Treating Dry Eye

What can we do to treat your dry eyes?

Meibomian Gland Dysfunction (MGD) has been shown to be responsible for 86% of all dry eye patients. It is chronic and progressive and seen on a wide array of patients. We see this is patients who have no symptoms to patients with debilitating symptoms. Traditional treatment for MGD has consisted of warm compresses preformed at home. In office treatment has included manual expression of the meibomian glands.  Office gland expression remains a helpful technique, but usually needs to be repeated frequently and can be uncomfortable.

  • Before we do anything to treat the obstruction it is important to get the lids unblocked. The doctor does this in the office by debriding, or clearing the blockage at the opening of the meibomian glands.
  • The LipiFlow® device provides vectored thermal pulsation to warm the meibomian glands through the inside of the lids and gently massage thickened meibum (lipid) and debris from the gland. This system is cleared by the US FDA for the treatment of MGD and evaporative dry eye. With many published results, LipiFlow® has proven to be safe and effective.
  • MiBoFlo is a heating device allowing us melt the meibum oil in the glands to allow the oil to release and giving an improvement in symtoms. This intensive heat therapy is a great adjunct to the lipiflow and is used mainly as a follow up therapy to keep the meibomian glands opened once they have been expressed.

Medications for Dry Eye

  • The two medications FDA approved for treating dry eyes in the United States is Shire’s Xiidra™ and Allergan’s Restasis®. Both Xiidra and Restasis are anti-inflammatory drops, working on different pathways in the inflammatory process. Xiidra is new to market and has been shown to help show improvement in signs and symptoms of dry eyes within days.
  • Topical steroid medications are often prescribed as a first line of treatment to help get the inflammation under control. Because steroid drops run the risk for potentially serious side effects, including glaucoma and cataracts, they are generally used for short terms and must be followed closely by a doctor.

Oral Supplements

  • HydroEye works from the inside-out with a combination of omega-3 and omega-6 fatty acids, antioxidants and other key nutrients that support proper tear secretion and a healthy tear film. It contains GLA (gamma linolenic acid) that is difficult to obtain from diet and omega-3 fatty acids from highest quality, pharmaceutical grade fish oil. Together, these fatty acids help to quiet inflammation. In a clinical study, HydroEye was shown to significantly improve dry eye symptoms, keep inflammation at bay and maintain corneal smoothness. Results from HydroEye are typically experienced within 30-60 days, although many experience relief sooner.

Lid Hygeine

  • Avenova eyelid cleanserHealthy lids are critical to managing dry eye and ocular surface disease. The lids contain the critically important meibomian glands which help support a healthy and stable tear structure. Bacterial overpopulation of the lids is extremely common and requires aggressive management. Avenova is a prescription medication that is used to treat blepharitis, an inflammation of the lids and lashes. Avenova is made of pure hypochlorous acid, the same agent that white blood cells use to neutralize infection.
  • For milder blepharitis that we need to manage daily we also offer Ocusoft eyelid foam. This is used on a daily basis to clean at the base of the eyelids/lashes.