Dry Eye

  • Do you suffer from blurred vision?
  • Do your eyes often burn?
  • Do you suffer from arthritis, asthma, gout or diabetes?
  • Do you wear contact lenses?
  • Are you watching a TV or computer a few hours a day?
  • Are your eyes sensitive to bright light?
  • Are you over 40/post-menopausal?
  • Do you wake up with mucus around your eyelids?
  • Do you sometimes have red eyes?
  • Do you have scratchy/itchy eyes?

Have you answered “Yes” to any of those questions?  Then you may very likely be prone to dry eye syndrome.  The   resultant   damage   to   the   eye   surface   increases discomfort and sensitivity to bright light.

If you suffer from one of these symptoms, you should make an appointment to talk about it with your optometrist.

ABOUT DRY EYE SYNDROME

A constant flow of tears is essential for good eye health. Sometimes the eye may not produce enough tears or the tear quality is poor. This results in dry eye syndrome. Dry Eye Syndrome is a common pathology affecting up to 20% of the population. Females are more affected than males, while increasing age also contributes to greater prevalence. It is mainly caused by the conditions of the modern life (computer screens, driving cars, artificial lights, pollution, etc.).

Dry eye syndrome is generally due to a Meibomian gland dysfunction or Blepharitis. This results in the important oil layer of our tears being unstable and thinner than it should normally be. This leads to dryness, irritation, redness, blurred vision and tear film instability that can lead to damage to the ocular surface.

RISK FACTORS FOR DRY EYE SYNDROME

What Causes Dry Eyes?

This list is designed to give you an overview of several causes of dry eye syndrome but does not cover all known causes. If you are feeling any of the symptoms of dry eyes listed above, or are feeling any kind of discomfort in your eyes, please contact our optometrist to make an appointment or discuss your symptoms with us over the phone.

Dry Eye is categorised into two main types:

  1. Aqueous Tear Deficient Dry Eye (Sjögren Syndrome Dry Eye or non-SSDE): A failure of lacrimal tear secretion which can be due to disease or obstruction of the lacrimal glands.
  2. Evaporative Dry Eye: is due to excessive water loss from the exposed ocular surface and can have many causes.

Sjögren Syndrome Dry Eye is an exocrinopathy in which the lacrimal and salivary glands, as well as other organs, are targeted by an autoimmune disease. Non-SSDE may also result from obstruction of the lacrimal glands due to cicatrising conjunctivitis, reflex hyposecretion due to sensory or motor block, and the use of systemic drugs including antihistamines, beta-blockers, antispasmodics and diuretics.

Evaporative Dry Eye is due to excessive water loss from the exposed ocular surface in the presence of normal lacrimal secretory function. Its causes have been described as intrinsic and extrinsic, although the boundary between these two categories is inevitably blurred. Intrinsic EDE is where the regulation of evaporative loss from the tear film is directly affected, for example, by meibomian lipid deficiency, poor lid congruity and lid dynamics, low blink rate, and the effects of drugs such as systemic retinoids. Extrinsic EDE includes those aetiologies that increase evaporation by their pathological effects on the ocular surface. Causes include Vitamin A deficiency, the action of toxic topical agents such as preservatives, contact lens wear and a range of ocular surface diseases, including allergic eye disease.

  • Climate/Environmental: dry air & wind or low humidity environments (including air conditioning, forced air heating, high altitudes & air cabins)
  • Irritants: dust, cigarette smoke, pollution and chemical exposure
  • Ageing: tear production slows as we age
  • Menopause
  • Medical conditions: such as rheumatoid arthritis or Bell’s Palsy
  • Medications: many medications are known to cause dry eyes such as antihistamines, diuretics, beta blockers, antidepressants & oral contraceptives
  • Eye trauma: impact injury or burns
  • Infrequent blinking: staring with a fixed gaze for prolonged periods (at the television or computer screen) without blinking
  • Incomplete blinking
  • Nocturnal lagophthalmos: a condition where the eyes don’t fully blink and stay partially open at night
  • Recurrent corneal erosions: when the cornea and eye lid stick together at night
  • Eye surgery: vision correction/laser eye surgery, cataract surgery
  • Lifestyle: diet, smoking and consumption of diuretics without proper hydration

HOW IS DRY EYE SYNDROME ASSESSED?

Looking at the symptoms and potential causes of dry eye syndrome will help determine if you may be suffering from a treatable condition. However, it is important to make an appointment to see one of our optometrists who will run a number of tests to accurately diagnose your condition.

Slit lamp exam/biomicroscopy: This exam allows our optometrist to see areas at the surface of the eye at a microscopic level, including the eyelids, conjunctiva, iris, lens, sclera, and cornea. The retina and optic nerve can also be seen.

Evaluation of the tear film: by putting a drop of sodium fluorescein (a yellow dye) into the eyes which mixes with the tears to give a clearer indication of the quality of tear film.

Evaluation of tear production: strips of filter paper placed between the lower lid and eye are used to measure tear production. Utilising the Antares Keratograph, your optometrist will assess and record the extent of your dry eyes including Meibography, Tear Film quantification & qualification, Lipid Layer assessment and Red Eye assessment. If autoimmune disease is suspected as a cause, blood tests may be required. Your optometrist will refer you to your GP to action this

Looking at the symptoms and potential causes of dry eye syndrome will help determine if you may be suffering from a treatable condition. However, it is important to make an appointment to see one of our optometrists who will run a number of tests to accurately diagnose your condition.

Slit lamp exam/biomicroscopy: This exam allows our optometrist to see areas at the surface of the eye at a microscopic level, including the eyelids, conjunctiva, iris, lens, sclera, and cornea. The retina and optic nerve can also be seen.

Evaluation of the tear film: by putting a drop of sodium fluorescein (a yellow dye) into the eyes which mixes with the tears to give a clearer indication of the quality of tear film.

Evaluation of tear production: strips of filter paper placed between the lower lid and eye are used to measure tear production. Utilising the Antares Keratograph, your optometrist will assess and record the extent of your dry eyes including Meibography, Tear Film quantification & qualification, Lipid Layer assessment and Red Eye assessment. If autoimmune disease is suspected as a cause, blood tests may be required. Your optometrist will refer you to your GP to action this

Antares Keratograph: The new Keratograph high-definition colour camera makes finest structures visible. NITBUT (Non-Invasive Tear Break-Up Time), tear meniscus height, lipid layer and tear film particles movement are examined carefully and documented for comparison with post-treatment images. The exams are non-invasive, user-friendly and reproducible.

i-Pen is an in vivo, point-of-care diagnostic testing device designed to detect and measure elevated tear osmolarity levels associated with mild, moderate and severe Dry Eye Disease.

YOUR ACTION PLAN!

We personalise the treatment plan depending upon the source of the problem.

A Decision To Have Treatment…

As you make the decision whether to have treatment, it is important to make sure that you understand any risks, benefits and limitations of treatment. If you do not have treatment, your symptoms and condition may continue to worsen. Your optometrist will explain the risks, benefits and limitations of dry eye treatment during your consultation.

There are a number of ways we can treat dry eyes depending on the causes and severity of your symptoms. Though there is usually no cure for dry eye syndrome, the condition can be successfully managed and you can return to a much more comfortable state with fewer symptoms. We aim to improve your quality of living with the latest technology and most up-to-date techniques backed by the best clinical research in line with Optometry Australia Association guidelines.

Treatment for dry eye syndrome may aim to increase tear production, maintain tear film volume or prevent excess loss of tears. In most cases we recommend a change in your behaviour (such as blinking more often) and will supply eye drops or gels than lubricate the surface of the eye (aka ‘artificial tears’). In the case of Meibomian Gland Dysfunction we have a specific treatment plan that is outlined here.

A general outline of some treatments of Dry Eye Syndrome is as follows:

  • Change of behaviour:blinking more often (which can take a conscious effort!); quitting smoking; remaining hydrated.
  • Artificial Tears:eye drops, gels which lubricate the surface of the eye maintaining a constant lubricated film.
  • Avoiding dry environments:air conditioning, dry winds and even direct exposure to simple fans can dry out the surface of the eye.
  • Medications:consult your doctor about the medications you take as side effects may include drying the eyes. There may be alternatives.
  • MGD:the leading cause of dry eyes requires special treatment which we outline here. E-eye device is convenient, safe, and allows clear vision during use, allowing you to carry out normal task activities such as reading, watching television or playing on your smart phone. We administer E-Eye treatment in our Noosaville Clinic for Dry Eyes patients.
  • Supplements:specialty formulation supplement called Dry Eyes –a proprietary blend of omega fatty acids which supports healthy tear film & reduces inflammation
  • Antibacterial Eye Wipes:Blepharitis (inflammation of the eyelids) is caused by bacteria which can be controlled using eye wipes to clean around the eyelids. These are most beneficial when used in conjunction with eye drops.
  • Antibacterial ointments:in more severe cases of Blepharitis we may recommend antibacterial ointments or tablets.
  • Punctal plugs:tiny, biocompatible devices inserted into tear ducts to block drainage to increase the eye’s tear film and surface moisture.
  • Surgery:only in severe cases surgery is considered in consultation with your GP and Ophthalmologist.
  • Specialty Warm Compress Products: Bruder EyeCompress applies a latent moist heat therapy around the eyelids to unblock the Meibomian glands and thus to improve eyelids and ocular health.(Available at both our Peregian and Noosaville stores.)

ABOUT THE E-EYE

The E-Eye is an IPL   device   that   generates   a polychromatic pulsed light by producing perfectly calibrated  and  homogenously  sequenced  light  pulses. The energy, spectrum and time period are precisely set to stimulate the Meibomian glands in order for them to return their normal function.

The E-Eye uses intuitive and simple software managed from a LCD touch screen. It starts in a few seconds and does not require any pre-heating.

Clinically tested and medically certified; all our IPL devices, the E-Eye is made in France and medically certified by TGA  (Therapeutic  Goods Administration) in Australia.

ABOUT THE TREATMENT

The goggles are adjusted on the patient’s eyes and the hydrogel applied on the skin. A series of four to five flashes are applied under the lower eyelid.

A session takes only a few minutes, no needles or injections are required!

THE RESULTS

Any  improvements  will  last  for about two weeks after the  first  treatment,  four  weeks  after  the  second  one, then for months afterwards. For optimum results four treatments are recommended as the effect is cumulative.

Scientifically Proven Efficacy

  1. Clinical trial in France 2012

Study on 150  patients  with  MGD,  Results  show  90% satisfaction rate after a series of 3 treatments on day 1, 15 and 45

  1. Clinical trial in New Zealand 2014
  2. Results at 45 days after 3 treatments
  • Significant improvement  in  the  Non-invasive tear break up time (NBUT) in the treated eye by not in the control
  • Significant improvement of the tear Lipid Layer Grade (LLG)
  • 86% of the participants noted reduced symptoms in the treated eye (SPEED Score)

HOW MUCH DOES IT COST?

The E-Eye has been designed and developed by the IPL world leader – French company E-Swin- in order to finally offer a treatment that actually works at a reasonable price.

E-Eye Treatment Course $570, consisting of 4 treatments. A booster is available at $190.

INSTALMENT PLAN

  • 1st treatment $300
  • 2nd treatment $300
  • 3rd treatment N/C
  • 4th Treatment N/C
  • Booster treatment $190