Dry Eye Disease

With state-of-the-art technology, we are able to do more than ever before to help manage and treat dry eyes. If you or someone you know suffers from dry eye disease, give us a call today. Our hour-long focused dry eye evaluations can tell you more about your condition than you may have ever thought possible. Don’t let dry eye disease hold you back. Our doctors use recent innovations and state-of-the-art technology to help go beyond just treating your symptoms.

Dry eye disease affects over 3 million people in Canada.

Symptoms include burning, watery, gritty eyes and fluctuating vision. Dry eye can develop from a deficiency in the watery (aqueous) layer of the tears and/or the oily layer.

Deficiencies in the aqueous layer are caused by a reduced ability of the lacrimal glands to produce tears. Many diseases such as autoimmune disease, arthritis and Sjogren’s syndrome can cause this disorder, as well as certain medications and aging.

Even though many patients have aqueous deficiency, 86% of dry eye is cause by a deficiency of the oily layer of the tears. This oil layer is produced by glands in the eyelid called meibomian glands. Every time you blink, a small amount of oil is expelled from the glands into the tears. This oil layer is an extremely important component of the tears, because without it, the tears will constantly evaporate, causing a never-ending cycle of irritated and even watery eyes.

Over time, the meibomian glands can become blocked, resulting in a condition called Meibomian Gland Dysfunction or MGD. The condition is chronic and progressive, resulting in a decline in oil production. Without treatment, the glands can shrink and even disappear entirely, leaving the patient miserable with limited treatment options.

Rosacea is a Major Contributor to Meibomian Gland Dysfunction (MGD) and Dry Eye Disease

One of the major risk factors of MGD and Dry Eye Disease is skin rosacea. Several mechanisms of action have been proposed to explain the relationship between Rosacea and MGD. First, in Rosacea, abnormal blood vessels (telangiectasia) release pro-inflammatory mediators, which can easily propagate to the eyelids via the orbital vasculature. Second, demodex thrive on skin affected with Rosacea. These parasites play a major role in causing eyelid inflammation.

In addition, demodex mites are infested with bacteria, especially Bacillus olerinus. Proliferation of this bacterium not only contributes directly to inflammation, but also increases the melting temperature of the meibum, thus causing thickened meibum to block the meibomian glands. Thickened secretions and blocked glands, or MGD, result in inadequate lipid contribution to the tears, causing tear film instability and a further increase in inflammation of the ocular surface.

How is Dry Eye Disease Diagnosed?

If you have dry eye symptoms, we encourage you to book a comprehensive Dry Eye Assessment at our office.

During a dry eye evaluation our doctors will take the time needed to fully investigate all underlying issues. A typical assessment takes about an hour. With access to a diverse and comprehensive range of treatment options, your doctor will develop a customized treatment plan that can treat more than just your symptoms. We know that treating the actual cause of your of dry eye disease will have a dramatic effect on how your eyes feel, how they look and can even have a big impact on the quality of your life. 

These include assessments of both aqueous and oil production, tear chemistry, presence of inflammation, blink assessment, gland structure, lid anatomy and a thorough assessment of all of the external eye structures. In addition to aqueous and oil deficiencies, we also look for bacterial, parasitic and inflammatory causes of dry eye. 

How is Dry Eye Disease Treated?

Once a definitive diagnosis of your dry eye is determined, a customized treatment plan is developed. Although there may be many treatments for dry
eye, the ultimate goal is to help you produce more of your own tears, rather than relying on artificial tears that only treat the symptoms and do not prevent progression of the disease.

Artificial tears are perhaps the most well known of all dry eye treatments and while they help soothe the eyes, the relief is temporary and they do not address the root cause of dry eye disease. Your customized dry eye treatment plan may include artificial tears and ointments in addition to nutritional supplements, lid hygiene methods, blink exercises, allergy management, neuropathic pain management, meibomian gland rehabilitation with the Lipiflow instrument, as well as IPL treatment with Optima IPL (Intense Pulsed Light).

Treating Dry Eye with IPL (Intense Pulsed Light)

Treatment involves the application of IPL pulses on the cheeks, nose (from tragus to tragus), and below the lower eyelids, usually administered in two passes. IPL settings depend on skin type. The schedule of treatments consists of 3 to 4 sessions, 2 to 4 weeks apart. Usually a single maintenance treatment is required after 6 to 12 months.

Patients may feel a mild snapping sensation during therapy, but treatment with Optima IPL continuously cooled handpiece is designed for enhanced comfort. Patients can resume everyday activities with minimal downtime. Signs and symptoms of inflammation may begin to improve after 1 to 2 treatments and steadily improve through the full course of therapy.

Treating MGD with Lipiflow

Another effective treatment for MGD is Lipiflow. This instrument unblocks the meibomian glands by using heat to soften the hardened oil in the glands and then gentle pulsation to expel the oil completely from the glands. The meibomian glands will then rehabilitate and start producing oil on their own again. It takes about one to three months (or more) for the glands to reach full function.

Contact us for a dry eye disease assessment

Please call our office at 902-835-2020 for an appointment.

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