OCULAR SURFACE DISEASE (DRY EYE)

What is Ocular Surface Disease?

Ocular surface disease, which is often referred to as dry eye, is a very common ocular condition. It can affect anyone, but its prevalence increases with age and it is more common among women. According to analyses from large long-term studies, such as the Physicians’ Health Studies and the Women’s Health Study, in the United States approximately 1.6 million men and 3.2 million women over age 50 experience ocular surface disease symptoms.

Causes of Dry Eye

Aging: As we age, tear production decreases. Men and women of any age can be affected. However, after menopause and during pregnancy, women are especially susceptible.

Contact Lenses: Wearing contact lenses often increases tear evaporation. This can result in irritation, increased protein deposits, infection, and pain. Dry eye has been shown to be the leading cause of contact lens discomfort.

Medications: A variety of common medications reduce tear secretion. These include decongestants, antihistamines, diuretics, beta-blockers, sleeping pills, antidepressants, pain relievers, and alcohol.

Environment: Occasional or continual exposure to various environments can reduce eye lubrication. These include sunny, dry or windy conditions; areas with heaters, dehumidifiers, fans or air conditioners; work settings (i.e.; areas with chemicals or hair dryers), high altitudes, smoke or air pollution and sand, dust or airborne pollen.

Auto Immune Disease: Auto Immune Disease can be accompanied by a dry mouth and dry eyes. This combination of symptoms is called Sjogren's Syndrome.

 

Symptom Checklist

If you experience any of the symptoms below, you may have the condition known as Dry Eye. Please read the above information and see our doctors for an evaluation and treatment.

  • Dry Sensation

  • Scratchy, Gritty Feeling

  • Burning

  • Stinging

  • Itching

  • Excess Tearing (watery eyes)

  • Mucous Discharge

  • Irritation from Wind or Smoke

  • Redness

  • Tired Eyes

  • Light Sensitivity

  • Contact Lens Discomfort

  • Contact Lens Solution Sensitivity

  • Soreness

  • Lid Infections / Sties

  • Sensitivity to Artificial Tears

  • Eyelids Stuck Together at Awakening


Aqueous-deficient dry eye

 

In aqueous-deficient dry eye, the lacrimal glands do not produce an adequate aqueous layer, in many cases because they are affected by inflammation.

This can be caused by:

  • an autoimmune disease, such as Sjögrens Syndrome, rheumatoid arthritis or lupus

  • some medications, such as oral contraceptives, hormone replacement therapies, antihistamines, sedatives, anti-depressants, isotretinoin for acne, anti-hypertensives, and medications to treat benign prostate hyperplasia

  • some medical treatments, such as chemotherapy, radiation or corneal surgeries

 

Evaporative dry eye

In evaporative dry eye, the lipid layer of the tear film is deficient or of poor quality because the meibomian glands are not functioning properly or are blocked, which is known as meibomian gland dysfunction. Common causes of meibomian gland dysfunction are eyelid inflammation known as blepharitis as well as rosacea and other skin disorders. Because evaporative dry eye compromises the lipid layer of the tear film, tears evaporate too quickly, leaving the surface of the eye exposed to discomfort and damage.

The eyelids and the eye’s surface can also play a role in ocular surface disease. If the lids are not working properly, either because of a problem with their structure or because they are inflamed, they cannot perform their crucial functions of spreading the tears across the surface of the eye to evenly lubricate it and remove irritants. When the surface of the eye itself is not smooth and regular, it can also result in problems with tear distribution

 

Treatment

Artificial tears and medications have provided a quick, short-term solution to dry eye. Today tear duct closure which allows you to retain your own natural tears may be the best solution.

Temporary closure of the tear duct (punctal canal) is accomplished by inserting a tiny plug (like a sink stopper) to prevent tear drainage. This allows your own tears to bathe your eye for a longer period of time. In about one week this plug will dissolve and wash away with your tears. You and your doctor can then evaluate the benefits of tear duct closure for you.

Long-term closure of the tear drainage ducts involves the use of a non-dissolvable, yet removable, plug to seal the tear duct. This is a painless procedure that takes only a few minutes in your doctor's office.

LipiFlow® Dry Eye Treatment

 

LipiFlow® is the only treatment approved by the FDA for long term dry eye relief. LipiFlow® is the only treatment that addresses the root cause, not just the symptoms, of Evaporative Dry Eye by treating the blocked Meibomian glands. If left untreated, blocked Meibomian glands prevent the eyes from secreting enough oil lipids to maintaining quality tear consistency.

When the delicate tear balance is disrupted by a lack of lipids, tears evaporate on the surface of the eye resulting in dry eye symptoms like burning, sensitivity to light, blurred vision and extreme discomfort in dry or windy conditions. Along with adversely affecting your quality of life and general eye health, evaporative dry eye disease can worsen over time, even with continued use of eye drops and other treatments.

Resume Natural Production of Lipids

LipiFlow® Thermal Pulsation reduces the need for artificial tears and other prescription dry eye treatments by attending to the cause of evaporative dry eye symptoms, the meibomian glands themselves. Opening and clearing these blocked glands can allow them to resume natural production of lipids (oils) needed for a healthy tear film.

Think of it as a “spa treatment” for your eyes. Gentle heat and light pressure create a warm massage that stimulates the meibomian glands’ natural lipid production and helps restore the balance disrupted by evaporative dry eye.

PROKERA

Lehigh Eye Specialists is pleased to offer our patients PROKERA®, a new treatment for chronic Dry Eye that heals the surface of your eye (cornea) and returns your eye to a normal, healthy state. PROKERA is a simple procedure and is easily inserted and removed in our office. Once removed your cornea is rejuvenated so you can see and feel better. In a recent patient survey, 93% of patients with Dry Eye said they felt better after treatment with PROKERA.

PROKERA is similar to a contact lens and is made of amniotic tissue, which is known for its natural therapeutic actions and heals your eye faster with less pain, scarring, and inflammation.  The amniotic tissue used in PROKERA is provided by a tissue bank regulated by the FDA and has passed numerous quality control tests making it safe and effective. Clinical studies have shown PROKERA reduces the sign and symptoms of Dry Eye, and helps soothe pain, heal the eye, and improve vision.

 

PROKERA is the only U.S. Food and Drug Administration (FDA)-cleared therapeutic device that reduces inflammation and promotes healing. For more information visit www.prokerainfo.com.