Dry Eye Treatment
Suffering from dry, itchy, red eyes? Dry Eye Disease may be the culprit. Learn how Gulfcoast Eye Center can help.
One of our main specialties at Gulfcoast Eye Center is treating chronic unresolved ocular discomfort and blurred vision.
A leading cause of that is multifaceted Dry Eye Disease. Dry Eye Disease (DED) is a complex condition with multiple contributing factors, primarily including Meibomian Gland Dysfunction (MGD), blepharitis, aqueous deficient dry eye, and evaporative dry eye. These conditions affect different parts of the tear film or eyelids, leading to eye discomfort, visual disturbances, and inflammation.
Please note there many different levels of severity and often a combination of contributing factors. By tailoring the treatments for each individual patient, we find success. Here’s a summary of each condition, and how they contribute to DED, and their treatments:
1. Meibomian Gland Dysfunction (MGD)
Overview: MGD is the most common cause of evaporative dry eye. It occurs when the Meibomian glands in the eyelids don’t produce enough oil (meibum) or the oil is too thick to properly coat the tear film.
Contribution to DED: The lack of oil causes the watery part of the tear film to evaporate too quickly, leading to dry, irritated eyes. MGD destabilizes the tear film and contributes to inflammation.
Treatment:
- Warm compresses: Helps to liquefy and unblock thickened meibum in the glands.
- Lid hygiene: Cleaning the eyelids with wipes (e.g., baby shampoo or commercial products like Ocusoft or Cliradex) to reduce debris and bacteria.
- LipiFlow to treat meibomian gland blockage and to improve oil secretion.
- Omega-3 supplements: May help improve the quality of meibum.
- Intense Pulse Light (IPL): This treatment helps with evaporative DED and MGD.
- Low Light Level Therapy (LLLT)
2. Blepharitis
Overview: Blepharitis is inflammation of the eyelids, usually at the base of the eyelashes. It is often caused by bacterial overgrowth, Demodex mites, or skin conditions like rosacea.
Contribution to DED: Blepharitis can block the Meibomian glands and worsen MGD, which destabilizes the tear film. The inflammation it causes further contributes to both evaporative and aqueous deficient dry eye.
Treatment:
- Eyelid hygiene: Daily cleaning of the eyelids with wipes or cleansers to remove bacteria, debris, and mites.
- Antibiotic ointments: Topical antibiotics (e.g., azithromycin or erythromycin) to reduce bacterial growth.
- Tea tree oil: Wipes containing diluted tea tree oil to target Demodex mites.
- Topical or oral antibiotics: In more severe cases, oral doxycycline or topical azithromycin may help reduce inflammation.
- Low Light Level Therapy (LLLT)
3. Aqueous Deficient Dry Eye (ADDE)
Overview: This type of dry eye occurs when the lacrimal glands don’t produce enough watery (aqueous) tears. It is commonly associated with aging, autoimmune diseases (e.g., Sjogren’s syndrome), or damage to the lacrimal gland.
Contribution to DED: Insufficient tear production results in dry, irritated eyes and can lead to chronic inflammation of the ocular surface. ADDE is classified as a tear-deficiency form of dry eye.
Treatment:
- Artificial tears: Over-the-counter lubricating eye drops to supplement tear volume.
- Punctal plugs: Small devices inserted into the tear ducts to block drainage and conserve tears.
- Autologous serum eye drops: Made from the patient’s blood to mimic natural tears and help heal the ocular surface.
- Medications: Prescription eye drops like Restasis (cyclosporine), Xiidra (lifitegrast), or Cequa to reduce inflammation and improve tear production.
- Intense Pulse Light (IPL): This treatment helps with evaporative DED and MGD
4. Evaporative Dry Eye
Overview: Evaporative dry eye occurs when the tears evaporate too quickly due to an insufficient or unstable lipid (oil) layer in the tear film, often as a result of MGD.
Contribution to DED: The rapid evaporation of tears leaves the eye’s surface dry and exposed, leading to discomfort, inflammation, and potential damage to the corneal surface.
Treatment:
- MGD Treatments: Same as MGD therapies (e.g., warm compresses, LipiFlow).
- Moisture chamber goggles: Help reduce tear evaporation, especially during sleep or in dry environments.
- Artificial tear gels or ointments: Thicker formulations that help coat the eye and prevent evaporation, especially at night.