There is no quick fix to dry eye disease. It is a chronic, multi-faceted condition that does not disappear after only a few visits; it requires ongoing care and daily management. During your initial evaluation at Jenkins Eye Care, Dr. Chang will measure your tear production, tear osmolarity, and tear film stability and evaluate the health of your meibomian glands. Dr. Chang will create a specialized treatment plan to improve your symptoms and increase your quality of life.
Aqueous Deficient Dry Eye Disease
In aqueous-deficient dry eye disease, the lacrimal glands do not produce enough tears. There are several treatment options to help you feel better.
Medicated eye drops
- Restasis and Cequa stimulate the lacrimal glands to produce more tears.
- Xiidra decreases inflammation.
- Punctal plugs are tiny devices that are placed in the eye’s tear ducts (called puncta). Puncta are the tiny openings that drain tears from your eyes. About the size of a grain of rice, the plug stops fluid from draining from the eye. This helps keep the eye’s surface moist and comfortable, relieving itchy, burning and red eyes.
Amniotic eye drops
- Containing nutrients and anti-inflammatory properties, amniotic extract eye drops have proven to help alleviate advanced dry eye symptoms in many people. Amniotic extract eye drops typically contain pluripotent stem cells, organized collagen, anti-fibrotic and anti-inflammatory cytokines, immune-modulators, growth factors, and matrix proteins.
- Amniotic membranes are made of collagen and growth factors and have been used in the eye care industry for a long time to help promote healing, especially after corneal injuries. They have also been shown to promote healthy tears, which combats dry eye symptoms thanks to their anti-inflammatory and anti-scarring effects.
Meibomian Gland Dysfunction
Meibomian glands secrete oils that stabilize the tear film to keep the surface of the eye moist and comfortable. However, in patients with meibomian gland dysfunction, the quality or quantity of oil released is inadequate, leading to tears that break up too quickly.
Rosacea is a common skin condition that causes blushing or flushing and visible blood vessels in your face. Rosacea can profoundly impact on meibomian gland morphology and function. As many as 80% of patients with rosacea manifest some degree of MGD In rosacea, abnormal blood vessels (telangiectasia) release pro-inflammatory agents and matrix metalloproteinases, thus contributing to a chronic state of inflammation that threatens the eyelids and ocular surface.
TearCare is a revolutionary dry eye treatment that works to unblock clogged meibomian glands during a single comfortable session. Patients simply relax in our office while wearing the TearCare device, which allows them to keep their eyes open and blink naturally as therapeutic heat is constantly applied to the meibomian glands. After 15 minutes with the TearCare device, Dr. Chang will apply pressure to the eyelids to clear away blockages. Clinical research shows that the TearCare device provides more relief than weeks or months of warm compresses.
- OptiLight intense pulsed light (IPL) is applied to the areas around the eye to target glands that may be blocked. The light is emitted onto the skin’s surface and penetrates below to the eyelid glands, breaking up gland blockages and promoting healthy oil flow to the eyes. It also eliminates the blood vessels that contribute to inflammation. IPL has been shown to reduce pain and discomfort, reduce dry eye inflammation, and enhance the tear quality.
- OptiLight can also be used for treating chalazia (styes) and Demodex (parasitic skin mites that live in or around the eyelashes).
Blepharitis is inflammation of the eyelids caused by an overabundance of bacteria at the base of the eyelashes and at the lid margin. Oil glands at the lid margin can become overactive, producing scaly flakes. This overgrowth produces a film that traps debris along the eyelashes and harbors bacterial exotoxins along the eyelids, causing inflammation. Left untreated, this condition can lead to significant damage to the eyelids and meibomian glands. Patients with blepharitis often experience grittiness, foreign body sensation, burning, irritation, and redness.
The key to treating blepharitis is keeping the eyelid margins and the eyelashes clean. Due to the chronic and persistent nature of blepharitis, lid hygiene is essential. In moderate to severe cases, an antibiotic ointment may be prescribed, and a blepharoexfoliation procedure called BlephEx may be recommended.
BlephEx is a painless in-office procedure that removes excess bacteria, biofilm, and bacterial toxins with a hand-held device. A microsponge rotates quickly along the edge of the eyelid margin to loosen and remove irritants. Relief is instantaneous.