Dry Eye Syndrome
Dry Eye symptoms can have a major impact on your quality of life, making daily activities uncomfortable and your vision unstable. Dry Eye Syndrome is often misdiagnosed as allergies since the hallmark signs include itching and watery discharge. At our Sugar Land clinic, our eye doctors specialize in diagnosis and treating Dry Eye Syndrome.
What is Dry Eye Syndrome?
Dry Eye Syndrome or Ocular Surface Disease is when surface of your eyes don't maintain the right balance of water, mucous and oil in your tear film, causing symptoms like burning, itching, watery discharge, redness, general discomfort and fluctuating vision. In essence, dry eye occurs when a person doesn't have enough quality tears to lubricate and nourish the front surface of the eyes. Dry eye is a complex disease and requires expertise and a thorough evaluation of your ocular surface and tears to help attain the correct diagnosis and treatment plan. Studies have shown that over the counter tears only help temporarily and are not a long term solution to treating dry eyes.
Before we delve into more serious dry eye treatment options, here are a few simple self-care options that can help manage minor symptoms associated with dry eye:
- Blink regularly when reading on a digital device or computer screen for a long time.
- Make sure there’s adequate humidity in the air at work and at home.
- Wear sunglasses outside to reduce sun and wind exposure. Wraparound glasses are the best.
- Take supplements with Omega 3's and essential fatty acids as these may decrease dry eye symptoms.
- Drink adequate amounts of water daily to stay hydrated.
- Find out if any of your prescriptions medications have dry eye as a side effect and if so, see if you can take an alternative. Common examples include over the counter anti-histamines.
Sometimes dry eye is induced by the things we do (such as starting at a digital device without blinking frequently) vs a true medical reason for dry eye sydrome. In these mild cases of dry eyes, a short term option are over-the-counter eye drops. Here are a few tips for selecting the right one:
- Low viscosity – These artificial tears are watery. They often provide quick relief with little or no blurring of your vision, but their effect can be brief.
- High viscosity – These are more gel-like and provide longer-lasting lubrication. However, these drops can cause significant blurring of your vision for several minutes. For this reason, high-viscosity artificial tears are recommended at bedtime.
Dry Eye Treatments
In your dry eye evaluation we will evaluate your medical history, all parts of the surface of your eyes, your eyelid glands and your tears to determine what the cause of your dry eyes are.
A custom treatment plan will then be initiated by Dr. Somji or Dr. Sana. Here are a few treatment options that may be discussed at your visit:
- Contact Lenses – either a soft lens used as a bandage lens to protect your eyes from dehydration or a custom scleral contact lens to help provide moisture and hydration to your eyes while providing excellent vision.
- Antibiotics – specific antibiotics can reduce inflammation of the glands in your eyelids, allowing the lipid or 'oily' part of your tears to flow more freely.
- Anti-inflammatory drugs – dry eye syndrome is also known as ocular surface disease because the surface of the eye can be inflamed from chronic dry eyes. In these situations, reducing surface inflammation in the short term with steroid eye drops or long term with prescription strenght drops such as Xiidra, Restasis or Cequa may be necessary.
- Punctal Plugs – sometimes when there isn't enough total tear volume in the eyes, our doctors will insert dissolvable punctal plugs into a specific area in your eyelids (tear ducts) to prevent the tears that are there from draining from the eyes too fast.
- Autologous blood serum drops – For serious dry eyes that do not respond to other treatments, these eye drops are made with a sample of your blood. It’s processed to remove the red blood cells and then mixed with a salt solution.
Amniotic Membrane Lenses – when there is excessive damage from chronic inflammation on the surface of your eyes, we may insert a special biological membrane contact lens for 3-5 days to help heal the damaged surface. This biological contact lens is made from human donation amniotic tissue and has extremely potent regeneration properties. Dr. Somji and Dr. Sana have provided many patients with relief by utilizing these special biological treatment lenses.
Warm Compresses and Eyelid Scrubs – usually prescribed as a supplement to other dry eye treatments. Warm compresses can help unblock the glands that are responsible for produce the oily part of your tears
- Mibo® Thermoflo - This treats dry eyes by massaging the margins of the eyelids. It uses controlled heat to unclog the meibomian glands to restore a healthier, more balanced tear film.
- ThermaeyePlus® IPL - This treats dry eyes by utilizing pulses of light that liquefies and releases hardened oils that have clogged meibomian glands in the eyelids. It reduces eyelid redness and stimulates healthy gland function. This treatment has long-term success in treating severe dry eye and the causes.
- BlephEx – This treatment helps to remove inflammatory material on the eyelids and unblock oil glands. This painless treatment is done in-office and takes only 10 minutes. We have provided residents of Sugar Land, Katy, Houston and other areas with amazing relief with this treatment since 2013!
BlephEx Eyelid Cleaning
The BlephEx™ treatment is a precise, safe and effective way to clean and exfoliate your eyelids and eyelashes to relieve symptoms of blepharitis.
What is blepharitis?
Blepharitis is an inflammatory disease affecting the eyelids and eyelashes and causes a buildup of scurf, debris and bacterial toxins at the base of the eyelashes. This is known as anterior blepharitis.
The inflammation caused by anterior blepharitis causes the eyelid tissue where the meibomian tear glands reside to become thick and swollen, preventing healthy oils from being released into the tears. This is known as posterior blepharitis or meibomian gland dysfunction (MGD). This causes significant symptoms of burning, itching, dry eyes, and general eye discomfort.
MGD traps bacterial toxins at the lid margin causing more anterior blepharitis and a continuous vicious cycle of inflammation is formed.
What is the most effective way to treat blepharitis?
With the new BlephEx™ instrument, we can now effectively clean and exfoliate scurf, debris, and inflammatory toxins from the eyelids and eyelashes to disrupt the vicious inflammatory cycle established with uncontrolled blepharitis!
What can I expect from treatment with BlephEx™?
It generally takes about fifteen minutes to perform the BlephEx™ procedure on all of your eyelid margins. The procedure is painless but you will feel a tickle or itch during the treatment! Dr. Sana and Dr. Alireza Somji take their time and make sure you are comfortable. This treatment allows most of the scurf and debris to be exfoliated from all of your eyelid margins. You can expect the treatment to last for several months. Some patients may need treatment once a year while others with aggressive blepharitis may need several treatments a year.
What are the symptoms of blepharitis?
- Itching or scratchy eyes
- Foreign body sensation
- Dry eyes
- Eye rubbing
This technology is used to diagnose meibomian gland dysfunction (MGD), which indicates an abnormality or blockage of the meibomian glands. When these glands are not working properly, it results in a reduction of oil secreted into tears, which causes dry eye syndrome. MGD is the leading cause of dry eye syndrome.
LipiScan is a non-invasive procedure which helps our doctors see and analyze the health of your meibomian glands. It plays an important role in diagnosing and treating the symptoms of dry eye syndrome.
LipiFlow complements LipiScan procedures by helping to treat dry eye syndrome caused by MGD. By combining gentle massage and heat, this directly treats the meibomian glands to improve gland secretions. This treatment is considered convenient for many patients, as it is a dropless option, and reduces the need for daily eye drops. The entire procedure is safe and comfortable and is performed in our office in under 15 minutes.
If your eyes are painful, scratchy, red, watering, irritated or feel dry MiBo Thermoflo may offer relief
MiBo Thermoflo Treatment
The MiBo Thermoflo is a therapeutic medical device providing a safe and effective alternative therapy for dry eyes. It uses a proprietary thermoelectric heat pump to help maximize liquefaction of meibum, thus improving preservation and function of the evaporative component of the tear film.
The MiBo Thermoflo supplies continuous controlled heat that is applied to the outer skin of the eyelids along with ultrasound gel for a gentle massage. The heat is absorbed deep into the tissue and breaks down the hardened lipids in the meibomian glands.
With a specifically prescribed therapy regimen, the ducts of the meibomian glands will secrete thinner and clearer lipids which will allow for a healthier tear film.
For best results, it is recommended doing three treatments two weeks apart. After evaluating the patients after the cycle of treatments, it may be determined that they require a fourth treatment. Most patients may go twelve months before needing additional treatments
The heat from the device is not hot enough to injure the eyelids. The treatment is pain free and most patients find it very soothing and relaxing. The treatment itself takes about 20-30 minutes.
Intense Pulsed Light (IPL) treatment for dry eye utilizes pulses of light to constrict blood vessels and liquefy and release hardened oils that have clogged meibomian glands in the eyelids. IPL also affects vascularization and inflammation of the eyelids, reducing eyelid redness and stimulating healthy gland function.
The procedure is relatively comfortable and quick — taking only about 10 to 15 minutes in total. Most patients require four treatments initially (one per month) and then maintenance treatments are required on an annual basis. This may vary depending upon each individual patient’s disease severity.
After the initial treatment, most patients report some improvement in their symptoms with the maximum improvement following the 4th treatment. Depending on the severity of the dysfunction, some patients may need fewer treatments while others require more. All patients will need maintenance therapy once to twice per year.
The best candidates are patients with dry eye, or patients suffering from meibomian gland dysfunction (MGD).
Schedule a Dry Eye Evaluation
You don’t have to suffer from the symptoms of dry eye or settle for being told to use an over the counter eye drop. Talk to our team to schedule your dry eye evaluation with one of our eye doctors who specialize in dry eye evaluation and treatment in Sugar Land.
Our Practice Recommends De3 by PRN for occasional eye dryness, to provide the body with the essential nutrients it needs to produce a soothing, healthy tear film.
Studies show that long-term use of 2240MG of EPA/DHA in the re-esterified Triglyceride form (RTG):
- Significantly improves occasional dry eye discomforts such as grittiness, dryness, and burning2
- Improves tear film quality, contributing to overall eye comfort and stable vision2
- Ensures tears are healthy as part of creating a healthy surface for surgery
- Provides critical nutrition to produce healthy, soothing tears
- Can produce optimal levels of omega-3s in 90 days