Dry Eye Disease (DED) is one of the most common eye problems that we see in our clinics. We have seen the number of our dry eye patients grow overtime, in one hand as the baby boomers become older and on the other hand as young adults and even kids spend significant amount of time staring at digital devices.
Treatment of dry eye disease starts with proper diagnosis to determine the cause and type of dry eye disease.
To proper diagnose dry eye disease we have made a significant investment on advanced technology, educating our team with the most recent advancement in the field of dry eye disease( DED).
Since early detection of dry eye disease is very important, to start the treatment in early stage to prevent or delay the progression, we provide, non- invasive screening dry eye tests ,such as interferometry, NIKTBUT (None Invasive Keratograph Tear Break Up Time), and redness scan for our patients as part of our comprehensive, wellness exam. If dry eye diagnosed, in dept dry eye assessment will be scheduled to find out the exact cause of dry eye and make a plan for treatment in early stage to delay the progression.
Depends on the cause and severity of dry eye, the treatment could include one or combinations of the following treatments.
Antibiotics, steroid eye drops, lubricating eye drops and ointments, autologous serum, , warm compress, blinking exercises, cyclosporine eye drops, lifitegrast, Omega 3, punctal plugs, probing, scleral contact lenses, amniotic membrane transplant, Lipiflow, intense pulsing light (IPL) and ILux device treatments.
Eye doctors at Empress Eye Clinic in North York, Toronto use advanced technologies such as meibography, osmolarity, and ILux device, to diagnose and treat the cause of dry eye disease.
Meibomian Gland Disfunction (MGD), is the main cause of dry eye in most cases. ILux Divice is used to express the meibomian glands to help the flow of meibom. Treatments are quick and efficient. Targeted therapy in dry eye, allows direct treatment exactly where needed.
In a clinical study reviewed by FDA, the ILux procedure significantly improved patient ocular surface disease index scores, which measures the severity of the dry eye symptoms. The study always showed a significant improvement in patients pain and discomfort, visual acuity, and meibum quality.
Combination of Non-Invasive keratograph Tear Break Up Time (NIkTBUT), tear film dynamic, tear meniscus, redness scan, interferometry, meibography and osmolarity tests, help our eye doctor at Empress Eye Clinic in North York, Toronto to make a precise treatment plan for dry eye patients. This technologies also are great educational tool for our patients to understand the root cause of their dry eye and therefore to increase the rate of compliance.
Dry eye is a chronic and progressive eye disease, if left untreated it may become so severe that interfere with work and normal activities and damage the cornea.
Dry eye is a multifactorial disease of the tear glands and ocular surface that causes symptoms of discomfort such as irritation, gritty, scratchy, itchy, blurred vision, and excess tearing.
What is Dry Eye?
In a healthy eye, tears are responsible for the perfectly smooth ocular surface which allows clear vision. Tears also clean and lubricate the eye. Every time we blink, a fresh layer of tears, called the Tear lm, spreads over the eye. The Tear film is important for keeping the eye moist and comfortable and also to create a smooth optical surface on the cornea to provide a clear vision. Sometimes, the eye may stop producing enough tears or tears evaporate too quickly. This common and often chronic condition is referred to as dry eye disease.
It affects your quality of life!
People with dry eye disease may experience irritated, gritty, scratchy, or burning eyes, excess watering, and blurred vision. The level of discomfort is increased if you wear contact lenses or live in a dry climate. Paying attention to dry eye symptoms is important. If left untreated it may become so severe and debilitative that it interferes with work and normal life activities.
Causes of Dry Eye
There are many causes with several broad categories of dry eye. Each type comes with particular treatments. There is some overlap between the types of dry eye, making the condition challenging to manage.
Evaporative dry eye
Meibomian Gland Dysfunction evaporative dry eye
Environmental evaporative dry eye
Life style – staring at computer screens, televisions, or electronic readers for long periods of time, exposure to air conditioning, wind, smoke, and dry climates
Aqueous deficient dry eye
The problem is due to decreased production of the aqueous component of the tears film from the lacrimal glands. Aqueous deficiency usually associated with auto-immune diseases (Sjögren's Syndrome and rheumatoid arthritis). Other medical condition such as diabetes, thyroid problem, and inflammation of eyelids. other causes are LASIK or other laser eye surgeries, where patients can experience dryness temporarily or even permanently due to the severing of the corneal nerves. long-term use of contact lenses Medical treatments such a radiation or chemotherapy may have side effects which cause permanent damage to the lacrimal glands that produce most of the tears. Certain medications such as antihistamines, nasal decongestants, tranquilizers, certain blood pressure medicines may cause aqueous deficiency, Parkinson's medications, birth control pills, hormone-replacement therapy (HRT) and anti-depressants.
Age – dry eye disease often gets worse as we age Gender – women are more likely to develop dry eyes
The tear film
The tear film is structured with 3 components that work together: a complex mucus component, a watery portion (Aqueous) and a complex oil outer layer (Lipid).
The oil component (Lipid) is important for reducing evaporation of tears and also provides structure to the tear lm. Lipid is produced by the meibomian glands and is injected unto the tears with each blink. Meibomian gland dysfunction (MGD) can create a deficiency in the lipid component of the tears, which leads to the evaporative dry eye.
The watery component produced by the lacrimal glands (aqueous) is also important. A lack of aqueous production can result in another type of dry eye called aqueous deficient dry eye. Aqueous deficient dry eye can be associated with disorders such as rheumatoid arthritis and lupus.
The Keratograph 5M examination
Quality and quantity of the tear film
To measure the quality and stability of the tear film, the OCULUS Keratograph 5M measures the tear film break up time non-invasively. This test takes less than 30 seconds and does not require touching the eye.
To evaluate the quantity of the tear film, the Keratograph 5M takes a picture of the lower eyelid to measure the tear meniscus height.
The Keratograph 5M can document a movie of the oily layer of the tear film. A healthy and thick lipid layer is colorful and protects the tears from fast evaporation. If there is not enough lipid, the tear lm becomes unstable, the moisture dissipates quickly and both vision and comfort can be compromised.
Located in both upper and lower lids, the meibomian glands produce complex oils that stabilize the tear film and prevent tear evaporation. If the meibomian glands do not function properly dry eye usually occurs. Your doctor can utilize the advanced features of the Keratograph 5M to directly assess the health of your meibomian glands.
Dry eye treatments
For evaluating the dry eye and ocular surface disease and measuring the quality and quantity of the tear film, optometrists at Empress Eye Clinic in North York, use an advanced non-invasive diagnostic instrument to create a personalized plan for treatment.
Dry eye treatment can now be targeted to address the underlying cause of the problem. Some patients suffer from a lack of tear production, others from excessive evaporation of their tears. Most suffer from a combination of both problems. After a comprehensive examination using the advanced diagnostic tools provided by the Keratograph 5M, osmolarity tests, etc, your doctor can more accurately assess the precise cause and severity of your dry eye. Using this detailed information, they can recommend the best course of treatment to address your specific problem.
Keratograph® 5M has a high-resolution colour camera and is 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. With help of the Keratograph® 5M your eye doctor in North York, ON can find the root cause of your dry eye disease and can suggest the best treatment plan.
For patients with more severe dry eye, scleral contact lenses can be life-changing. By providing a physical barrier that holds a layer of tears in place and prevents evaporation, scleral lenses can provide comfort like nothing else. Using advanced technology we can design scleral contact lenses to provide clear and comfortable vision for dry eye pateints.
Wellness exam & general screening with the Keratograph 5M
Early detection is important for preserving your eyesight. Many eye disorders that lead to discomfort and reduced vision are easily treatable if diagnosed early. Regular eye wellness exams are recommended by our eye care professionals in North York, Ontario. The dry eye screening with the Keratograph is quick and easy.