Dry Eye Therapies

Dry eye disease sounds like a fairly benign condition but actually affects a significant proportion of the population and leads to discomfort and impaired vision. Dry eye disease can be due to deficiencies in water, mucus, or oil. It's important that these three ingredients are present in healthy proportions in order to maintain a healthy tear and ocular surface.

When we are young, the tiny little glands within our eyelid produce a clear “olive oil” consistency oil which spreads on top of the water on the eyeball and prevents tear evaporation. As we age, and partly due to hormonal changes and inflammation, the oil and its production can become impaired over time, can thicken up and can clog inside the gland. In addition, the gland itself can start to disappear. Without this vital substance, the tears will just evaporate away, which means that the surface of the eye is dry.

One thing that can be difficult to understand is why people’s eyes can be so watery as they age. This is because your eyes are highly sensitive and designed to detect poor lubrication on its surface. As your eyes hate being dry, the reflex sends a message to the brain to turn on the “hose” and caused tear overproduction. This overwhelms your drainage systems and can cause the eye to water. It is therefore easy to see why dry eyes can lead to eye over-watering.

In terms of treatment, any blockages to tear drainage should be firstly unblocked. This by itself will not improve the situation. Correcting dietary deficiencies and certain types of antibiotics may help treat any inflammation around the eye. Inflammation from the eyelid margin can be treated with dedicated anti-inflammatory eye drops and topical preservative free lubricants. What patients find useful as homework exercises, is the application of a prolonged period of very high heat to help express melted oil out onto the ocular surface.

Intense post light is the therapy that our dermatology colleagues have used for over 25 years. Primarily it had been used to treat prominent blood vessels and hyperpigmentation. In 2002, it was noted to have demonstrable improvement in dry eye symptoms in a patient in the US, and a series of studies with the FDA in this area have yielded promising results.

It is important to have a thorough examination to see if you are a candidate for this treatment. Treatment will involve three sessions one month apart which take approximately 15 to 20 minutes to conduct. Patients often report a sensation of a light sting. Anesthetic gel may be applied should you require this prior to treatment. Best results are usually seen after the second or third treatment. It is important to note that advanced disease may not see a huge or demonstrable improvement in their situation, and that homework still needs to be done with heat treatment and massage at home. Patients should think of this like cleaning their teeth in between dentist visits. However, for the first time in many years we now have something to offer for this extremely common and frustrating problem.

Dry Eye Therapies

Dr. Trinh

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