There are many types of dry eye, though all types of dry eye result in similar symptoms: irritated, sandy, red eyes. The causes of dry eye are diverse, as are its treatments. For Vista Eye Care’s patients, dry eye is an especially prominent issue because of Colorado’s dry climate, and the fact that so many of our patients (including our own doctors and staff!) work a great deal of the day at computer screens.
Dry eye can be caused by a general lack of tear production. This can be influenced by age, medication use, and occupation. For patients with this type of dry eye, there are a variety of useful treatment options including artificial tears (to add bulk to the tear layer), punctal occlusion (to prevent tears from draining out of the eye too quickly), and medications designed to increase tear production (including Restasis® and Xiidra®).
If a patient has poor quality tears, then the above solutions may not work well. Most cases of poor tear quality stem from eyes being deficient in the oil layer of the tears. Think of the oil layer as floating on top of the tears and preventing the evaporation of those tears. Tear oil is secreted from oil glands in the lids called “Meibomian glands.” These Meibomian glands are prone to clogging up which traps the oil uselessly inside the lids, and the leaves the tears without that insulating barrier to the atmosphere. Now, tears are overproduced by the body, though these low quality, oil-deficient tears are incapable of adhering properly to the front of the eye. They evaporate quickly, or collect at the lower lid where exit the eye still leaving the cornea without good tear coverage.
The condition of clogged Meibomian glands is called meibomitis, and is thought to be the cause of the majority of dry eye cases. So for those patients suffering from Meibomitis, will adding artificial tears help? Will the treatments for poor tear production aid someone with tears of poor quality? The two forms of eye dryness are unique enough that their treatments are not interchangeable. Meibomitis needs to be resolved before dry eye issues can be solved. One excellent way to clear the Meibomian glands is to apply a heat mask. The heat in the mask breaks down the oil trapped in the lids making it easier for that oil to exit the Meibomian glands. A simple lid massage with your fingers after heating can help free-up the clogged glands. If the glands are sufficiently impacted, it may be necessary to use mechanical removal. Our doctors can express the Meibomian glands using specialized forceps. Now free of obstruction, the Meibomian glands can produce oil which can enter the tear layer and seal your own tears up against your eye. For cases of Meibomitis too severe for manual expression, an instrument called LipiFlow® can help restore the Meibomian glands to better functionality.
If you suffer from dry eye, please don’t hesitate to contact us at (303) 450-2020 to schedule a medical appointment for your eyes. Feel free also to use the button below to schedule your appointment online: