Dry eye syndrome is a chronic disease and is usually progressive. In most cases, dry eye can be successfully controlled, and the result is obvious increased eye comfort, fewer symptoms, and sometimes sharper vision. Depending on its cause and severity, the treatment may be for life.
Since dry eye syndrome can have various causes, various treatment methods are used.
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Below is a list of treatments that eye health professionals use to reduce the signs and symptoms of dry eye. . Your provider may recommend just one of these dry eye treatments or a combination of several treatments depending on the cause and severity of your condition.
Also, before starting dry eye treatment, some providers will ask you to fill out a questionnaire about your symptoms. Your responses to that survey are used as reference values. After several weeks of treatment, you may be given the survey again to assess the effectiveness of your chosen treatment method.
For the dry eye treatment to be successful, it requires that the person is in a position to follow the doctor’s recommendations and that he uses the products that the doctor recommends constantly and with the frequency indicated.
1. Artificial tears
For mild cases of dry eye caused by computer use, reading, schoolwork, and other exogenous causes, the best treatment is simply to use frequent artificial tears or other lubricating eye drops.
There are many brands of artificial tears that are sold over the counter. There is no lack of availability of the product, what does pose a challenge is choosing from the large number of brands and formulations available.
Artificial tears and other lubricating eye drops counter (OTC) are available with a wide variety of ingredients and viscosities (thicknesses).
Low viscosity artificial tears are light and watery. Often, they provide quick relief and produce almost no blurred vision when applied. Since their soothing effect is very brief, they must be used very frequently to relieve dry eye effectively.
On the other hand, artificial tears that have a high viscosity are more gelatinous and provide long-lasting lubrication.
However, many times these drops cause a noticeable blurred vision for several minutes immediately after applying them and that is why they are not a good option if they have to be used during the working day or when you need to have clear eyesight immediately. to perform tasks like driving a car, for example. It is best recommended to use them only at bedtime.
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Also keep in mind that the ingredients in certain brands of artificial tears determine which type of dry eye condition they are best suited for. For example, there are brands that work best for dry eye with watery mood failure, while other brands are more effective for evaporative dry eye condition.
If your eye doctor recommends that you use one or more artificial tear brands or formulations, be sure to follow their instructions about when and how often to use them. Also, do not substitute a brand that your provider has recommended for a different one. Using a different brand or multiple brands of artificial tears will make it difficult to assess the success of the treatment your doctor recommended for dry eye.
Study reveals operating rooms have an atmosphere conducive to dry eye
September 2016 – Dry eye affects approximately 10-20% of the population and the majority of people with the condition are over 50 years old.
In the case that you work in a ‘clean room’ environment, such as in an operating room, the risk is even higher: up to 56%. This is reported by a new study that evaluated the frequency of dry eye among residents of surgical specialties with only an average age of 27.8 years.
The clinician knows that activities that decrease the blink rate increase the prevalence of dry eye syndrome. For example, spending many hours in front of the computer screen is a well-proven risk factor for dry eye.
However, the use of digital devices is not the only activity that reduces the frequency of blinking and causes dry eye syndrome. A study conducted at the National Medical Center of the West (Mexico) concluded that residents of surgical specialties are also exposed to risk factors, including decreased blink rate, causing damage to the surface of the eye.
As the study explains, operating rooms are closed environments with artificial ventilation, where doctors and other team members perform activities that require intense concentration and fixation on details, such as using a microscope.
The study report appeared in the July 2016 issue of the journal BMC Ophthalmology. .
Steroid Dry Eye Drops
In recent years, doctors have recognized inflammation as a major factor causing dry eye. The inflammation frequently causes redness and burning associated with dry eye syndrome; But in many cases, it occurs without any visible signs or symptoms.
Artificial tears often do not adequately address these inflammatory changes, and the doctor will likely recommend steroid eye drops to better control the underlying inflammation related to dry eye syndrome.
Steroid eye drops are generally used short-term to quickly control symptoms. Often, they are used in conjunction with artificial tears and Restasis, as a complement to these long-term treatment strategies.
Although a small amount of steroids are absorbed systemically, in the right candidate, the effects of steroid eye drops are generally not perceived beyond the eyes themselves. Still, it is important to discuss your medical history with your provider before starting steroid eye drops.
There are many types of steroid drops and they differ in their potency. Most doctors prefer to start with mild steroids that break down quickly inside the eye. However, in some cases, more powerful drops are needed to address more severe symptoms.
Steroid eye drops can increase the risk of developing high blood pressure or even cataracts if used for long periods of time. Although these risks are low when the drops are to be used for short-term treatment of dry eye.
Tear plugs are sometimes used in the treatment of dry eye to help tears stay on the surface of the eye longer.
A tear plug is a small, sterile device that is inserted into one of the small openings (tear dots) in the lacrimal drainage system located at the inner corner of the upper and lower eyelids.
After these holes are plugged, tears can no longer drain out of the eye through these tubes. In this way, the tear film remains intact longer on the surface of the eye and thus alleviates the symptoms of dry eye.
So if the eye no longer drains the tears, where do they go? They usually simply evaporate from the surface of the eye without any symptoms. In the event that the tear plugs caused tearing, one or more may be removed.
Expression of the meibomian glands
A large percentage of dry eye cases are caused by insufficient oil ( meibum ) secreted by the Meibomian glands, which are located next to the margin of the eyelids.
The openings in these glands are near the base of the lashes, and if these holes become clogged, the oil, which is essential to prevent the tear film from evaporating too quickly, cannot do its job. This is called Meibomian Gland Dysfunction (DGM) and is the cause of a condition called Evaporative Dry Eye Syndrome.
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To treat DGM and dry evaporative eye, the eye doctor performs a procedure called meibomian gland expression in the office.
This procedure consists of applying hot compresses to the eyelids, and then a forceps-like device is used to compress the obstructed content of the Meibomian glands, which includes various substances, including a hardened oily compound called meibum. .
To fully squeeze out the contents of the Meibomian glands, and to get them working properly again, a lot of pressure must be applied to the eyelids, which can be uncomfortable; Although, the discomfort of the procedure is worth resisting for a short time.
An even more comfortable alternative to help open clogged Meibomian glands to treat dry eye is to apply warm compresses to closed eyelids to soften the meibum. .
Unfortunately, some researchers indicate that for hot compresses to work well they must maintain a temperature of 108 degrees Fahrenheit (42 degrees C) for more than 10 minutes, and in addition, compresses have to be applied twice a day during that time span. .
Most people are unable or unwilling to perform this type of dry eye treatment in the correct way. It should also be borne in mind that if hot compresses are applied for less time, less frequently and with variations in temperature, they are generally ineffective.
LipiFlow (TearScience) or thermal pulsation system is an automated medical device to treat dry eye. The treatment is performed in the doctor’s office and combines the best features of hot compress therapy and the expression of the Meibomian glands.
The patented device fits over the eye and over the eyelids, applying precise heat in a controlled manner to the eyelids to soften the hardened meibum . At the same time, the LipiFlow system applies pulsed pressure to the eyelids to open and squeeze the clogged Meibomian glands, restoring the correct balance of oils in the tear film to alleviate dry eye syndrome.
Lipiflow treatment takes approximately 12 minutes on each eye. In a clinical study on the real efficacy of this procedure, the majority of the patients (76%) declared an improvement in the symptoms of dry eye within two weeks.
The patients also showed an improvement in the quality and quantity of secretions from the meibomian glands, as well as in the duration of the time that their tear film remained in the eye before evaporation. However, in some cases, it may take a few months for the improvements to be noticeable.
Typically, the beneficial effects of LipiFlow last for one to three years or even longer.
Possible side effects of LipiFlow dry eye treatment include corneal abrasion, eye pain, swollen eyelids , irritation or inflammation of the eyelids, chalazion. , transient blurred vision, itching, and redness of the eyes.
Intense pulsed light
Intense pulsed light (IPL) is another way to treat rosacea that affects the skin of the face. Often, facial rosacea also travels to the eyelids. Ocular rosacea presents with dilatation of the small blood vessels that flow along the base of the eyelashes in patients suffering from blepharitis and contributes to the symptoms of dry eye.
In IPL treatment, a handheld device emits flashes of bright light on the skin. The light is filtered to allow only wavelengths that can be absorbed by the dilated blood vessels. The effect of this treatment is the resolution of the presence of dilated vessels and inflammation.
After IPL therapy, many patients notice relief from dry eye symptoms and rely less on artificial tears and other eye drops to control dry eye symptoms. For this reason, IPL treatment may be suitable for patients with dry eyes who do not want to worry about the drawbacks of frequent use of eye drops.
Typically, patients need four to six intense pulsed light treatments and about a month between each treatment. Treatments are usually well tolerated and are not associated with any period of convalescence. However, before treatment it is important to tell the doctor how much time you spend in the sun.
Generally, IPL treatment is not covered by health insurance or vision insurance and may also not be appropriate for those patients with certain skin pigmentation.
Sometimes doctors recommend nutritional supplements as part of a comprehensive dry eye treatment plan. Studies have found that supplements containing omega 3 fatty acids decrease dry eye symptoms.
Good sources of omega 3 are cold-water fish such as salmon, sardines, herring, and cod. For a vegetarian source of omega 3, some eye health professionals recommend flaxseed oil to relieve dry eye.
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Drinking more water also helps. Mild dehydration often makes dry eye problems worse, especially when the weather is hot, dry, and windy. Sometimes just drinking more water reduces symptoms of dry eye syndrome.
Home remedies for dry eyes
If you have mild symptoms of dry eye, there are several things you can try to get relief before visiting your eye care provider:
Blink more frequently
When we use the computer, the smartphone or any other digital device, we tend to blink less frequently than normal, causing or worsening dry eye symptoms.
You should be aware of this and blink more frequently when using these devices. In addition, the full blink must be performed: gently squeeze the eyelids to wash the eyes completely with a new layer of tears.
Take frequent breaks while using the computer
A good rule of thumb is to stare off-screen at least every 20 minutes and look at something that is at least 20 feet (6 meters) from your eyes and for at least 20 seconds.
Some vision professionals refer to it as the 20-20-20 rule, and following it can help alleviate the symptoms of dry eye and digital eye fatigue .
Completely remove eye makeup
Eyeliner and any other eye makeup can clog the meibomian gland openings at the base of the lashes, which can lead to dysfunction of the meibomian glands and evaporative dry eye.
At the end of the day, carefully remove all traces of makeup from the eyelids and eyelashes.
Clean the eyelids
When you wash your face before bed, also gently wash your eyelids to remove bacteria that cause blepharitis and problems with the Meibomian glands that lead to dry eye symptoms.
Apply a warm, damp cloth to closed eyelids for one to two minutes.
Then gently rub your eyelids and lashes with a mild cleanser, such as diluted baby shampoo or wet eyelid wipes sold at drugstores.
Wear quality sunglasses
When outdoors during the day, always wear sunglasses that block 100% of the sun’s UV rays. It is best if the lenses have a wraparound style frame to protect the eyes from wind, dust, and other irritating agents that can cause or worsen dry eye symptoms.
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Other aspects of dry eye treatment
In addition to the aforementioned dry eye treatments, your eye doctor may recommend one or more of the following supplemental measures if you have any of the conditions listed:
Many medications, including antihistamines, antidepressants, birth control pills, and certain blood pressure medications, can cause or worsen dry eye symptoms. Even over-the-counter (over-the-counter) medications for allergies and other conditions can cause dry eye syndrome.
If you are having any ailment related to dry eye, remember to tell your eye care professional about all the medications you are taking.
In some cases, when adjusting the type and number of medications you take, it helps reduce dry eye symptoms without causing adverse health effects; however, a medication should never be discontinued without first discussing it with the doctor.
If your eye doctor believes that adjusting to any of the medications could help alleviate dry eye symptoms, he or she will discuss it with your GP (or ask you to speak to your doctor) to see if this can be done. said change.
Treating eyelid conditions
If the person has blepharitis, meibomian gland dysfunction, or other diseases of the eyelid, they are often associated with dry eye syndrome and should be addressed as part of the dry eye treatment regimen.
For example, if the person has blepharitis, the eye care professional will recommend the use of antibiotics or steroids in ointment or eye drops, in addition to daily cleaning of the eyelids with a non-irritating shampoo.
Discontinue or reduce the use of contact lenses
If you wear contact lenses, it can be difficult to determine if the discomfort when wearing them is caused by an underlying dry eye condition or if the contact lenses themselves are the cause of dry eye symptoms.
If you wear these lenses, it’s usually best to discontinue them (or perhaps switch to disposable contact lenses on a daily basis for only partial daily use) while your dry eye treatment is ongoing.