Dry eye syndrome is a complex condition that presents with an array of possible symptoms.
The main two types of dry eye are
1. aqueous tear deficiency and
2. evaporative dry eye (also known as Meibomian Gland Dysfunction).
The tear film is comprised of three main layers – the mucin layer, aqueous layer and the lipid layer.
The aqueous component is mostly secreted by the lacrimal gland, the gland we use when we cry. Aqueous deficiency accounts for approximately 10% of dry eye cases and most people with this type of dry eye have a separate condition causing reduced secretions from certain glands in their body. In particular, Sjögren’s Syndrome causes reduced secretions from both the lacrimal gland and salivary glands resulting in dry eyes and a dry mouth.
For aqueous deficient dry eyes, treatments are limited to supplementing the tear film primarily with preservative free ocular lubricants. These include eye drops, gels, and ointments. Other treatments include modifying your environment to reduce tear evaporation by increasing humidity, reducing computer use and taking regular breaks, and increased conscious blinking. Another option for these patients are punctal plugs. These are small devices which are inserted into the tear drainage duct on the bottom eyelids to help tears remain on the eye for longer. Without the lipid layer the tears evaporate too quickly leaving the eye exposed and dry.
The lipid layer of the tear film is produced within the meibomian glands which line our upper and lower eyelids and is secreted when we blink.
Meibomian gland dysfunction (or evaporative dry eye) is diagnosed when these glands become blocked and inflamed and fail to secrete oil onto the eye surface. Without this lipid layer the tears evaporate too quickly leaving the eye exposed and dry. Often the lacrimal gland will work in overdrive to compensate for the lack of oil on the eye and will cause excessive tearing and watery eyes.
Treatments for Meibomian gland dysfunction include tear supplements such as preservative free ocular lubricants or lipid based eye drops. Heat supplied to the eyelids on a regular basis aims to melt the oils in the meibomian glands to increase secretion. This can be done in the way of a Bruder Eye Mask which is specially formulated for this purpose. Increasing omega 3s in your diet can also improve evaporative dry eye.
Leading the way in dry eye treatment is intense pulsed light therapy, more commonly known as IPL.
IPL therapy supplies high frequency pulsed light to the meibomian glands in the bottom eyelids. This works to stimulate and unblock the glands and to decrease the inflammation from the surrounding blood vessels. IPL is provided as four treatments over a three month period.
Currently IPL remains one of the only long term treatments for evaporative dry eye. Dry eye patients at Gulf & Ranges Optometrists have shown very promising results with IPL.
