What is Dry Eye Disease (DED)?
Dry eye disease (DED) is a prevalent condition affecting millions worldwide, characterized by insufficient tear production (aqueous deficiency) or excessive tear evaporation (evaporative dry eye). It results in symptoms such as eye dryness, irritation, and vision disturbances. Studies indicate that DED affects approximately 5-50% of the global population, with higher rates in older adults, women, and contact lens users.
The causes of DED are multifactorial, including aging, hormonal changes, autoimmune diseases, environmental factors, and certain medications.
In recent years, the prevalence of dry eye disease has been increasing, notably in the digital age. Prolonged use of digital screens reduces blink rates, leading to faster evaporation of tears and exacerbation of symptoms. The increased screen time, combined with other modern lifestyle factors such as air conditioning, pollution, and reduced outdoor activities, contributes significantly to this rise.
Modern-day treatment options for DED focus on alleviating symptoms and addressing underlying causes. These include artificial tears and lubricating eye drops, prescription medications like ciclosporin, lifestyle modifications to reduce screen time and improve indoor air quality, and the use of devices such as warm compresses or punctal plugs to maintain tear film. Advanced treatments like intense pulsed light therapy (IPL) and serum eye drops are also ‘changing the game’, offering new hope for those with severe cases.
Meibomian Gland Dysfunction (MGD).
The majority of DED cases are related to Meibomian Gland Dysfunction (MGD). The Meibomian glands are important secretory glands located within the upper and lower eyelids. The lipid-rich secretion, called meibum, reduces tear evaporation and help keeps the tear film stable.
Obstruction or malfunction of the Meibomian glands prevents sufficient secretion of meibum, and affects the quality and texture of the meibum produced. An insufficient or absent lipid layer can result in tear film evaporation up to 16 times faster than what is normal.
Do you have any of these symptoms?
These symptoms in the diagram are often associated with dry eye disease. Speak to us or arrange a Dry Eye Assessment with our Optometrists if you experience any of these.
Occasional altered vision
Burning/Stinging
Foreign body sensation
Redness
Watery eye
Itching
Frequent eyelid infections (styes and chalazion)
Contact lens intolerance
The Tear Film
Before we consider dry eye disease, it is important to understand the nature of tear film which is the outermost, moisture-protective barrier of the surface of the eyes. Comfortable, clear vision is dependent on many factors, including a healthy tear film which is formed of 3 layers:
A mucin layer in contact with the corneal surface, secreted by the conjunctival goblet cells
The mucin layer is made up of protein rich substance called mucous, which helps the tear film remain against the eye surface and reduces friction between the tissues.
An aqueous layer secreted by the lacrimal glands
The middle layer of the tear film is made up of aqueous, which is a watery and antibacterial substance that is hydrating and protective.
A lipid layer secreted by the Meibomian glands
The lipid layer is made up of a waxy and oil-rich substance called meibum, to lubricate and slow down tear evaporation.
Ideally, the components of all these 3 layers should be in balance and of optimal consistency to facilitate clear, comfortable vision.
Dry Eye Assessment
Dry eye can be attributed to multiple factors, but identifying the major causative factors will allow determination of an appropriate management plan. Therefore we recommend a Dry Eye Assessment to investigate your symptoms and understand your condition better. A Dry Eye Assessment will involve the following:
- A detailed discussion of your history and symptoms
- Biomicroscopic assessment of your eyelids and eyelashes, including photography
- Scan of your tear film to assess quality, break-up time and meniscus height
- Use of diagnostic dyes, such as fluorescein and lissamine green, to assess for any surface cell damage
- Upper and lower eyelid Meibomian gland scans, also known as infrared meibography, to visualise the architecture of your Meibomian glands and grade the degree of MGD
If you are among the many with have MGD-related dry eye disease, you could benefit from Eye-Light IPL treatment.
Artificial tears are over-the-counter eye drops that mimic natural tears, providing temporary relief from dryness and irritation. They come in various formulations, including preservative-free options for sensitive eyes. Regular use helps maintain eye moisture, particularly in environments with low humidity or during prolonged screen use
Applying warm compresses to the eyes helps to open blocked meibomian glands, improving oil secretion and stabilizing the tear film. This treatment can be easily done at home using a clean, warm cloth or specialized eye masks, providing relief from symptoms associated with meibomian gland dysfunction.
Serum eye drops are created from a patient’s blood, processed to extract the serum, and diluted to form eye drops. These drops contain essential growth factors and nutrients that promote healing and provide significant relief for severe dry eye patients, especially those who do not respond to conventional treatments.
Low dose antibiotics, such as doxycycline and azithromycin, effectively treat blepharitis by reducing bacterial load and inflammation. They improve meibomian gland function and alleviate symptoms like redness, swelling, and crusting of the eyelids. Taken over an extended period, these antibiotics offer a targeted approach for managing chronic blepharitis and promoting long-term eyelid health.
Ciclosporin (Restasis or Ikervis) is a prescription medication that reduces inflammation in the eyes and increases tear production. It is typically used for chronic dry eye conditions where over-the-counter treatments are insufficient. It can take several weeks to months for patients to experience significant improvement
Punctal plugs are tiny devices inserted into the tear ducts to block tear drainage, allowing tears to remain on the eye surface longer. This procedure is minimally invasive and can provide significant relief for patients with moderate to severe dry eye, particularly when other treatments are ineffective
IPL therapy is a cutting-edge treatment that uses broad-spectrum light to target inflammation and improve the function of the meibomian glands, which are crucial for maintaining a healthy tear film. Administered by eye care professionals in a series of sessions, IPL has been shown to significantly reduce dry eye symptoms and enhance tear quality. This innovative approach is particularly effective for patients with moderate to severe dry eye, offering long-lasting relief and improving overall eye comfort. As a leading provider, we offer personalized IPL treatments tailored to meet individual patient needs, ensuring optimal results.
Scleral contact lenses are an innovative treatment for dry eye disease, providing significant relief by creating a fluid-filled reservoir over the cornea. These larger-than-standard lenses vault over the cornea and rest on the sclera, offering continuous hydration and protection from external irritants. Scleral lenses help maintain a stable tear film and reduce symptoms like dryness, irritation, and visual disturbances. They are particularly beneficial for patients with severe dry eye conditions unresponsive to other treatments. Custom-fitted, scleral lenses enhance comfort and improve quality of life for those suffering from chronic dry eye. They can also correct any underlying prescription.
Eye-Light IPL Treatment
Eye-Light® IPL therapy is a cutting-edge treatment designed to relieve dry eye symptoms by utilizing two synergistic technologies that target Meibomian gland dysfunction (MGD), a primary cause of dry eye disease. The treatment incorporates two patented methods: Optimal Power Energy® (OPE) IPL and Light Modulation® (LLLT), both working together to provide optimal results.
Procedure and Benefits
Optimal Power Energy® (OPE) IPL
Light Modulation® employs a light mask that applies photo-biomodulation technology, traditionally used in fields like dermatology and dentistry. This technology emits light at specific wavelengths, generating an internal heating effect on the eyelids. This process enhances cellular activity, promoting the release of the oily component of the tear film from the Meibomian glands. The treatment works on both the upper and lower eyelids, providing comprehensive relief and improving the stability of the lipid layer of the tear film.
Light Modulation® (LLLT)
OPE IPL uses polychromatic intense pulsed light, applied to the periorbital and cheekbone areas. The light’s thermal pulses target and warm the Meibomian glands, liquefying any blockages and stimulating increased natural lipid flow, which reduces tear evaporation and stabilizes the tear film. Additionally, OPE IPL helps reduce inflammation by closing abnormal blood vessels and eliminating bacteria and mites that can impair gland function.
About the Treatment
The treatment is an in-office procedure involving two main steps. During the IPL treatment, patients wear protective light-blocking googles and a series of 5 pulses is applied to the lower periorbital area. This is followed by the application of the LLLT mask over both closed lids and the periorbital area typically for about 15 minutes.
The thermal-based effect of IPL is supplemented by the further photobiomodulation effect of LLLT, to stimulate gland function and soften gland secretions ready for gland expression immediately after the procedure.
Most patients notice significant improvement in their dry eye symptoms after one or two sessions of this combined therapeutic approach, with optimal results often achieved after a series of treatments.
Soothe Your Dry Eyes Today
For more information and to schedule a consultation, please contact our Battersea branch and discover how Eye-Light® IPL can provide lasting relief from dry eye symptoms.
