DRY EYE DISEASE AND BLEPHARITIS

What is Dry Eye?

 

Dry Eye Syndrome can range from a mild irritant to chronic problem.

The symptoms of Dry Eye Syndrome may include:

  • Dry, irritated, or red eyes

  • Excessive tearing/watery eyes

  • Inflammation

  • Sore or sensitive eyes

  • Itchiness

  • Burning or inflammation

  • A gritty or pasty feeling in the eyelids

  • Crusty or gunky eyes

  • Blurriness

 

What Causes Dry Eye?

 

Dry eyes, or, Dry Eye Syndrome, is a complex condition that can have multiple causes but tends to share common symptoms. Our optometrist uses the latest technology to assess the cause of your dry eye symptoms, in order to provide the best possible care.

Poor Tear Quality

For tears to effectively moisturize and lubricate your eyes, they need to have right balance of:

  • Water

  • Lipids ―oils produced by the meibomian glands

  • Mucus

The water provides moisture and keeps the eyes clean while simultaneously delivering oxygen to the tissue of the eyes.

The lipids (oils) produced by the meibomian glands provide essential lubrication and control the rate at which the water of tears evaporates. The time it takes for the tear film to evaporate is referred to as the tear-film break-up time.

The mucus in tears helps to keep the tear-film evenly distributed and stable.  

When someone is suffering from Dry Eye Syndrome, one or more of these factors is off and your eyes suffer for it. In 85% of cases, Meibomian Gland Disorder is responsible for dry eye syndrome.

Meibomian Gland Disorder

Our eyes have glands which produce the lipids (fatty oils) essential for proper lubrication. These are referred to as the meibomian glands. The blockage or dysfunction of these glands causes a condition known as Meibomian Gland Disorder. This condition is responsible for roughly 85% of all instances of Dry Eye Syndrome.

Blepharitis

Blepharitis is related to Dry Eye Syndrome and is often a contributing cause or a parallel condition. It involves inflamed eyelids, particularly where the eyelashes grow. Blepharitis is usually caused by bacterial infections, Demodex or other skin problems resulting in similar symptoms to dry eye syndrome in general.

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Symptoms of Blepharitis

  • Inflamed Eyelids

  • Bacterial Infection

  • Red Eyes

Poor Tear Volume

A low supply of tears is a less common cause of Dry Eye Syndrome. This can be caused by a number of factors such as medication and certain health conditions, resulting in Dry eyes.

Age, Gender & Dry Eye

As we age, we experience hormonal changes. These changes are known to cause or contribute to dry eyes. While this is true of both men and women, it seems that women over 50 are particularly more prone to developing dry eye symptoms. Pregnancy is also known to contribute to or exacerbate dry eye syndrome.

Environmental Factors & Irritants

By increasing the rate at which our tears evaporate, the following environmental factors are known to play a huge role in causing or contributing to dry eyes:

  • Smoke

  • Pollution

  • Cold-climate and central heating

  • Dry climate

  • Sandy or dusty conditions

  • Altitude

 

Contact Lenses & Dry Eye

Poor cleaning habits, not changing the contact often enough, and sleeping in contact lenses can contribute to dry eyes. However, even for those who take proper care with their contacts, they can still be a contributing cause of dry eyes. In fact, one of the main reasons people discontinue contact lens usage is due to dry eyes. The good news is there have been major improvements across all the brands with special contacts that are aimed at preventing dry eye symptoms.

Medical Conditions

Various diseases contribute to, or even cause, dry eyes. Autoimmune diseases are a known factor. Rheumatoid arthritis and Sjogren’s syndrome – a common symptom that rheumatologists treat can also contribute to dry eyes. Diabetics or those with Glaucoma that requires medication are also more likely to have dry eye syndrome.

Lifestyle & Dry Eyes

As with everything, proper balanced diet and exercise are important in preventing or managing dry eye syndrome. There are two specific activities that relate directly to Dry Eyes.

Does Staring At A Screen Cause Dry Eye?

Continuous staring at a fixed object, such as a phone or computer screen, usually results in a decreased blink rate. The lack of blinking actually causes the eyes not to replenish the tears often enough. The meibomian glands, therefore, can become blocked or even atrophy and die.

Prolonged and continuous use of Digital Devices is thought to be the likely culprit in the significant increase of Dry Eye Syndrome throughout the general population.

Does Drinking More Water Help With Dry Eye?

The main component of tears is water. Most of us don’t drink enough water. If you are dehydrated or not drinking enough, then you may not produce enough tears to keep your eyes moist. Soft drinks and other caffeinated drinks like coffee and tea may feel like they quench your thirst, but they actually dehydrate the body. Your body needs water to prevent dry eyes symptoms.

Medications & Dry Eye

Whether prescription or over-the-counter, certain medications are known to decrease tear productions, or otherwise, contribute to Dry Eye Syndrome. These include:

  • Beta-blockers / blood pressure medications

  • Antihistamines

  • Decongestants

  • AntiDepressants

  • Oral Contraceptives

How Is Dry Eye Treated?

 

Artificial Tears

These are OTC tear supplements that add tears to your eyes for temporary relief. They are commonly administered 2-4 times a day to temporarly relief symptoms of dry eyes. They do not treat the underlying inflammatory disease.

 

Punctal Plugs (Occlusion)

Is an in office procedure to treat moderate to severe dry eye. Punctal plugs are small silicone or synthetic plugs that are inserted into the puncta (drainage area) to slow or even block the drainage of tears. The result is increased tear availability and moisture present in the eyes. These work very well for contact lens patients with dry eyes.

Warm Compresses and Lid Scrubs

Blepharitis and Meibomian gland deficiency contribute to dry eye symptoms. Good lid hygiene with daily lid scrubs and warm compresses with a bruder mask can relieve symptoms of dry eye.

 

Prescription Eye Drops and Nasal Sprays

RESTASIS® was developed specifically to treat a type of Chronic Dry Eye with decreased tear production due to inflammation. It can help increase the eyes’ natural tear production with time and consistent use. In a study, patients using RESTASIS® saw an increase in tear production at 6 months. Individual results may vary.

For more information visit: https://www.restasis.com/

 

Xiidra is a prescription eye drop approved by the FDA to treat the signs and symptoms of dry eye disease. It specifically targets the inflammation associated with dry eye.

For more information: https://www.xiidra.com/

 

Tyrvaya is a prescription nasal spray to help the signs and symptoms of Dry eye.

For more information:

https://www.tyrvaya.com/

 

BlephEx:

BlephEx® is a painless in-office procedure performed by your eyecare professional. A revolutionary new patented BlephEx® handpiece is used to very precisely spin a soft medical grade micro-sponge along the edge of your eyelids and lashes. This procedure effectively removes years of accumulated bacterial biofilm, much like a dental cleaning removes accumulated plaque, also a biofilm. Once the biofilm is removed, your eyelids are cleaner and healthier. A healthy eyelid is critical for normal tear production.

The patented micro-sponge is disposable and for optimal cleaning and exfoliating, a fresh clean one is used for each eye. The eyes are rinsed well afterwards.

The procedure lasts about 6 – 8 minutes. Most patients simply report a tickling sensation. A numbing drop is usually placed in each eye prior to treatment for increased comfort.

After the procedure, you may resume normal activities. Home cleaning regimes can continue but are are only semi-effective. BlephEx® should be repeated every 4-6 months as determined by your eye doctor. 

The sooner in life that BlephEx® is begun as a routine element of eye care, the better the long-term results. If you wait until you have symptoms before seeking treatment, much damage may already be done to your tear glands.

 

Treat your eyelids early and often. 

 

For more information: https://blephex.com/patients/

 

Ilux Meibomian Gland Treatment:

iLux® is a handheld device that is designed to heat and apply gentle pressure on the eyelids to open up blocked meibomian glands (the oil glands). This makes it easier for the glands to naturally release their oil which is so important for a good quality tear film.

The device has a specially designed eyelid smart tip that gently delivers treatment directly to the blocked glands while protecting the surface of the eye. Your dry eye doctor has complete control with iLux® and administers the therapeutic effect. 

The treatment takes approximately 8-12 minutes for both eyes. First your dry eye doctor will assess your eyelids to determine the treatment zones. Next, your eyelid will be held between the soft biocompatible pads of the iLUX® device. Then the therapeutic light-based heat will begin to warm the blocked glands to a safe temperature to soften and release the oil.

As the oil melts, your doctor has the ability to apply additional heat or pressure depending on your needs. With gentle pressure and heat, the oil will be expressed from the glands and the treatment is complete.

For more information: https://ilux.myalcon.com/

Also watch this informative video below

RHINEBECK EYE CARE

 When you see more clearly, you can live life more fully! We want to help make that possible. And with the technology and expertise available to you at Rhinebeck Eye Care, you can more clearly see and enjoy moments and memories that will enhance your entire life experience. We are ready to see you in our Rhinebeck NY or Hudson NY office locations; make your appointment today.

Image by Elia Pellegrini