Dry Eye Syndrome
Tears are essential for healthy eyes and vision.
WHAT IS DRY EYE SYNDROME?
At our Dry Eye Center, Dr. Arlene Schwartz has extensive experience treating all forms of Dry Eye. Dry Eye is a term used to describe an eye condition that can create many symptoms and cause burning, tearing, and redness of the eyes. Dry Eye may be secondary to decreased tear production or too rapid evaporation of tears due to a poor lipid layer, an oil layer.
Once the type of Dry Eye is determined there are multiple ways to treat the condition including artificial tears, prescription eye drops, omega supplements, lid hygiene, and warm compresses. There are office procedures such as lid debridement and Blephex available.
Tears are more than just fluid in the eye; they have a chemical makeup comprised of water, enzymes, proteins, metabolites, lipids, and mucins.
Tears are important because they keep your eyes well-lubricated and protect them from foreign bodies or dust particles, which can cause irritation. When an insufficient amount of tears is produced in the tear ducts, Dry Eye Syndrome occurs.
Enzymes are proteins that cause a chemical reaction inside the body
Proteins are molecules containing amino acids that are found in tissues in the body
Metabolites are small molecules that are related to metabolism
Lipids are molecules with an oily substance which contain healthy fats
Mucins are glycoproteins that helps cells stick together
The most frequent types of Dry Eye symptoms include:
- Blurry vision
- Burning sensation
- Gritty feeling
- Itchy eyes
- Redness
- Stinging
- Soreness
- Watery eyes
It may seem ironic, but one symptom of DES is watery eyes. This occurs when the body attempts to self-soothe the dryness by producing excessive tears, a condition known as Keratoconjunctivitis Sicca (KCS). The tears lack a sufficient amount of water, so although these tears may provide temporary relief, the excessiveness of the tear production isn’t healthy.
Who Is at Risk for Developing Dry Eye Syndrome?
Like other diseases and eye conditions, there are some people who are more susceptible to developing DES. Age, gender, medical conditions, even the environment can contribute to sensitivity to dry eyes.
Certain medical conditions can make Dry Eye more prevalent. Patients with any of the following diseases may notice signs of DES symptoms:
- Arthritis, an inflammation of the joints
- Blepharitis, an inflammation of the eyelid, usually caused by skin conditions such as dandruff or rosacea
- Diabetes, a condition causing high blood glucose levels
- Glaucoma, a disease of the optic nerve, which causes vision loss
- Hypertension, high blood pressure in the arteries
- Lupus, a chronic autoimmune disease that causes damage to healthy tissue
- Thyroid Disorder, when the tissues that surround the eyes become swollen or inflamed
- Vitamin A Deficiency, when there is an insufficient amount of Vitamin A, which normally helps protect the cornea
Environmental Factors
People who live in areas with heavy winds or with dusty or dry air may find that their eyes often feel dry. Being around smoke or hair dryers can cause the same reaction. Being in direct aim of a heater or air conditioning unit can also dry out the eyes.
Women are more prone to DES because of hormonal changes due to pregnancy, birth control, and menopause. Women over age 50 have a 50% greater risk of developing Dry Eye than men of the same age. Additionally, women tend to visit their doctor more often than men and at earlier stages of discomfort, so diagnosing the condition in women is more common.
According to the National Eye Institute, the risk of experiencing DES goes up with age. That’s because the natural tears of the eye decrease over time, which is a natural part of aging. As the patient’s tear production diminishes, signs of Dry Eye increase.
Diagnosing Dry Eye Syndrome
Dr. Arlene Schwartz evaluates & diagnoses dry eye and meibomian gland dysfunction (MGD) using a variety of techniques and modern technology.
Dry Eye Diagnostics
- Meibography
- Meibomian Gland Evaluation and Expression score
- Tear Osmolarity
- Fluorescein and Vital Dye staining
- Tear Break Up Time
- Schirmer Testing
- SPEED questionnaire
- Corneal Topography
Treatment for Dry Eye Syndrome
Dr. Arlene Schwartz treats patients from all over Westchester, New York who have Dry Eye. Our staff has the experience and knowledge needed to help give you relief from DES symptoms and improve your quality of life.
Some Dry Eye Treatments
- Tear Substitutes
- Lid warming eye masks
- Tea Tree Oil based lid cleanser and hypochlorous acid
- Omega 3 – triglyceride form
- Prescription Cyclosporine drops (Restasis, Cequa, and Klarity-C)
- Prescription Xiidra drops
- iLux – eyelid thermal pulsation
- Regener-Eyes drops
- Intense Pulsed Light (IPL) Therapy
- Debridement of lid margin
- Blephex – microblepharo exfoliation
- Punctal Occlusion
- Azithromycin drops
- Scleral contact lenses
Depending on your specific case, we may recommend artificial tears or lubricant eye drops to produce tears to moisten and make your eyes feel more comfortable. Prescription drops can help stimulate tear production and, in some cases, steroids can provide significant short-term relief.
For patients with more severe DES, the doctor may suggest the use of punctal plugs. These tiny devices are placed inside the tear duct to block tears from draining. As the natural moisture is prevented from leaking out, it remains in the eye and coats it properly, keeping it lubricated and comfortable.
Scleral lenses can provide effective relief, as well. These are custom-designed rigid contact lenses with a large diameter that cover the entire sclera (the white part of the eye) without touching the cornea. Scleral lenses contain a tiny pool of water, providing constant moisture to dry eyes.
Helpful Home Treatments for Dry Eyes
If you have dry eyes and find it challenging to read, drive, watch TV or play sports, there are a number of DIY home treatments that are worthwhile to try out. In addition to Dr. Arlene Schwartz’s recommended medical dry eye treatment, you can also take action with some of the following tips:
- Many over-the-counter remedies, such as artificial tears, can add lubrication. Be sure to check with Dr. Arlene Schwartz about the particular brand that’s right for you.*
- Use an air filter to remove irritants from your environment
- A humidifier will increase moisture in the air and slow the evaporation rate of your tears
- Stay well-hydrated by drinking enough
- Fish oil supplements may help with dry eyes
- Sunglasses can protect your eyes from drying winds and damaging UV rays
A Note About Lubricating Eye Drops:
Moisturizing eye drops for dry eyes are widely available. This can be a particularly effective treatment for uncomplicated dry eye, such as contact lens wearers or people who work or study in an excessively dry environment. Some eye drops may be purchased without a prescription, but it’s always a good idea to consult with Dr. Arlene Schwartz before using any eye medication – even over-the-counter eye drops – because there are formulas that are known to cause irritation.
Our dry eye specialist, Dr. Arlene Schwartz, will develop a customized treatment plan for each patient, depending on the severity and likely causes of the dry eye symptoms.
Medications and Dry Eye
All medications include warnings of possible side effects which some patients may experience. There are certain categories of medications that are known to decrease natural tear production, such as:
- Antidepressants
- Antihistamines
- Anxiety medications
- Birth control pills
- Blood pressure medication
- Decongestants
If you are taking any of these medications and feeling any signs of Dry Eye, speak with Dr. Arlene Schwartz about some alternative medications or treatments to alleviate your symptoms
Many symptoms of Dry Eye Syndrome last for the short term, meaning, they can fade with proper treatment or sometimes, on their own. Blurry vision, itchy or red eyes, and stinging can be treated effectively and perhaps eventually disappear.
Some symptoms of Dry Eye Syndrome have long-term effects, which means that they can last for months or even years. These may include:
- Corneal abrasions or ulcers
- Long-term inflammation
- Vision impairment
Corneal abrasions can become serious if left untreated. They often heal on their own, but in more severe cases, prescription creams or bandage contact lenses may be needed for more efficient treatment. In cases of vision impairment from Dry Eye Syndrome, we can help.
These long-term effects of Dry Eye can negatively impact your life. Sensitivity to light and difficulty driving are 2 primary examples of everyday tasks that can become restricted with severe Dry Eye Syndrome. This leads to a lower quality of life.
If you suffer from Dry Eye and are ready for a solution to your painful symptoms, contact Hartsdale Family Eyecare today. We are here to help you experience better vision today.
Dry Eye Technology
BlephEx Treatment for Blepharitis
Blepharitis is an overgrowth of bacteria along the eyelashes that can permeate eyelid tissue, cause inflammation and damage your tear ducts. Chronic dry eye and all of the associated irritations often develop. As eyelids are typically difficult to clean, the bacteria overgrowth may accumulate over years – to the point where significant damage is caused. BlephEx, the only clinician treatment customized to target blepharitis, can help prevent dry eyes by cleaning your eyelids.
With BlephEx, dry eye symptoms are alleviated almost immediately. Our optometrist, Dr. Schwartz, will use a specialized handpiece with a micro-sponge to precisely clean along the edge of your eyelashes. Essentially, this 6-8 minute procedure exfoliates your eyelids, and numbing eye drops are inserted first so BlephEx is painless. For best results, we generally recommend that you repeat the procedure every 4-6 months in our Hartsdale optometry clinic.
Intense Pulsed Light Therapy (IPL)
Intense Pulsed Light (IPL) Therapy, which has been traditionally used as a cosmetic procedure for treating facial skin conditions, effectively treats chronic dry eye and Meibomian Gland Dysfunction (MGD). In fact, IPL Therapy is among the more groundbreaking treatments for dry eye.
Intense Pulsed Light Therapy is a painless method that delivers pulses of light to liquefy and release oils that have hardened and clogged the meibomian glands in the eyelids. IPL also reduces eyelid redness and stimulates healthy gland function.
Dr. Arlene Schwartz will begin your IPL treatment by placing shields over your eyes to protect them from the light pulses. Following that, a thin layer of cooling gel will be applied to the treatment area and a small device will administer the pulses of light to the region around the eyelids. The pulses of light heat the skin around the eye and dislodge the oil buildup.
After administering IPL, Dr. Arlene Schwartz will express oil from the glands, which will restore normal oil flow in the tear film. Though patients usually notice improvement in dry eye symptoms following their first or second treatment, it is generally recommended they undergo an initial series of four IPL treatments, performed monthly over a period of four months. This ensures long-term success in treating both chronic dry eye syndrome and Meibomian Gland Dysfunction.
Depending on the severity of their dry eye condition, certain patients may require occasional maintenance treatments following the initial series of IPL treatments. It is not unusual to combine IPL treatments with other dry eye therapies in order to optimize effectiveness and promote healing.
iLUX® Dry Eye Treatment
Dry eye is a chronic, progressive, irreversible disease caused by deficiencies in the quantity and quality of meibum or other tear components within the tear film. Dry eye affects over 30 million people in the United States, and 86% of dry eye sufferers are reported to have clinical signs of meibomian gland dysfunction (MGD). However, less than half of patients with MGD show symptoms, and many MGD sufferers may not even know they have it.
The iLUX® MGD Thermal Pulsation System delivers treatment directly to the blocked meibomian glands with the goal of clearing the blockages. Therapeutic heat at the optimal temperature is applied to your eyelids. Then, while the oil is thoroughly melted, it is expressed with the precise pressure required. A medical professional will be at your side every step of the way, providing real-time feedback. Treatment of both eyes takes approximately 8 to12 minutes.5 After the glands are unblocked, it will be easier for the meibum to be released naturally.
Treatment with the iLUX® device was shown to significantly reduce dry eye symptoms such as gritty eyes and irritation. 6 In clinical studies, iLUX® was shown to increase meibomian gland function by 300% at 4 weeks post-treatment, compared to baseline.
If you experience symptoms such as blurry vision, dry eyes, and irritation, it may be MGD. Even if you aren’t experiencing symptoms, the American Optometric Association recommends annual comprehensive eye exams. This includes an evaluation of the tear film and glands. Learn more about MGD and if treatment with the iLUX® MGD Thermal Pulsation System is right for you.
Other Treatments for Dry Eye
There are other treatments available for Dry Eye Syndrome. Give us a call to find out more about:
- Scleral Lenses - These lenses have a small amount of liquid solution between them and the eye, providing moisture and relief. Many dry eye sufferers can wear these lenses for up to 14 hours!
- Hyclear - This spray solution is designed for the removal of foreign material including microorganisms and debris on and around the eyelid margins that may be associated with Blepharitis, Meibomian Gland Dysfunction (MGD), and Dry Eye Syndrome.
- Azasite Ophthalmic - An eye drop that can fight eyelid infections, and can facilitate the correct functioning of the oil glands.