Dry Eye

Dr. Alfred
Dry Eye Center of Excellence

Under the leadership and direction of Dry Eye Expert, Dr. Pierre Alfred, our center of excellence team is comprised of highly skilled individuals focused on delivering first-rate care and relief to patients suffering from Dry Eye Disease.

Typically, when patients think of eye health, it often revolves around visual acuity and their risks for conditions such as cataracts, glaucoma, or macular degeneration. However, what patients may not be aware of is that eye health also relates to the quality of their tear film which can lead to common complaints and dry eye symptoms such as redness, discomfort, and excessive tearing.

Dry Eye Team

What is Dry Eye disease?

Dry eye disease is a chronic, progressive, and underdiagnosed condition in which the surface of the eye does not retain moisture as it should. Dry Eye Disease may result from insufficient tear production, excessive tear evaporation, or an imbalance in the tear film quality. When an imbalance exists, the front of the eye becomes irritated, and if left untreated can impact vision, cause difficulty with daily activities, and affect quality of life.
Tear Film Layer

What are the Symptoms of Dry Eye?

Dry eye symptoms include redness, scratchy, stinging, burning, sensitivity to light, eye fatigue, discomfort, blurry vision, and excessive tearing. 90% of patients in our clinic experience symptoms of dry eye disease.

Dry Eye TreatmentWhat Causes Dry Eye?

Dry eye is a multifactorial condition that can have a variety of causes including:

Age and Gender – General characteristics such as the natural aging process and gender may contribute to dry eye. For example, reduced tear production causes most people over the age of 40 to experience some symptoms of Dry Eye. Also, hormonal changes caused by menopause, the use of contraceptives, and pregnancy make women more likely to develop dry eye.

Environmental and Lifestyle Conditions – Exposure to environmental conditions including smoke, pollutants, wind, dust, dry climates, forced hot air heat and fans, are just a few which can increase tear evaporation resulting in dry eye symptoms. Lifestyle choices and hobbies which involve extended periods of reading or prolonged computer/cell phone use also lead to excessive tear evaporation due to reduced blinking.

Medical Conditions and Medications – Medical conditions such as Sjogren ’s syndrome, Rheumatoid Arthritis, Lupus, Ocular Rosacea, Diabetes and/or Thyroid problems often lead to symptoms of dry eye. Certain medications including antihistamines, decongestants, pain relievers, blood pressure medications, and anti-depressants can reduce the volume of tears produced in the eye which causes dry eye.

Blepharitis or Meibomian Gland Dysfunction – Chronic inflammatory diseases of the eyelids can interrupt the production of tears and lead to evaporative dry eye.

Low Omega 3 Fatty Acid Intake – Can lead to decreased oil layer of the tear with faster tear evaporation and secondary dry eye issues.

Other Factors – Individuals with long term use of contact lenses, history of refractive surgery such as LASIK or PRK can develop a higher risk for dry eye disease.

How is Dry Eye Diagnosed?

Patients who visit our Dry Eye Experts Treatment Center receive a thorough medical evaluation that begins with a survey called a SPEED Questionnaire. The results from this questionnaire along with a medical examination helps our team facilitate disease detection and score the severity of the dry eye condition.

A state-of-the-art advanced diagnostic tool called a Keratograph is used for tear film analysis. This analysis provides information on how fast tears evaporate, the oil layer thickness and the water content of the tears. This information is critical to understanding the qualitative and quantitative aspects of the tear film while also providing measurements on which treatment effectiveness is monitored.

The Keratograph has imaging functions which are used to perform meibography. This image of the oil glands provides critical information on the evolution and extent of Meibomian gland dysfunction. Furthermore, photos are obtained to document and measure the extent of corneal and conjunctival staining which is a measure of ocular surface injury and breakdown.

Keratograph

In addition to tear film analysis and imaging we perform certain laboratory diagnostic tests which may include Tear Osmolarity, Inflammadry and allergy testing. These labs along with a careful history, a complete exam, tear film analysis and meibography provide answers to the root cause of the Dry Eye condition while providing guidance to the best treatment plan. Our providers review with you the results of this analysis and treatment options are discussed.

TearLab

How is Dry Eye Treated?

Dry Eye is a multifactorial disease and each patient’s condition is unique, therefore, several treatment options must be considered. Some Dry Eye treatments control symptoms while others aim to correct the underlying condition that is causing the dryness.

All patients receive guidance on basic ocular home care which may include; warm compresses, eyelid hygiene, tear substitutes and nutritional supplements. Additional modalities; including anti-inflammatory medications, tear supply strategies, and ocular surface rejuvenation techniques may be recommended.

At the Dry Eye Experts Treatment Center, we utilize specialized in-office Meibomian (oil) gland treatments to reduce bacterial overgrowth and inflammatory burden on the eyelids. Relief of oil gland obstruction and rejuvenation of glands promoting better function is our goal.

Specific in-office treatments we perform include BlephEx, LipiFlow, and Intense Pulsed Light (IPL):

BlephEx:

Blephex

Microblepharoexfoliation (MBE) removes excess bacteria, biofilm, and bacterial toxins which are the main causes of inflammatory dry eye and lid disease. This short procedure lasting 6-8 minutes uses a handheld device with rotational spinning of a medical grade micro-sponge to delicately and very precisely remove debris while exfoliating your eyelids.

LipiFlow:


 

For adult patients with chronic Meibomian Gland Dysfunction (MGD), also known as Evaporative Dry Eye, an application of localized heat and pressure therapy may be a treatment option. The LipiFlow System is designed to safely deliver pulses of therapeutic energies to the meibomian glands while protecting the delicate structures of the eye. As a result, the obstructed meibum is liquefied and cleared from the gland orifices.

IPL:

IPL

IPL is Intense Pulsed Light Therapy, treats your skin and eyelid inflammation gently, safely and effectively. With IPL technology, light pulses target the pigment on the surface of the skin and penetrate the abnormal vessels below the surface with heat to address the root cause of the inflammation. The body’s natural reaction to the treatment removes abnormal vessels and heals the inflammation.

Typically, 3 sessions are recommended with 3-4 weeks in between to achieve optimal results. Each session lasts approximately 15 minutes. While you may experience a warm sensation as light is being applied to the skin, the treatment is gentle and should not feel uncomfortable. Following the treatment your physician may perform meibomian gland expression.

Following the full treatment session, it is recommended you have maintenance sessions every 12-18 months to maintain optimal results.

Frequently Asked Questions

Could Dry Eye Lead to bigger eye problems?

There are risks to chronic dry eye, including a greater risk of eye infection or damage to the surface of the eyes. Without sufficient lubrication the corneal surface may get scratched or may develop an ulcer from chronic inflammation. Ultimately quality of life can suffer when discomfort and visual quality degradation from dry eye persists.

Can Dry Eye be cured permanently?

Dry Eye disease is chronic and progressive. Severe cases may not be completely curable, though proper treatment can successfully manage symptoms. Mild to moderate Dry Eye Disease may respond very well to medical treatment.

If I have Dry Eye, can I still wear contacts?

Wearing contacts can be extremely uncomfortable for those with dry eyes. Recently, several manufacturers have developed specially designed contact lenses to improve comfort during lens wear. Some of these contact lenses have a moisture barrier to keep the tear film intact longer, some contain innovative water gradient that softens the feel of lenses against the eye. If you are concerned about dry eye symptoms and contact lens wear, speak with your doctor about new lenses and products.

Over the counter treatments for Dry Eye

Over the counter eye drops may temporally reduce the symptoms of Dry Eye Disease. While OTC eye drops can reduce symptoms by enhancing moisture temporally, they do not contain ingredients that reduce inflammation and progressive damage caused by insufficient tears.

Schedule a Consultation

If you are interested in learning more about Dry Eye Disease and how this problem can be treated, please call (800)676-5050 or request a consultation online.