Dry eye and the need for tears has been recognized by healers since Ancient Egyptian times. Traditionally, doctors have battled the condition with dry eye treatments such as drops, warm compresses, even tiny punctal plugs that fit in the drainage structures of the eyelid to keep lubricating fluids on the surface longer. (You’ll find information on Horizon Eye Care’s Dry Eye page.)
Yet new, noninvasive technologies may allow eye care providers to diagnose and treat dry eye more efficiently. Horizon is proud to offer cutting-edge instruments like the LipiScan and LipiFlow to their patients.
Dry Eye Explained
About 30 million Americans, one in every 11, have a mild, moderate or severe form of the disease and it is the leading cause of visits to eye care providers in the U.S. Though causes vary, the most common is Meibomian Gland Dysfunction, or MGD, which is a blockage or abnormality of glands in your eyelids. MGD contributes to an estimated 86 percent of dry eye problems;; the rest come from aqueous deficiency, a reduced ability to produce the water component of the tear film.
Healthy tears contain lipids (oil), aqueous (water) and mucin. Lipids keep tears from evaporating too quickly; water lubricates the eyes; mucin helps anchor and spread tears across the eye. Tears, like your cornea and lens, refract light into the back of the eye, and must be of adequate supply and content to achieve optimum vision.
The lipid layer, as produced by the Meibomian glands, is perhaps the most important aspect of the tear film as it is the first place of contact between your eye and the outside world. A healthy lipid content looks a bit like baby oil, but if the glands are blocked or malfunctioning can become cloudy or even resemble toothpaste.
LipiScan And LipiFlow
Doctors have historically checked for MGD by examining the discharge from glands and measuring how long tears stay on the eye (ideally lasting 10 seconds or more). The LipiScan allows physicians to “see” the glands within the eyelid by taking a picture. Patients rest their chin in the device and look up, while a technician gently pulls down the lower eyelid and captures an image within seconds (without pain or exposure to bright light).
Doctors may examine the images on the spot. If Meibomian glands show signs of blockage or atrophy, a LipiFlow treatment may be recommended. Lipiflow is a painless, 12-minute long procedure which heats and massages your eyelids, working out stagnant oils, bacteria and dead skin cells to open glands.
Studies have shown an 86% improvement in secretions and symptomatic relief over 12 months with LipiFlow. It can be a one-time procedure or repeated as necessary; patients may help maintain improvement through the year by supplementing with warm compresses, eye drops, and flax or fish oil.
Who’s at risk for dry eye? Age, cosmetics and contact lens wear may contribute. Medications for conditions like high blood pressure, diabetes or allergies may worsen symptoms. Personal habits such as smoking or prolonged use of computers or handheld devices may irritate or dry out the surface as studies have shown reduced or incomplete blinking, decreasing proper lubrication.
Schedule An Appointment
If you want to investigate dry eye treatments, schedule an exam at Horizon Eye Care. Use our Patient Portal or call 704-365-0555 Monday-Friday, 8 a.m. to 5 p.m.
Lemp, M. A., Crews, L. A., Bron, A. J., Foulks, G. N., & Sullivan, B. D. (2012). Distribution of Aqueous-Deficient and Evaporative Dry Eye in a Clinic-Based Patient Cohort. Cornea, 31(5), 472-478. doi:10.1097/ico.0b013e318225415a
Blackie CA, Coleman CA, Holland EJ. The sustained effect (12 months) of a single-dose vectored thermal pulsation procedure for meibomian gland dysfunction and evaporative dry eye. Clin Ophthal. 2016;10:1385-1396.