Dye eye syndrome – Peter D’Arcy Optometrist Bega
Dry eye syndrome can occur when basal tear production decreases, tear evaporation increases, or tear composition is imbalanced. The lipid layer overlays a mucoaqueous layer.
TFOS DEWS II recommends using one of two validated questionnaires for evaluating the symptoms component of a dry eye diagnosis: the Ocular Surface Disease Index (OSDI) and the five-item Dry Eye Questionnaire (DEQ-5)
Women are more likely to develop the condition due to hormonal changes during pregnancy and after menopause. This syndrome is evidenced in up to 50 per cent of the population and can occur at any age.
Even chronic cases may require topical corticosteroids, tetracyclines, and cyclosporine A as anti-inflammatory therapy.
While studies do show serial IPL can restore the MG morphology viable natural therapies such as above can be controversial.
However omega 3 supplements if exceeds 1200mg/day,blinking exercises are becoming increasingly important. Humidifiers can be very helpful as can eyelid massage but need to minimise pressure on the globe hence merit of blephasteam
Blephasteam is a natural therapy and can be supplemented with Blephex debridement,to increase tear breakup time.
Blephasteam melts via comfortable,effective and safe moist heat technology the commonly blocked meibomian glands which cannot be safely achieved with conventional heat packs.
After 10 minutes of treatment where vision is not adversly effected the blocked essential evaporation reducing lipid oils are naturally released through normal blinking.Blephasteam heats your eyelids to 40°C, which has been demonstrated to be sufficient to melt the obstructing meibum with no risk to your eyes and eyelids.
This level of temperature and moisture combined with the length of the treatment has been shown to be safe and comfortable for use.
The safety and efficacy of Blephasteam have been evaluated in many clinical studies at this temperature.
Blephasteam is applied before Meibomain Gland Expression as it provides optimal conditions (such as consistent temperature and duration of heat) to prepare the glands and oils for unblocking.
Eyelid warming is important as it is used to melt the solid or blocked lipids into a more viscous oil again. This allows the natural oils in your tear film to flow freely again and to form the oily layer of the tears which reduces evaporation.
In case of Meibomian Gland Dysfunction, the oily secretions become more solid, ultimately blocking the glands. This can lead to atrophy of the glands and produce the symptoms of this eye syndrome.
Warm compresses require continued reheating which is unnecessary with Blephasteam.
The Tear Film and Ocular Surface Society [TFOS] DEWS II (International Dry Eye Workshop ) referenced more than 1,000 publications for an evidence based review of eye therapies.
The ocular surface disease index OSDI confirms the possibility of DED requiring diagnostic tests of non-invasive tear break-up time, osmolarity and ocular surface staining to determine if cause predominantly evaporative or aqueous deficiency.
In this eye disease, reduced tear secretion leads to inflammation and eye nerve damage which can be assessed.
We can avoid people making the mistake of self diagnosing eg eye drops for their allergens, or swollen eyes with cucumber slices or tea bags or use the wrong eye ointments based on their on waking symptoms.
Atrophied or blocked
Congealed or semi-solid discharge
Coloured liquid discharge
Clear liquid oil discharge
The correct frequency of blinking milks your meibomian gland oils which are very temperature sensitive.
Reduced frequency of blinking which can happen easily deteriorates the tear film leading in severe cases to such conditions as keratoconjunctivitis sicca.
To avoid optical aberrations a quality tear film is paramount as light can scatter from the highly powered corneal suface.
Tears are complex being hundreds of different protein, fatty oil, water, mucus types
In the first 6 postnatal months, the lipid layer of the tear film is much thicker than in adults. The NIBUT in newborns is prolonged compared with adult values. This thick lipid layer in infants provides stability that may help prevent the thin aqueous layer from evaporating.
Pain in this condition is caused by tear hyperosmolarity, loss of lubrication, inflammatory mediators and neurosensory factors, while visual symptoms arise from tear and ocular surface irregularity.
Also advancing age and conditions such as Rosacea, Blepharitis , Sjögren’s syndrome, Lupus, Scleroderma, Rheumatoid Arthritis, Diabetes, Thyroid disorders,Parkinsons Disease and Vitamin A deficiency,Eyelid health eg bacterial films ,oil gland congestion
Leptospermum sp honey (Manuka) can aid in this condition and meibomian gland dysfunction, Blepharitis Sore, irritated eyes and eyelids. The only adverse effects noted with the use of Optimel Manuka+ Eye Drops in the eye are stinging and redness.
Blepharitis is a chronic,common condition associated with this syndrome that affects the eyelids and it can be be associated with a bacterial infection, dry flaky skin (seborrheic dermatitis) or acne rosacea. It often can easily be treated with proper daily eyelid hygiene and warm compresses.
People suffering from Blepharitis may experience loss of eyelashes or abnormal growth of eyelashes; excess tearing/watery eyes or severe cases , scarring of the eyelid margin; eye infections such as sty, chalazion or conjunctivitis; difficulty wearing contact lenses.
Anterior blepharitis is commonly caused by bacteria , allergies, mite infestation, or dandruff of the scalp and eyebrows involving excess oil produced by the meibomian glands.
Posterior Blepharitis develops when the meibomian glands become inflamed and a thick, paste-like substance (meibum) is secreted or no oil is produced by the glands of the eyelids or skin conditions such as acne rosacea and scalp dandruff
Common symptoms (which may vary): itching, burning, scratchiness, foreign body sensation, excessive tearing, crusty scaling around the eyelashes, especially upon waking.
Common signs and symptoms include:
Many people routinely use often expired Visine or “clear eyes ” that constrict the eye’s superficial blood vessels.
Your eyes can develop a tolerance to the whitening effect of these drops, and even greater redness (called rebound hyperemia) can indeed occur
Optimel Leptospermum spp. honey products used twice daily over two months can improve MGD and evaporative dry eye .
Compared with conventional therapy, significant improvements in meibum quality and gland expressibility, reduced lid margin Staphylococcus spp. bacterial isolates and reduced ocular surface expression of the inflammatory cytokine MMP‐9 can be achieved.
•Lacritec is a formulation that works from the inside out to provide continuous dry eye relief.
•Lacritec delivers a proprietary blend of omega fatty acids sourced from Flax Seed, Fish Oil and Borage Oil.
•Australian developed, patented formulation works to support a healthy tear film thereby increasing Tear Film Breakup Time, and reduce inflammation in tear glands.
•Much more powerful than flaxseed oil or fish oil alone, also provides the unique omega fatty acid, GLA, from Borage Oil that cannot be easily obtained from diet alone.
•Improves dry eye relief with continued use; maximum results typically experienced within 4-6 weeks.
Apart from observing with high in office magnification using an illuminated self examination mirror such as Ichek helps in identifying the debris and crusting you may have on your eyelids and eyelashes before effectively cleaning and gently scrubbing
OCuSOFT Lid Scrub Original is recommended for routine daily eyelid hygiene and cosmetic removal,while OCuSOFT Lid Scrub PLUS is an extra strength, “leave-on” ( can be used twice a day for several hours and rinsed off) formula recommended for moderate to severe conditions.
Ocusoft Oust containing tea tree oil is also “leave on overnight ” even on face reserved for infestations from the demodex Mite and reducing inflammation that it creates.
To use pre Moistened fresh Pad fold over your index finger onto closed eye and gently scrub over your eyelid using side-to-side strokes with index finger for approximately 30 seconds.
Once you are done cleansing that eyelid, turn the pad over and use the opposite side to repeat the procedure with your other eyelid. You can use one pad for both eyelids,followed by rinsing off.
To use the pre-lathered foam formula, make sure your hands are clean pump Lid Scrub foam onto a clean,lint-free washcloth or fingertip.
Intense pulse light (IPL) of 500nm light in a series of calibrated pulses stimulate the Meibomian glands in order for them to return their normal function by closing the blood vessels that secrete inflammatory mediators. The 20-25 glands in both top and bottom lids decline with age. Over 40 we have between 10-12 on each lid. The Inferior glands tend to dysfunction first though. Minimum required is 3-4 each lid for comfortable eyes in most people.
Lipiflow(vectored thermal pulsation (VTPTM) technology) heats and massages for a continuous 12min but serial Blephasteams every week for 4-5 weeks could achieve a similar outcome.
For severe or persistent cases , or post-surgery use.
Preservative-free eye drops in a unique bottle.
Citrate buffered – completely phosphate-free.
Precisely delivers at least 300 sterile drops per pack through the patented COMOD multi-dose application system at 60% less cost per drop.