Dry Eye

Dry eye (also known as dry eye syndrome or keratoconjunctivitis sicca) is a common condition that occurs when your tears aren’t able to provide adequate lubrication for your eyes. This can happen due to insufficient tear production or poor tear quality.

Common Symptoms:

• Burning or stinging sensation in eyes
• Redness
• Sensitivity to light
• Gritty feeling, like something is in your eye
• Blurred vision
• Watery eyes (paradoxically, a response to irritation

Our Treatments:

IPL Laser: Intense pulsed light (IPL) therapy is an increasingly popular treatment for evaporative dry eye, especially when caused by meibomian gland dysfunction (MGD)- a condition where the oil-producing glands in your eyelids become blocked or inflamed, leading to rapid evaporation of tears.

How it works: IPL uses broad spectrum light applied to the skin around the eyes (typically the cheeks and lower eyelids). The light reduces inflammation and improves the function of meibomian glands, allowing better secretion of the oils that stabilize the tear film. It also destroys abnormal blood vessels that contribute to chronic inflammation on the eyelid margins.

Benefits:

• Reduces inflammation in eyelids and ocular surface
• Unblocks meibomian glands
• Improves tear film stability
• Decreases reliance on artificial tears
• May help reduce the symptoms of rosacea (which can worsen dry eye) What to expect:

What to expect:

Typically involves a series of 4 sessions, 1 week apart

Each session lasts about 15 minutes

Some redness or warmth in the area may occur temporarily

Improvement in symptoms can take weeks

Is it effective?:

Clinical studies show IPL is effective for many patients, especially when combined with:

• Lid hygiene
• Warm compresses
• Omega-3 supplements
• Manual gland expression

LLLT: Low-Level Light Therapy uses red or near-infrared LED light to stimulate cellular activity and reduce inflammation, particularly in the meibomian glands of the eyelids.

How it works:

• Non-invasive, light is applied to the closed eyelids (often using a mask device)
• Stimulates blood circulation and cell metabolism
• Helps liquefy stagnant oils in the meibomian glands
• Promotes gland healing and secretion

Benefits:

• Comfortable, gentle treatment
• No downtime
• Can be combined with IPL
• Suitable for more skin types than IPL

What to expect:

Typically requires multiple sessions (often 4–6)

Each session takes 10–20 minutes

Is it effective?:

• Still newer than IPL, but growing evidence supports its efficacy
• Often part of a comprehensive dry eye management plan

Punctal Plugs: Punctal plugs are tiny medical devices inserted into the tear ducts (called puncta) in your eyelids to block tear drainage, helping retain moisture on the surface of the eye. They're commonly used to treat moderate to severe dry eye syndrome, especially when artificial tears or medications aren’t enough.

How they work:

• Your tears normally drain through small openings (puncta) into the nasal
• Punctal plugs block these openings, slowing tear drainage and keeping the eye’s surface lubricated longer.

Types of Punctal Plugs:

1. Temporary (Dissolvable)

• Made of collagen or other biodegradable materials

• Dissolve in days to months

• Used as a trial to see if permanent plugs would help

2. Semi-permanent (Non-dissolvable)

• Made of silicone or acrylic

• Can last for months to years

• Can be removed if needed

3. Intracanalicular plugs

• Inserted deeper into the duct, not visible on the surface

• Less likely to fall out, but may require irrigation or surgery to remove

Who might need them:

• People with chronic dry eye
• Individuals with Sjogren’s
• Patients post LASIK surgery, where dryness is a common side
• Those who have not responded well to eye drops or other

Procedure:

• Performed in an eye doctor’s
• No anesthesia usually required (numbing drops may be used).
• Quick and painless – typically takes just a few

Maintenance:

• Regular checkups to ensure the plugs are still in place and working
• May need replacement or removal depending on symptoms or plug

Amniotic Membrane Treatment: Amniotic membrane treatment is a type of advanced therapy used primarily for severe dry eye cases that don’t respond to more conventional treatments. It involves the use of amniotic membrane tissue, which is the innermost layer of the placenta. This tissue has unique healing properties that can promote the repair of damaged eye tissues and reduce inflammation.

How It Works:

• The amniotic membrane is derived from human placental tissue and is processed for medical use.
• It contains growth factors, anti-inflammatory cytokines, and collagen, which help promote healing of the surface of the eye (especially in cases of severe dryness or damage).
• The membrane is typically transplanted onto the ocular surface, where it serves as a protective layer and helps restore normal cell function and tear production.

Uses in Dry Eye:

• Severe dry eye syndrome (especially when associated with Sjögren’s syndrome or inflammatory conditions)
• Corneal ulcers or other surface damage due to dryness
• Non-healing epithelial defects (areas of the eye’s surface that won't heal)
• Chemical burns or other trauma to the eye Chronic ocular surface inflammation

Treatment Process:

1. Preparation: The amniotic membrane is usually obtained from a tissue bank, where it is processed to remove cells and prevent rejection.
2. Application: The membrane is applied directly to the surface of the eye, either as a graft or In some cases, it may be applied temporarily (e.g., for a few days) or permanently (as a form of healing treatment).
3. Healing: Over time, the membrane integrates with the corneal surface and promotes healing of damaged cells, as well as reduces inflammation.

Benefits of Amniotic Membrane Treatment:

• Promotes tissue repair: Speeds up healing of damaged eye
• Reduces inflammation: The amniotic tissue has anti-inflammatory properties, which are particularly helpful for chronic dry eye sufferers.
• Prevents scarring: The membrane helps prevent scar tissue formation on the
• Long-lasting effect: It may provide longer-lasting relief, particularly for patients with severe dry eye conditions.

Effectiveness:

Amniotic membrane therapy is particularly beneficial in cases where more standard treatments like artificial tears, punctal plugs, or even anti-inflammatory medications have not been effective. It has been shown to help in:

• Severe and non-healing corneal defects
• Reducing pain and irritation
• Promoting recovery of damaged ocular surface cells

Scleral Lenses: Scleral lenses are a specialized type of gas permeable contact lens that are larger than traditional lenses and are designed to cover the entire cornea and rest on the sclera (the white part of the eye). They are often used in the treatment of severe dry eye, irregular corneas, and other conditions that affect the eye's surface.

How Scleral Lenses Help with Dry Eye:

• Moisture reservoir: The space between the lens and the eye traps a thin layer of tears, providing continuous moisture and lubrication to the eye’s surface.
• Protection: Scleral lenses protect the cornea from environmental irritants (like wind or smoke) and reduce the exposure to the dry air that often exacerbates dry eye symptoms.
• Even surface: They can help even out irregular corneal surfaces (due to conditions like keratoconus) and improve vision quality by creating a smooth optical surface.

Conditions Treated with Scleral Lenses:

Scleral lenses are often recommended for conditions that result in severe dry eye or irregular corneas, including:

• Severe dry eye (e.g., from Sjögren’s syndrome or meibomian gland dysfunction)
• Keratoconus (a condition where the cornea becomes cone-shaped, leading to blurred vision)
• Post-surgical corneal scarring (from LASIK, cataract surgery, etc)
• Corneal dystrophies (inherited conditions that affect the cornea)
• Blepharitis (inflammation of the eyelids that contributes to dry eye)
• Chemical burns or trauma to the cornea How Do Scleral Lenses Work?
  
  

How Do Scleral Lenses Work?

1. Custom fitting: Scleral lenses are custom-made for each patient, based on the specific shape of their cornea. A detailed fitting process is essential to ensure comfort and effectiveness.

2. Lens application: The lens sits on the sclera (the white part of the eye) and covers the cornea. The space between the lens and the cornea is filled with preservative-free saline solution.

3. Tear reservoir: This tear-filled pocket provides constant moisture to the eye, reducing irritation and improving comfort throughout the day.

Advantages of Scleral Lenses for Dry Eye:

• Comfort: Because they create a moisture reservoir, they often feel more comfortable than regular contacts or even glasses, especially for people with severe dry eyes.
• Clear vision: Scleral lenses can improve vision, especially for patients with irregular corneas, and they provide a smooth, stable surface for light to focus
• Long-term relief: Scleral lenses can be worn for hours at a time, providing long-term relief from dry eye symptoms.
• Protection: They act as a barrier between the cornea and the environment, shielding the eyes from wind, dust, and other irritants.

What is the Fitting Process Like?

1. Initial evaluation: Your eye doctor will conduct a detailed eye exam and corneal topography to determine the best lens shape and size for your eyes.
2. Trial lenses: You’ll likely be fitted with trial lenses to test the fit, comfort, and vision. Adjustments may be made.
3. Ongoing follow-up: After the lenses are ordered, there will be follow-up visits to make sure the fit is perfect and that you’re getting the most benefit.

Over-the-Counter Medications

Treatment	Use
Artificial Tears	Lubricate eyes; used frequently
Gel drops or ointment	Thicker; for nighttime use
Eyelid scrubs/wipes	For blepharitis-related dry eye
Omega-3 supplements	May help improve tear quality (fish/flaxseed oil)