Download “The Effect of Dry Eye”, by Vivek P. Vasuki, M.D.

Survey
yes no Was this document useful for you?
   Thank you for your participation!

* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project

Document related concepts

Vision therapy wikipedia , lookup

Eyeglass prescription wikipedia , lookup

Blast-related ocular trauma wikipedia , lookup

Diabetic retinopathy wikipedia , lookup

Cataract surgery wikipedia , lookup

Human eye wikipedia , lookup

Dry eye syndrome wikipedia , lookup

Transcript
THE EFFECT OF DRY EYE
By Vivek P. Vasuki, M.D.
According to the National Institute of Health, dry eye affects close to five
million Americans over the age of 50 as well as many younger patients. Are you one
of them? Here are some of the symptoms: watering, burning, foreign body
sensation, and intermittent blurred vision to name a few. If you are reading this
article and you are over the age of 50, there is a significant chance that you are
experiencing some or all of these symptoms. Unfortunately, most non-eye
specialists are not equipped to fully diagnose and treat the cause of this serious
problem.
The reality is that dry eye syndrome is so prevalent that it accounts for
about four billion dollars of national healthcare spending each year. Moreover,
a large quality of life survey conducted in 2011 found that having dry eyes impacts
us as much as cardiac chest pain. At first glance, that seems surprising, but if we
stop and think about the number of activities that require visual focus (reading,
watching television, cooking, knitting, fishing, hunting, etc.), maybe it’s not that
shocking after all.
WHY IS DRY EYE SOMETIMES SO DIFFICULT TO TREAT?
For being a simple two-word phrase, “dry eye” is actually an extraordinarily
complex topic. Finding the root cause of dry eye is not always easy. We know that
many factors play a role: systemic medications, autoimmune diseases, hormone
imbalances, and advanced age are at the tip of the iceberg. Even in situations where
certain contributing factors are more obvious, finding an effective and lasting
therapy is still a challenge for many patients.
Eye care providers have battled dry eyes for decades. You are probably
familiar with the use of artificial tears and lubricating ointments. Other approaches
to dry eye include tear preservation with punctal plugs or treatment of ocular
surface inflammation with topical medications such as Restasis or prednisolone.
While these treatments prove to be enough for some people, there is a growing
population of patients with dry eye that is resistant to traditional therapies.
Fortunately for these patients, dry eye research and treatment has matured quite a
bit over the past several years.
TEAR FILM QUALITY AND NEWER APPROACHES TO DRY EYE THERAPY
In order to have a proper clinical approach to treating this condition, we
must first understand what it means to have dry eye. Dry eye can be classified into
two groups: 1) Poor quantity or 2) Poor quality. The tear film is composed of oil and
water, and the quality of our tears has more to do with the oil in our tear film. Oil is
produced by 50 to 60 structures called Meibomian glands that line the edges of our
eyelids. The oil functions not only to smoothen the tear film but also to prevent
tears from evaporating in between blinks.
Over time, some degree of clogging of the Meibomian glands seems to be a
normal process, and this is termed Meibomian gland dysfunction or MGD. However,
in many patients this happens too early and/or too much. Clogging of glands is
reversible in its early stages, but if ignored, it leads to secondary inflammation and
ultimately to gland death. Historically, the treatment of MGD has been hot eyelid
compresses a few times a day to help free the oil glands. Unfortunately it is difficult
to get enough heat to the internal parts of the eyelid by placing the hot compresses
externally.
So how can we treat poor quality tear film? Two procedures have emerged
in the past several years that help boost and augment the oil in our tear film:
Lipiflow and BlephEx. Lipiflow uses a thermal pulsation system to actively express
oil from clogged glands. BlephEx uses a surgical grade microsponge to treat
inflammation of the eyelid margin that would otherwise lead to breakdown of the
oil layer in the tear film. Both treatments have demonstrated tremendous success
for patients who have failed traditional therapies. Both are also in office procedures
that can be done in many instances on the same day as the in-office visit. To learn
more about dry eyes and available therapies, contact Carolinas Centers for Sight, P.C.
to schedule a consultation (843-664-9393).
Dr. Vasuki manages complex medical and surgical eye disease. His specific
areas of interest include small-incision and bladeless laser cataract surgery as well
as treatment of dry eye that has not responded to conventional therapies.