DRY EYES, aka, MEIBMOIAN GLAND DYSFUNCTION (MGD) TREATMENT

TREATMENT OF DRY EYES

Treating dry eyes can be frustrating, and, at times, unrewarding.  More recently, newer technologies have emerged that can help to alleviate some of the symptoms of dry eyes, but more importantly, to halt or slow its progression.

 

The treatment of dry eys is best directed toward the cause:

 

 

 

  • MUCUS:  This deficiency is usually caused by disease of the goblet cells that are resident on the conjunctiva. This can be due to chemical injury, or relatively uncommon diseases like pemphigoid.  There are no truly adequate replacements for mucus deficiency, and the conventional approach to compensating this condition is replenishment of the tears with artificial tears and products that similate the mucus layer.  Addiitonally, attempts can be made to prevent breahdown of the tear film by wearing moisture goggles.

 

  • AQUEOUS: The conventional approach to aqueous inadequacy is tear replenishment with ARTIFICIAL TEARS. 

 

ARTIFICIAL TEARS are manufactured in many different consistencies directed toward supplementing the major deficiency in the person's tear film.

Different preparation focus on oil replenishment, while others try to enhance deficiencies in the aqueous component.  

 

ARTIFICIAL TEARS are an important part of treating dry eyes. They come in preserved and preservative-free variations. The latter, because they have fewer chemicals, may be less irritating with frequent application.

 

While there is important science in ARTIFICIAL TEARS, at the end of the day, a person must discover by trial and error which is the most satisfying for their needs. It is not uncommon for one person to use several different types of ARTIFICIAL TEARS to address different symptoms or to compensate different environments.

 

RESTASIS:

RESTASIS is a prescription medication called Cyclosporin. Cyclosporin is an anti-inlammatory  that is used in the teratment of some cancers, and immunologocal diseases. It was observed that people on this medication often had increased production in the aqueous component of their eyes, and a preparation was designed for topical use.

 

The medication is prescribed for twice daily aplication, and takes several weeks until a "therapeutic level" is achieved and symptoms diminish.  Not all patients note subjective improvement from this medication, and those that do recognize a benefit must remain on RESTASIS indefinitely.

 

HUMIDIFICATION OF THE ENVIRONMENT:

While this modality seems intuitive, it is often neglected.  Some environments like airplanes lack humidity and many people can identify exacerbation of their dryness in this circumstance.  But, fewer people realize that climate control devices - air conditioners and heaters - can also dry out the environment. When in use, HUMIDIFIERS  replenish some of the lost moisture and can temporarily reduce dryness.

 

  • OIL:  While oil is a small percentage of the tear film, the oil layer is critical to its preservation and durability.  If the frequency of one's blink, The completion or the blink or the quality of the oil are not optimum, the eyes will dry out between blinks. When working at the computer or doing particularly engaging tasks, people often stare and reduce their blink frequency.  This allows the tear film to evaporate without renewal by the blink. Without realizing, people can maintain this behavior for hours at a time, which is often why peoples eyes bother them after extended computer work.

 

LIPIFLOW:

In addition to the conventional treatments already reviewed, there is a newer technology that is intended to revitalize the oil glands that have begun to function less efficiently and postpone, or prevent further decay.

 

LIPIFLOW is a computerized system that was developed to apply controlled heat and pulsed massage to the eyelids in order to melt the oil that has become dormant and to extrude this sludgy oil from the meibomian glands.

 

Over the cours of 12 minutes, the electronic transducers heat up, melt and express the oil from the glands in the eyelids that have become non-productive and havebegun to atrophy.  When people feel graiy crust in their eyes, see flakes on the base of their eyelashes, or experiences fluctuations in their vision, Meibomian Gland Dysfunction is often the cause.  In addition to making the patient more comfortable, and helping to improve vision, treating these glands may maintain their vitality and halt, delay or prevent their gradual decay.  

 

Because not all dry eyes are due to Meibomian Gland Dysfunction, there is an allied technology, LIPIVIEW that can directly visualize the eyelid (Meibomian) glands to determine if they are diminisheing or losing their proper anatomy.  With this ability to actually see the glands and compare them to normal anatomy, an informed decision to treat with LIPIFLOW is available.  Furthermore, the success of the LIPIFLOW treatment, and the progression of the eyelid condition can be monitored objectively.