Most dry eye is caused by rapid evaporation of the tear film, and is known as evaporative dry eye. This occurs when there is a shortage of oil in the tear film, causing the tear layer to break down too quickly. The oil in the tear film is produced by glands in the eyelids called meibomian glands. Meibomian glands run the length of the lids and can become blocked over time. In some cases, the glands can begin to atrophy and stop producing the oil completely. In either case, the results are the same, as the function of the tear film is reduced and dry eye symptoms are increased. Dry eye symptoms include excess tearing, burning, redness, fluctuations in vision, and scratchiness among others.
In the past, evaporative dry eye was largely ignored or treated with palliative therapy. Now, thanks to advances in research and technology, new treatment options are available to improve meibomian gland function. The most promising new treatment is the LipiFlow by TearScience. The LipiFlow works by applying precisely targeted heat to the back of the eyelid while at the same time applying slight pressure to the front of the lid. This heat and pressure unplugs blocked meibomian glands, allowing for free flow of the oil necessary for a functional tear film. The LipiFlow has been used successfully on a number of patients, including participants in a clinical trial in which almost 80% of the patients reported improvement in their symptoms within four weeks.
At Boland Eye Center, we are a designated Dry Eye Center of Excellence and we screen every patient we see for dry eye symptoms. Symptoms of dry eye can be so varied that many patients do not even realize the "allergies" or "tired eyes" they deal with every day are actually symptoms of dry eyes. Symptoms may include fluctuating vision, scratchiness, itching, burning, and excess watering. During the initial examination our doctors will review the brief screening questionnaire filled out by all patients prior to their exam. The doctors then use the results of the survey to direct the exam as it pertains to dry eyes. Technology such as the Tear Osmolarity test by TearLab, the RPS InflammaDry, the Meibomian Gland Evaluator, and the LipiView by TearScience help pinpoint the origin of dry eye symptoms which allows our doctors to formulate a unique treatment plan for each patient. Our doctors also use another instrument known as the HD Analyzer. The HD Analyzer is able to accurately measure the tear film and its influence on image quality. This instrument can evaluate tear film dynamics with just a simple click of a button, giving our doctors the ability to find the root cause of fluctuations in vision.
Chronic Dry Eye problems are appearing in more patients and at a significantly younger age. Dr. Josh Holmes has moved quickly to the forefront of combating this problem. Our office is the first in the area to use the LipiFlow technology to treat Evaporative Dry Eye, which is the most common cause for Dry Eye symptoms. The newest technology available for treatment of dry eyes is TrueTear, which is a novel approach to stimulating tear production. TrueTear provides a drop-free option for patients who are interested in an easy, natural way to treat their tear insufficiency. At Boland Eye Center, we are able to evaluate patients using the latest diagnostic tests and equipment, including the InflammaDry Test, the LipiView Tear Film Evaluation System, and the TearScience Meibomian Gland Evaluator. Our doctors' expertise combined with the information gathered by these instruments can significantly reduce patient symptoms related to dry eye disease which can lead to a greatly enhanced life. Other treatment options include but are not limited to TrueTear, prescription drops, punctal plugs, nutraceuticals, and use of the BlephEx instrument to clean and debride the eyelid margin. If you have been self-medicating with OTC eyedrops, make an appointment for a formal evaluation to learn about the newest treatments available. For more information, please see the Dry Eye Center area of this website.