Dry Eye and Blepharitis
Dry Eye And Blepharitis
Dry Eye is a medical condition of the ocular surface that affects tear production and/or the quality of your tears. It is one of the most common disorders of the eye. Dry eye patients may have difficulty reading, viewing a computer, watching television, or seeing clearly or consistently while driving. These symptoms may worsen later in the day or may vary throughout the day. Patients with dry eye may complain of stinging, burning, itching, redness, irritation, or intermittently blurred vision.
Blepharitis is inflammation and redness of the eyelid margins. It stems from disfunction and blockage of the glands. Discomfort, blurry vision, redness and mattering of the eyes can result, and dry eye is often present with blepharitis. Cleansing the glands of the lid margin is the usual answer to the problem and there are several approaches that can accomplish this. Cleansing the glands from within reduces the inflammation present and also helps moisture and comfort return by returning function to the glands.
In the past, these conditions have often gone unrecognized or inadequately treated. Patients may have been advised to simply use artificial tears, warm compresses, or use a few types of prescription drops or pills. All of these options treat the symptoms of dry eye but do not always address the underlying problem. We can do better than this. New testing and treatment methods are now available.
Dry Eye and Blepharitis Testing
Correct Testing Leads to Effective Treatment
The evaluation of Dry Eye and Blepharitis is both comprehensive and advanced at Marion and Delaware Eye Centers. We have incorporated the most straightforward and current methods of pinning down the reason why your eyes are troublesome and that results in providing an accurate diagnosis and specific answers to your dry eye problem. If there is a way to diagnose and treat your dry eye or eyelid irritation problem, we will find it.
Below are several of the tests we perform to diagnose your specific type of dry eye and blepharitis.
STEP 1-SCHIRMER TESTING
The Schirmer test is a standardized test which measures the aqueous (water) portion of the tear production. There are three portions our tears: water, mucous and oil. All three are important, and whether the watery portion is lacking or insufficient is detected by this test.
The InflammaDry test detects the presence of the MMP-9 protein marker in the tear film. This is a substance which shows the presence of inflammation in the ocular tissues. Inflammation is not quieted by artificial tear drops alone and may be a reason that such products do not always help in the treatment of dry eye. Recognizing inflammation allows us to prescribe a proper treatment to relieve your dry eye symptoms.
STEP 3-SURFACE STAINS
Use of a high-resolution microscope and digital photography after applying various stains (fluorescein and lissamine green) in the form of drops allow us to evaluate the quality of the tear film and detect surface damage to the eye from dryness. Such testing also allows us to document and monitor improvements in dry eye and surface health over time.
STEP 4-TEAR LAB TESTING
The Tear Lab instrument measures tear osmolarity, a critical tear quality index which shows the tear film’s ability to resist premature evaporation. Information gathered from this test is used to properly choose the type of artificial tears that will be helpful. Results are also used to monitor the effectiveness of treatment over time. This is essentially a measurement of how “normal and balanced” the tears are and allows the doctor to supplement what is lacking.
Lipiscan is an imaging device that reveals the function of the glands of the eyelid margin. Congested or blocked glands are revealed and the degree to which gland dysfunction contributes to eyelid inflammation is determined.
Lipiscan guides the physician and patient to decide whether the treatment of eyelid margin gland blockage is appropriate. If treatment is needed, the Lipiflow device described in the treatment section of our website is used.
Dry Eye and Blepharitis Treatment
We are a Certified Dry Eye Center of Excellence!
Marion and Delaware Eye Centers tailor treatment recommendations to match the results of testing. For some patients, moisture is still the simple answer. For others, there are several abnormalities causing dry eye and eyelid issues. This being true, all problems cannot respond to the same treatments or to artificial tears and/or lid cleansing. In some instances anti-inflammatory medications are used. For others, treatments to purge the material or organisms responsible for irritation and blur may be needed. The best treatment for your dry eyes is only discovered with proper testing. Discover which of the treatments may be helpful for your eyes by calling for an appointment today.
These are the classic treatment to add moisture to the surface of the eye. They are available in various thicknesses and vary based on the amount of water and lipid they contain. Different eyes require different types of artificial tears, some even requiring thicker agents such as gels and ointments. Testing indicates which is best for you.
BLEPHEX AND LID CLEANSING FOAM
BlephEx® is a painless in-office procedure performed by your eye care professional or trained technician. A revolutionary new patented BlephEx® handpiece is used to very precisely and carefully, spin a medical grade sponge along the edge of your eyelids and lashes, removing material and debris, while exfoliating the eyelid margin.
WARM COMPRESSES/GEL MASKS
Warm compresses are commonly utilized to improve the quality and drainage of the lid margin oil glands which produce oils that keep the tears from evaporating too quickly, producing longer lasting tears and more comfortable eyes with a more stable focus.
AVENOVA AND CLIRADEX
Avenova is a daily topical lid solution prescribed to treat mild to moderate eyelid inflammation. Cliradex is a daily lid-scrub wipe containing Teatree Oil, a substance that is very effective in the treatment of eyelid inflammation, especially when the cause is known to be due to the presence of the mite, Demodex, a common eyelid margin parasite.
Punctal plugs help to retain the naturally produced tears of the eye in the hopes of reducing or eliminating dependency on artificial tear drops. A small item is placed in the office into the small tear drain opening at the inner corner of the lid, thus blocking some of the outflow of tears and retaining them on the surface of the eye, reducing dryness. This is a simple office procedure that takes just a few minutes.
PRESCRIPTION EYE DROPS
This class of treatments includes antibiotics, which are prescribed to treat bacterial infections of the ocular surface and lid margin. As well, anti-allergy drops such as Zaditor, Pataday and Alaway are prescribed to treat symptoms of ocular irritation due to allergy. Topical steroids and other anti-inflammatory drops such as Restasis, Xiidra, and Cequa are occasionally prescribed to reduce chronic inflammation, thereby restoring the eye’s natural ability to produce tears.
Lipiflow from Johnson and Johnson is a treatment that purges and renovates the eyelid margin glands. Several warming and massage cycles gently remove blockages from the eyelid margin glands. As gland function improves, the eyes are left more comfortable and vision can become more stable. This comfortable treatment takes about 15 minutes to perform in the office and can last up to two years or longer.