Dry eye syndrome is a common problem. Estimates are that 14.5% of adults 25 to 84 years old have dry eye disease. Over 25 million in the United States have some degree of dry eye. It is a very common reason for making a trip to the eye doctor.
This article is part of a series where we recognize Dry Eye Awareness month.
There are many symptoms of dry eye such as, stinging, burning, itchiness, redness, occasional blurry vision, and the feeling that you have something in your eye. Dry eye disease may make wearing contact lenses uncomfortable, or in severe cases, impossible.
The leading cause of dye eye is meibomian gland dysfunction (MGD). The meibomian glands are located in the upper and lower eyelids and secrete an oily substance that coats your natural tears and keeps them from evaporating too rapidly. There are approximately 25-40 meibomian glands in each lid.
MGD causes dry eye in two ways; either the gland is blocked and can not secrete normally or the gland produces poor quality meibom. In either case, there is increased evaporation of the tears.
Diagnosing Dry Eye Disease
You may already think you have dry eye based upon your symptoms, but a confirmed diagnosis of the cause of your dry eye by your eye doctor can help you find the best treatment to manage your dry eye syndrome.
Your eye doctor will use a slit lamp to thoroughly examine your eyelids and look for blocked meibomian glands or other cause of the dryness.
A tear film breakup test will allow your doctor to determine if your tear film coats your cornea adequately. If your tear film is breaking up too quickly, there may not be enough meibum to seal in your tears or the composition of the meibum is not oily enough. The composition of your tears can also be examined.
Direct visualization of affected meibomian glands is now possible with LipiScan.
Dry eye disease is usually a chronic condition, but it can be effectively treated and controlled, both by your doctor for more serious blockages, and with self-care that you can use to treat minor blockages or to maintain the unblocked glands after clinical treatments.
The clinical treatments for severe meibomian gland blockages are meibomian gland probing, meibomian gland expressing, and thermal pulsation. LipiFlow is a relatively new treatment combining pulsed heat and pressure to the affected glands. Treatment occurs in the office and may need to be repeated.
Meibomian gland probing is done with a small wire to pierce and unblock clogged meibomian glands. Meibomian gland expression uses paddles to squeeze blocked glands so the clogging material is “expressed” and the gland can resume secreting the oily meibum that coats your tears. Thermal pressure is done with a LipiFlow® pulsation device that applies both heat and pressure to open the clog and express it so it can be washed away.
Preventing Meibomian Gland Clogging
Even if your doctor unclogged your meibomian glands, you will need to maintain your eyelid health so your glands don’t reclog. Your doctor will discuss the recommended self-care you should follow. Among the options are daily eyelid hygiene with a gentle eyelid cleanser, warm compresses, Omega-3 fatty acid supplements such as fish oil or flaxseed oil capsules, and lubricating eye drops.
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