Dry Eye, is essentially chronic dryness of the eyes and is caused by a deficiency in one or both of the layers of the tear film that covers the surface of the eyes; the thick water layer that mainly provides the lubrication, protection and delivery of nutrients to the surface cells of the eye or the thin, top oil layer that prevents the water layer from evaporating. The underlying tear film deficiency leads to the eyes drying out which in turn damages the surface cells of the eye leading to inflammation which causes the symptoms of dry eye. Interestingly, the inflammation caused by dry eye leads to more dryness which leads to more inflammation and so, resulting in a vicious cycle which can become chronic (long term) and sight threatening if an appropriate management plan is not implemented.
Dry Eye is very common and is estimated to affect 1/3 of the general population, however, certain factors can make you more susceptible. Factors such as age, female gender, medical conditions such as Sjogren’s syndrome, medications such as the contraceptive pill, a dusty, windy or air conditioned work environment and certain hobbies such as cycling. These factors can often cause or exacerbate existing dry eye, the symptoms of which include; burning, stinging, grittiness or general discomfort of the eyes, vision fluctuation throughout the day, difficulty reading or working on a computer for an extended duration, and discomfort with contact lens wear. The severity of symptoms can vary from mildly irritating to severely disabling and can adversely affect ones quality of life.
In Dry Eye, the glands that produce the water layer (located inside the skull) and/or the oil layer (located inside the eye lids) of the tear film are not functioning properly. Treatment options are intended to improve these tear film deficiencies and break the inflammatory cycle. In mild or intermittent cases this involves the appropriate selection of artificial tear drops specific to supplementing the lacking component in the tear film and other therapies such as warm compresses used to encourage the oil glands to function in a healthier manner.
Moderate to severe cases may require more advanced therapies to promote the health of the glands or prescription medications to assist in healing the eye surface, returning the eyes to a more manageable state. Advanced therapies aimed at improving the function of the oil glands include the Blephasteam and E-Eye Intense Pulsed Light (IPL) therapies. Prescription medications including anti-inflammatory eye drops and low dose oral anti-biotics can also be utilised to stop the ongoing cycle of dryness and inflammation, restoring the eyes natural balance. For all severities of dry eye, the right food types and or dietary supplements to support your eye health may also be advised by your dry eye specialist.
It is essential that the underlying cause of dry eye is determined as this will help the dry eye specialist team at Mortimer Hirst tailor the management plan to the type and severity of your dry eye, as well as to suit your personal needs. All the members of the clinical team at Mortimer Hirst are highly experienced at diagnosing and managing dry eye. Furthermore, Mortimer Hirst are among the early adopters of the Blephasteam and E-Eye Intense Pulsed Light (IPL) therapies, exemplifying our dedication to remaining at the forefront of diagnosing and managing dry eye utilising the latest technology and treatment protocols. If you have any concerns with dry eye or are not sure if what you are experiencing is dry eye, please consult our clinical team who aim to provide practical advice and who will work with you to optimize your eye health.
The clinical team at Mortimer Hirst can help diagnose and formulate a treatment plan so that this frustrating condition will not compromise your lifestyle.
Artificial Tear Supplements
Artificial tear supplements are eye surface lubricants, which aim to stabilise the tear film. There is an overwhelming number of these products available for the treatment of dry eye. These drops vary tremendously in their composition, some have preservatives and some do not, there is a large variation in viscosity (thickness) and some have an oil component. Our dry eye specialists will be able to recommend the most suitable eye drops, or combination of eye drops specific to your eye condition.
Essential fatty acids are contained within certain food types, which we must consume in order for our bodies to be able to create the correct composition and consistency of oils. A healthy oil layer of the tear film (known as meibum), needs to be secreted from a row of glands positioned along the lid margins. Our dry eye specialists will be able to provide advice on the types of foods to eat more of and introduce the most appropriate dietary supplement to help you obtain the right balance of oils in your diet.
This is a new in practice treatment that can be performed by your optometrist to help improve the tear film quality. It involves wearing a pair of humidified and heated eye goggles for a period of 10-15 minutes, which works to improve meibomian gland function and improve the health of the oil layer of the tear film. Once the period of heating is complete your optometrist will perform a manual expression of the glands to dislodge any blockages and increase the outflow of the oily layer into the tears.
E-Eye Intense Pulsed Light (IPL)
Intense Pulsed Light therapy is a new long-term treatment strategy for chronic dry eye disease. It involves applying intense white light in consecutive pulses to the area beneath your lower eyelid to help stimulate the oil producing glands and improve their ability to produce a healthy oily layer of the tear film. It is recommended that three sessions be performed to obtain the best results from this treatment. If the clinical team believe you are suffering from chronic dry eye disease they will refer to you an ophthalmologist for this treatment which is often covered by Southern Cross health insurance.
Anti-Inflammatory Eye Drops and Oral Anti-Biotics
The optometrists at Mortimer Hirst are all therapeutically qualified. This gives them the ability to prescribe anti-inflammatory eye drops and oral anti-biotics to break the cycle of ocular surface inflammation that occurs in dry eye. This can often be an important first step in the long term management of dry eye. Oral anti-biotics also play a role in improving the production capabilities of the oil producing glands.