An increasing number of people worldwide suffer from dry eye disease, the result of which can have a detrimental effect on vision, quality of life and work productivity.
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
- An aqueous layer secreted by the lacrimal glands
- A lipid layer secreted by the Meibomian glands
*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.
*The middle layer of the tear film is made up of aqueous, which is a watery and antibacterial substance that is hydrating and protective.
*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.
What is Dry Eye Disease (DED)?
Dry eye is a disease of the ocular surface resulting from an imbalance in the substances that compose the tear film. An imbalance of the components of the tear film may manifest as reduced tear secretion or excessive evaporation of the tears. This in turn leads to inflammation and damage to the eye surface tissue and nerves, often manifesting in eye discomfort which can limit daily activities.
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.
Risk Factors for Dry Eye
- Hormone imbalances – menopause
- Meibomian gland dysfunction
- Contact lens wear
- Prolonged use of screens
- Prolonged use of systemic drugs (e.g. antihistamines, antidepressants)
Use and abuse of eye cosmetics
- Low humidity environment
- Air pollution
Managing Dry Eye Disease
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 treatment.
What is eye-light treatment?
eye-light® relieves dry eye symptoms by using two synergistic technologies to stimulate Meibomian glands to resume the production of healthy lipids necessary for tear film stability.
It is the only instrument with 2 patented technologies which complement each other to achieve optimal results:-.
Optimal Power Energy® IPL is polychromatic intense pulsed light that is applied to skin in the periorbital and cheekbone area. The thermal pulses target the Meibomian glands and super-charge them, thus increasing the natural lipid flow and reducing the evaporation of tears. IPL is also known to reduce the inflammatory markers that negatively affect the function of Meibomian glands.
Light Modulation® LLLT is a light mask which applies photo-biomodulation technology that has been used for many years in various fields of medicine (e.g. dermatology, dentistry). The emission of light at a specific wavelength triggers an internal heating effect of the eyelids. This improves cellular activity and eases the spill of the tear film’s oily component from the Meibomian glands, hence stabilising the lipid layer and providing immediate relief. A useful benefit is that this treatment works on both the upper and lower eyelids.
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