By Dr. Anna Spicer (B. Optom (Hons) UNSW GradCertOcTher)
If you have experienced eyes which are sore, red, burning, watery, sting, sensitive to glare or blurry vision, you may have dry eye.
Dry eye disease affects more than 4 million Australians and it’s on the rise. In January 2020, Optometry Australia reported 77 percent of Australians have suffered with dry eye, yet only 26 percent have seen an optometrist about the latest treatment options available.
Dry eye can occur when your tears don’t properly lubricate your eyes, making them sore and gritty.
Tears comprise of three layers: the mucin, aqueous and lipid. Any disruption of these layers can cause dry eye.
- Mucin coats the eyeball and helps tears to adhere to and spread over the eyeball
- The aqueous layer makes up most of the tear film thickness. It includes nourishment for the eyes (vitamins, minerals) as well as defence mechanisms (cells which target bacteria and viruses)
- The outer layer is made of oil (secreted by Meibomian glands) to prevent evaporation. The Meibomian glands are tiny oil glands which line the margins of the upper and lower eyelids (the edges which touch when you blink).
Meibomian gland dysfunction (MGD) is involved in most dry eye conditions. MGD occurs when the Meibomian glands are not secreting enough oil, or when the oil secreted is of poor quality. The oil gland openings can become clogged, preventing the lubricating oil to come out of the glands. The oil that does make it out of the glands can be unhealthy and cause irritation to the eyes. The tears evaporate at a higher rate due to the lack of this oily layer. MGD is very common and leads to dry eye disease. If left untreated, MGD can progress and become chronic, causing a vicious cycle.
Dry eye is caused by many factors and is an inflammatory disease. The tears are disrupted, become unstable and result in discomfort and vision disturbances. Dry eye leads to damage to the surface of the eyes and is more common with increasing age. It is also seen in younger people due to increased use of screens (computer, phones and other devices). Children as young as 10 have been diagnosed with dry eye disease. Most people have dry eye at some point in their life and some may not even realize it!
Contributing factors of dry eye include:
- Increasing age
- Menopause
- Cataract surgery
- Laser eye surgery
- Contact lens wear
- Meibomian gland dysfunction (MGD)
- Health conditions (e.g. autoimmune conditions like rosacea, lupus, rheumatoid arthritis and Sjogren’s syndrome)
- Eyelid conditions (e.g. blepharitis – inflammation of the eyelids. Blepharitis usually affects both eyes along the edges of the eyelids. Blepharitis commonly occurs when tiny oil glands near the base of the eyelashes become clogged, causing irritation and redness)
- Medications (e.g. for blood pressure, allergies, acne, contraception)
- Environmental factors (e.g. air conditioning, wind)
- Using computer and phone screens.
As dry eye is a chronic and progressive condition, early diagnosis and treatment is key. The longer it is left unaddressed, the harder it is to treat. Preventative care is also now possible with new technology.
Commonly, lubricating eye drops are recommended. This only treats the symptoms and not the cause. Eye drops can provide temporary relief while the underlying condition continues to progress. The best protocol for dry eye treatment is to address the root cause, so patients can be weaned off medications, drops and supplements.
Management for dry eye can include:
- Lubricants and medicated eye drops
- Addressing eyelid issues
- Lifestyle modifications (e.g. minimising dry environments, eating more fruit and vegetables, stress management)
- Visual hygiene (taking breaks from reading/computer use)
- Avoiding irritants (cigarette smoke, shimmery/powder makeup)
- Supplements
- Intense Pulsed Light (Lumenis Optima IPL).
Intense Pulsed Light (IPL) is a revolutionary treatment for dry eye developed by world–leading ophthalmologist, Dr Rolando Toyos (USA). It gently and effectively treats your skin and eyelid inflammation with maximum safety, comfort, and full customisation. IPL uses gentle pulses of light to treat the underlying cause of dry eye. It is a painless procedure done in an eye health professional clinic.
The light technology stimulates the Meibomian glands, melts the clogged oils and improves their function. IPL targets the skin around the eyes, reducing inflammation and excess bacteria. It also targets abnormal blood vessels which cause rosacea, improving the appearance of the skin and ocular rosacea. Over a series of treatments, the glands improve and maintain function, giving relief to dry eyes, reducing the dependency on eye drops. It is drug free and non–invasive.
Lumenis IPL is the only FDA (Food and Drug Administration) and TGA (Therapeutic Goods Administration) approved IPL for dry eye. It is now increasingly integrated into the treatment for dry eye and provides the best results of all treatments currently available for dry eye worldwide.
Treatment is customised to the patient’s skin type. Patients report that treatments are gentle, thanks to a continually cooled handpiece designed for enhanced comfort. There is minimal downtime, and improvements can be felt after one or two treatments. For many years Lumenis IPL has been used aesthetically to improve the appearance of skin and patients notice a reduction in fine lines, pigmentation, and improved skin texture after dry eye treatment.
Dry eye is a common and multifactorial condition which can be managed. It starts with finding an optometrist or ophthalmologist with an interest in dry eye, correct diagnosis, and evidence based up to date treatment to return to healthy function of the meibomian glands and tear film.
Dr. Anna Spicer is an optometrist on the Central Coast. She enjoys working with Lumenis IPL in the prevention and treatment of dry eye, giving long–time sufferers immediate and prolonged relief. Dry Eye Solution Erina is a dedicated dry eye clinic, utilising the only Lumenis IPL on the Central Coast. To book, call 4312 4273 or book online at www.dryeyesolution.com.au