Dry Eye

Dry eye is a chronic and progressive condition in which the eye does not produce enough tears or when tears composition is off balance and does not function properly. Aqueous deficiency, evaporative dry eye, or a combination of these types is very common.

Additionally, inflammation of the surface of the eye may occur along with dry eye. Untreated, dry eye can cause pain, ulcers, or scars on the cornea, and blurry vision. Dry eye can make it more difficult to perform some activities, such as watching TV, using the computer, and reading.

Other names for dry eye include dry eye syndrome (DES), keratoconjunctivitis sicca (KCS), dysfunctional tear syndrome, lacrimal keratoconjunctivitis, evaporative tear deficiency, aqueous tear deficiency, and LASIK-induced neurotrophic epitheliopathy (LNE). Dry eye symptoms may include any of the following:

• Stinging or burning of the eye
• A foreign body sensation in the eye
• Episodes of excess tears following very dry eye periods
• A stringy discharge from the eye
• Pain and redness of the eye
• Episodes of blurred vision or fluctuating vision
• Heavy eyelids
• Intolerance to contact lenses
• Decreased tolerance of reading, working on the computer, or any activity that requires sustained visual attention
• Eye fatigue

Depending on the causes of dry eye, the doctors at the Gavin Herbert Eye Institute may use various approaches to relieve the symptoms. Dry eye can be a chronic condition. The first priority is to determine there is an underlying cause of the dry eye (such as Sjögren's syndrome or lacrimal and meibomian gland dysfunction). If it is, then the underlying disease needs to be treated.

Treatments are varied depending on the type and severity of the disease. Your doctor will develop a customized treatment plan after a thorough workup is done. Your treatment may start with preservative-free artificial tears and/or ointments. Additionally, a prescription anti-inflammatory eye drop may be prescribed. There are several FDA approved medication drops to help improve symptoms and signs of dry eye disease.

If dry eye results from taking a systemic medication, your doctor may recommend switching to a medication that does not cause the dry eye side effect.

If contact lens wear is the problem, your doctor may recommend another type of lens or reducing the number of hours you wear your lenses. In the case of severe dry eye, your doctor may advise you not to wear contact lenses at all.

Punctal plugs are another option.  These block the drainage canals, small circular openings at the inner corners of the eyelids where tears drain from the eye into the nose. They are easily inserted by your doctor in the office. These plugs are made of silicone or collagen, are reversible, painless, and are a temporary measure.

In some patients with dry eye, supplements or dietary sources of omega-3 fatty acids (especially DHA and EPA) may decrease symptoms of irritation. The use and dosage of nutritional supplements and vitamins should be discussed with your primary medical doctor.

In severe cases, the use of autologous serum drops may be advised. In this situation, your own blood is drawn and spun down to eliminate the blood cells. The serum is then processed and bottled for use as drops on the ocular surface. At the Gavin Herbert Eye Institute, we have the facility and expertise to determine if this is a treatment option for you.

If you have concomitant eyelid margin disease or meibomian gland dysfunction (MGD), the oils in your tear film are poor. There are several in-office, painless procedures such as thermal pulsation or Lipiflow or TearCare, that can relieve the obstruction in the oil glands and restore a healthy oil layer in your tear film. Your doctor can assess whether this would benefit your type of dry eye disease.

Treatment of evaporative dry eye involves opening the blocked eyelid meibomian glands by applying a combination of localized heat and pressure therapy. Previous approaches, such as the use of warm compresses, have been inconvenient and of limited effectiveness in advanced cases.

The LipiFlow Thermal Pulsation System is a significant technological shift in evaporative dry eye treatment, effectively relieving blockage of the meibomian glands during an in-office treatment. Opening and clearing blocked meibomian glands allows the body to resume the natural production of lipids (oils) needed for the tear film.

Treatment can be performed the same day of your initial evaluation. The procedure takes 12 minutes for each eye and is performed in our Irvine office. In a clinical study, 76% of patients reported improvement of their symptoms within two weeks.

If you are concerned that you are experiencing a chronic dry eye condition or have ever been told that you have meibomian gland dysfunction or MGD, please make an appointment to discuss your situation with our doctors.

Call 949-824-9970 for information on Dry Eye treatment.