affecting more than 100 million people. Without proper treatment, it can continue to worsen over time.
Dry Eye Symptoms
If you experience any of these symptoms, you may benefit from a Dry Eye Evaluation at our office.
- Discomfort and irritation
- Grittiness or feeling of a foreign body in the eye
- Burning or stinging sensation
- Vision Disturbance
- Sensitivity to light
The Tear Film
Tears are made up of three layers: the lipid (oil) layer, the aqueous (water) layer and the mucin layer. The lipid layer prevents tear evaporation while the aqueous layer provides the moisture and nourishment to the eye.
Click on photo below to enlarge.
There are two main forms of dry eye: evaporative and aqueous deficient.
Types of Dry Eye
Aqueous Deficient Dry Eye & Evaporative Dry Eye
Aqueous deficient dry eye occurs when the lacrimal gland, which produces the watery portion of the tears, does not produce enough aqueous to keep the eye comfortable and moist. Treatment for this type of dry eye consists of using artificial tears to replace the moisture, punctual plugs to stop the tears from draining quite so fast and keep more tears on the eye for a longer period of time, or cyclosporine ophthalmic emulsion 0.05% drops (Restasis) which is a prescription eye drop that can increase tear production in some cases.
Evaporative dry eye occurs when the lipid layer of the tears is deficient. It is estimated that 86% of all dry eye patients have evaporative dry eye. This form of dry eye is caused by meibomian gland dysfunction or blockages in the meibomian glands that are located in the upper and lower eyelids. There are approximately 75 of these glands in the lids of each eye and they create the oil layer that prevents the tears from evaporating too quickly. Tears can evaporate from 4 to 16 times faster with a deficient lipid layer. The lipid produced by a normal functioning meibomian gland has the consistency of olive oil and flows freely. With meibomian gland dysfunction, this oil can have the consistency of toothpaste and can be trapped in the glands. With chronic disease, the structure of the glands can be affected either by shortening in length or by completely shutting down. This damage is irreversible and can cause worsening of symptoms.
The Dry Eye Evaluation
The first step is to have a dry eye evaluation to determine which type of dry eye is present.
You will be asked to fill out a Dry Eye lifestyle questionnaire: This brief assessment allows us to understand how your eyes feel on a daily basis. Feel free to print out our online copy, complete the questionnaire, and bring it to your dry eye evaluation appointment.
The Lipiview device was able to measure the lipid layer of the tear film to see if it is deficient. But now we can also view detailed images of the meibomian gland structure by DMI (Dynamic Meibomian Imaging) with the NEW Lipiview II. These dramatic images of the glands can show if the structure is healthy or if the glands are showing degenerative changes such as blockages, atrophy or thickening. And this imaging can be easily repeated over time to monitor the glands for changes making it easier to see the progression of this disease. The type of oil the glands produce is determined and the water component of the tears is measured. This will help to determine the specific treatment plan for each individual patient and their symptoms. If it is determined that you have evaporative dry eye, the LipiFlow treatment may be an option for you. Click on photo to enlarge.
View of normal meibomian glands with new Lipiview II
View of truncated meibomian glands with new Lipiview II
Note for Dry Eye Evaluation: It is very important that no drops, oil based facial makeup or sunscreens are used the day of the evaluation. Do not use any ointment in the eyes for at least 24 hours prior to the appointment. Do not swim for one day prior to the visit. These types of products can affect the findings of the testing and render it useless. Feel free to speak with the dry eye counselor if you have any questions.
Visit the LipiFlow website to learn more about LipiView.
Geneva Eye Clinic is proud to be one of the few clinics in the Chicagoland area to have this breakthrough technological advance in dry eye treatment available for our patients. Now we can do more than just treat the symptoms, we can treat the cause.
The Lipiflow System is a groundbreaking treatment that addresses the cause of evaporative dry eye. This twelve minute in-office procedure applies a combination of direct heat and massage to the eyelids. This liquefies the oil in the meibomian glands and gently expresses the oil out of the glands. Opening the blocked glands can allow your body to resume its natural production of normal tear film oil. While some patients report feeling relief soon after the procedure, it can take up to three or four months to see the maximum results. Recent studies have shown that approximately 70% of patients have not needed a re-treatment after three years. Although Lipiflow is not a cure for evaporative dry eye, it is a very important treatment aimed at preventing deterioration of the meibomian glands caused by chronic disease. Patients should become less dependent on their current dry eye therapies, be able to wear their contact lenses longer and generally be more comfortable with fewer symptoms. Click on photos below to enlarge.
Visit the LipiFlow website to learn more about LipiFlow. www.lipiflow.com/dryeye/
Dry Eye Products
Geneva Eye Clinic is pleased to carry several high quality dry eye products available only in physicians’ offices. Please visit our optical shop to purchase any of these products.
Retaine MGD Eye Drops
Retaine MGD has the highest oil contact available in an artificial tear with the added benefit of no preservatives. They provide long lasting relief for moderate to severe evaporative dry eye. They are available in a box of 30 individual preservative free vials. Click on photo to enlarge.
Retaine CMC restores moisture with the same healthy quality as natural tears and is preservative-free. These drops provide relief for aqueous deficient dry eye and are available in a box of 30 individual preservative free vials. Click on photo to enlarge.
Tears Again is a mineral oil based lubricating ointment for night-time use only since it may blur the vision. It is available in a 3.5gm tube. Click on photo to enlarge.
Ocusoft Plus Foam is an extra strength eyelid cleanser utilizing a low-level preservative and moisturizer blend offering a wide range of antibacterial properties. It is ideal for moderate to severe eyelid conditions such as meibomian gland dysfunction. This leave on formula comes in a 50ml bottle and will last approximately three months. Click on photo to enlarge.
These goggles are used for warm compress therapy. This treatment gets warmer and retains more heat longer than traditional warm compress therapy meaning a more effective treatment. Made from glycerin, the beads heat up in hot water. Use a microwave or other source to heat water, let them sit for a minute, remove and insert into Tranquileyes™ goggle and wear. Enjoy 15-18 minute warm compresses with ease. Click on photo to enlarge.
Each set includes one pair of Tranquileyes™ XR goggle, one set of NEW Thermoeyes™ XR Microwavable Beads™, one set of fabric pockets and a net wash / dry bag. The beads can be used approximately 60 times and replacement beads are available. Click on photo to enlarge.
4 Thermoeyes™ Microwaveable Beads™ included in replacement pack.