Dry eye is often a chronic condition affecting about 1/3 of Australian adult population in which half is over the age of 50. It is more prevalent in females. Tear film covers the outside surface of the eye to keep it moist. Natural tear film constitutes of 3 unique layers with different but equally important functions.
Mucin layer: This is the most inner layer of the tear film which is almost like sea weed that helps the tear film spread all around the ocular surface
Aqueous layer: This is the middle and the thickest layer of the tear film. This is the water produced by the lacrimal gland
Oil layer: This is the outer most layer of the tear film which help prevent evaporation of the water
Quite simply dry eye results when there is not enough tears being secreted by the lacrimal gland and/or if the tears evaporate too quickly.
Causes of dry eye can be environmental, age related, ocular allergy, lifestyle related, medications and systemic disease related. Meibomian gland dysfunction (MGD) the leading cause of dry eye where the glands don’t secrete enough oil due to blockage and/or deficiency. Depending on the severity dry eye symptoms can include intermittent to severe visual disturbances, irritation, foreign body sensation, redness, sleep disturbances, stye formation, eye burning, eye watering, light sensitivity and depression.
Dry eye cannot be completely cured but proper treatment can control symptoms effectively. Early diagnosis and treatment is the key in preventing disease progression. Our optometrists specialises in understanding and diagnosing the cause of the condition which ultimately is the key to formulating a customised treatment plan for best outcomes.
There are many treatments that is proven to show success in combating dry eye.
This is very commonly used in aqueous dry eye treatments where lack of tears is being supplemented by frequent addition of artificial tears. However it is very important to follow prescribing doctor’s instructions in using tear supplements as different supplements will yield different outcomes.
We do not blink enough and/or effectively when using digital screens like smart phones and tablets. Far too often this can lead to dry eye and poor visual outcomes. We need to blink more in order for lacrimal gland to get a stimulus to produce more tears. Blinking can be trained to be more effective in certain scenarios.
This is when a warm moisturised mask is placed on top of eyes for few minutes. This will open up the Meibomian gland pores on the lids and softens the oil for easy expression. Our optometrists can teach you to do this at home while there is also commercially produced steaming devices available at our clinic for more effective treatment. Couple of minutes of using these steaming devices can elevate symptoms.
Blepharitis is a condition of eyelid margin inflammation due to Meibomian gland blockage. This can cause mild to severe irritation of eyes. Optometrists can manually express blocked glands to elevate symptoms. We also may use other devices and products to clean the eyelid margin as needed.
Studies have shown Omega 3 fatty acid rich oral supplements are able to naturally boost tear production. We have Lacritec which is available at our practice that have proven to consistently show sustainable results in boosting natural tear production. Lacritec is made in Australia on the recommendation of the AREDS 2 study conducted.
The role of wraparound sunglasses is often under rated in dry eye control. But often a good pair of polarised sun glasses can protect our eyes against sun’s harmful UV rays while reducing tear film evaporation from the eye surface. We have access to high quality sunglasses at the practice.
Our optometrists can also artificially block punctums which are channels in our eyes that drain tears. In aqueous deficiency dry eye when punctums are effectively blocked, then the volume of naturally occurring tears are able to be retained at the surface of the eyes for a longer duration. Punctal plugs can also reduce the frequency of use of artificial tear drops.
Optometrists are also able to prescribe specific ocular medications which are able to control ocular inflammation that can result due to prolonged severe dry eye.
This is a mode of treatment with very promising results in reducing eyelid inflammation due to MGD dysfunction. We use the Lumenis M22 IPL for MGD treatment. Please consult our practice to see if you would benefit from the revolutionary treatment for dry eyes.
The above is just a short summary of dry eye and some of the effective treatments available. Talk to our optometrists about your specific dry eye.