Dry Eye Symptoms
At Accent Vision Specialists, our optometric physicians have special interest and expertise in the diagnosis and treatment of Dry Eye and other ocular surface diseases causing symptoms such as:
• Eye Fatigue
• Scratchy Feeling
• Intermittent Blur
• Contact Lens Intolerance
Diagnosing Dry Eye
Computerized Tear Analysis
Accent Vision uses an advanced technology called the Oculus Keratograph to examine your eyes. This instrument has a high-resolution color camera equipped with intelligent software to analyze the collected data and document the findings. It can also compare the results and show the success of the dry eye treatment. For more information view our brochure here.
Treatments for Dry Eye
There are many options for successful dry eye treatment. Once your doctor has examined your eyes and analyzed the data, he may recommend one of the following treatments and then track your progress. Please contact our office if you have questions, or to schedule an appointment to explore the options for dry eye relief.
Home Hot Masks or Compresses and Hygiene with Ocusoft Hypochlor
The Bruder Eye Hydrating Compress improves oil gland production, stabilizes tear film, and helps slow tear evaporation. Water molecules are continuously absorbed from the air and stored inside the compress. When microwaved, the absorbed water is released as clean moist heat. There is no need to add water. Unlike other hot masks, this compress is reusable, washable, and non-allergenic.
Ocusoft Hypochlor spray is a gentle, refreshing, and soothing spray used for lid and lash hygiene. Ocusoft Hypochlor contains hypochlorous acid, which is produced and released by neutrophil cells, part of the body’s natural defense mechanism against pathogens.
Office Procedures for Meibomian Gland Dysfunction
Over the last decade, several studies have shown that certain procedures addressing the oil glands in the eyelids significantly improve symptoms of dry eyes in patients with Meibomian Gland Dysfunction – MGD. This form of tear instability is seen in 80-90 percent of dry eye sufferers. In MGD, the oil glands are blocked due to genetics, age and/or inflammation, and the oil needed to prevent tear evaporation is deficient or too thick to spread evenly.
Meibomian Gland Expression (MGX)
Meibomian Gland Expression (MGX) can relieve irritation and stabilize vision but also revitalize gland tissue, thus preventing eventual loss of the glands entirely. Performed in the office under topical anesthesia, the results of MGX are immediate for some. The procedure is part of a broad-based treatment strategy for difficult to treat dry eyes and is most often done when home therapy by itself (hot masks or moist heat compresses, and lid massage) fails. The effects of MGX may last 6-12 months if adjunctive home therapy is used to keep the oils flowing. Otherwise, MGX will need to be scheduled more often. Plan on a half-hour for the visit. Mild but fleeting discomfort is to be expected during the expression of each gland; however, normal activities can immediately be resumed. The fee for MGX as a stand-alone procedure is $300 for both eyes, and it is not covered by medical insurance at this time.
Intense Pulsed Light (IPL) Therapy
Intense Pulsed Light (IPL) therapy is an alternative treatment for MGD that is even more effective and longer lasting – without the need for supportive home therapy. Used for decades by dermatologists in facial rejuvenation, IPL is now being repurposed by eye doctors for the treatment of moderate to severe dry eyes that are unresponsive to traditional therapies. IPL is currently utilized at Mayo Clinic, Johns Hopkins and Duke University, among others. In clinical studies the procedure has been found to increase oil secretions, tear stability and comfort in up to 90% of dry eye sufferers. A combination of light and heat generated by an IPL handset is directed by the physician across the upper face in overlapping sections up to the inferior boundary of the eye shields. Both safe and relatively comfortable, the session lasts 20-30 minutes. It is followed immediately by MGX, which is included in the IPL service.
Most patients need four treatments over 3-5 months to receive the maximum benefit, with single touch-up treatments recommended every 6-12 months, depending on the case. Topical medications and lubrication can usually be reduced or discontinued after IPL/MGX as the ocular surface and tear film are restored. Like MGX, IPL is not currently covered by insurance. The combined IPL/MGX fee for the initial four treatments of both eyes is $1,200 total, and subsequent touch-ups are $400 each.
Punctal occlusion is a very safe, painless and effective treatment option for dry eye. Plugs partially block the tear drain in the eye lids to decrease the loss of tears from the surface of the eye. There are two main types of punctal plugs, temporary (dissolvable) and permanent. The dissolvable plugs are used for diagnostic purposes or for short term treatment post-surgery. Permanent plugs do not dissolve but can easily be removed if needed. The most common side effect is excess tearing. If the plugs are repeatedly lost, a minor surgical procedure can close the tear drain permanently.
Restasis / Xiidra / Short term use of steroids
Restasis is a prescription eye drop used twice per day to stimulate tear production. Restasis is the only drop that helps increase your eyes’ natural ability to produce tears. This drop is instilled twice daily. Restasis works by treating the inflammation associated with dry eyes. It may take a few weeks to get an initial effect. Studies show most patients will begin to feel better within 4-6 weeks. Occasionally a short burst of steroid eye drops before starting Restasis gives more immediate relief.
Xiidra is a newer drug used to treat dry eye disease by reducing inflammation to increase tear production. This drop is used twice per day and works in as little as 4 weeks to relieve the signs and symptoms of dry eye.
Lubricating drops are solutions specially formulated to moisten the eyes. Artificial tears should be used to supplement other dry eye treatments and do not provide long term relief. Preservative-free drops are recommended when used four or more times per day to avoid any toxic effects from the preservative use. For MGD, oil-based drops are used to provide the lipid layer of the tear film that prevents rapid evaporation.
In some cases of MGD, a short course of very low dose antibiotics works to help thin the oils of the meibomian glands and reduce inflammation along the eyelid margin.
Omega-3 Fatty Acids
Omega-3 Fatty Acids, found in fish, krill, flax seed and dark leafy vegetables, has been clinically found to benefit patients with evaporative dry eye. Many patients who regularly take Omega-3 supplements have noted a significant decrease in the symptoms of dry eye.
Contact us to schedule an appointment and find options to relieve your dry eye symptoms.