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At Durrie Vision, our focus is on providing each patient with their best possible vision. Through our advanced diagnostics, our doctors are able to identify factors hindering your vision. Dry Eye is a common condition that can have a negative impact on visual performance. Durrie Vision’s Tear Optimization diagnostics and treatment plans combine to offer the region’s most advanced solutions for Dry Eye.

Dry Eye Overview

Dry eye is a multifactorial ocular surface disease, which affects millions. The lack of moisture on the front surface of the eye leads to discomfort, dissatisfaction with vision, and decline in visual performance. The tears are made of water, oils, and mucous. Any imbalance in the tear composition can lead to dryness.

Many people experience dry eye after prolonged screen time on the computer or with electronic devices, on an airplane, in air-conditioned/heated rooms or while outdoors.

Symptoms of Dry Eye 

  • Blurred vision
  • Visual fatigue
  • Itchy eyes
  • Burning
  • Redness
  • Light-sensitivity
  • Watering

What are the types of dry eye?

Dry eye is categorized as either evaporative tear loss or aqueous deficiency, or may be a combination of the two.

Evaporative Tear Loss occurs when the meibomian glands of the eyelid become dysfunctional due to inflammation or environmental factors such as wind, dry air, or plane travel. This accounts for an estimated 86% of dry eye patients.

Aqueous Tear Deficiency occurs when the lacrimal gland fails to produce enough of the watery component of tears.

Diagnosing Dry Eye with Lipview II

The eye examination and patient history are important in determining the presence of dry eye.  Recent advancements in testing aid in the detection of and categorizing dry eye. More accurate testing also helps to guide and objectively measure treatment progress for dry eye.

Using Lipiview II, the doctors at Durrie Vision can better analyze meibomian gland structure and function. Meibomian gland disease, or irregular lipid layer production of tears, is responsible for the majority of dry eye. LipiView II Dynamic Meibomian gland imaging accurately monitors meibomian gland structure, blink rate and the lipid layer measurements of the tear film.

Lipiview II allows earlier detection for meibomian gland dysfunction.  Blocked glands become damaged, and may eventually deteriorate or atrophy. Atrophy is a late consequence of untreated dry eye.  Once atrophy occurs, the damage can no longer be repaired.  Treatment, such as with Lipiflow, is more successful in patients with the milder form of the disease, before atrophy occurs. Earlier intervention in dry eye aims to keep patients from progressing to the more advanced, end-stages of dry eye disease. Patients with advanced meibomian gland dysfunction can still receive dry eye treatments to improve symptoms, but must continually manage chronic dry eye. Advanced, chronic dry eye has no cure.

Treatment & Therapeutics

Many treatment options are available, and should be customized to the patient and to the type of dry eye.  Treatments can be directed to decrease evaporation, decrease drainage, stimulate tear secretion, suppress inflammation, stabilize the tear film, or to enhance ocular surface healing.

LipiFlow

LipiFlow is the only FDA approved instrument for MGD shown to restore gland function. LipiFlow is a standardized 12 minute in-office procedure that uses therapeutic heat on the inside portion of the eyelid, with gentle pressure applied outside the lid. The mechanical, thermal massage liquefies and unblocks meibomian glands. Restored meibomian glands can secrete essential oils, improving natural tear production.

Avenova

Avenova is a prescription eyelid cleanser that uses gentle, non-preserved dilute hypochlorous acid which kills harmful and damaging bacteria. The cleanser is used daily for lid and lash hygiene. Avenova improves dry eye, lid irritation, and can be used as part of the regimen for ocular surgery. Avenova improves eyelid health without the use of antibiotics, which is especially important amid the concern of frequent antibiotics usage and growing bacterial resistance.

Artificial Tears

Topicals help to temporarily increase lubrication for the front surface of the eye. Lubricants provide instant relief, although are not often a long-term solution or stand-alone therapy.

Bruder Compress

The Bruder face mask warms eyelids and loosens clogged oils from dysfunctional meibomian glands. Warm compresses can be performed while at home daily or as directed by your physician.

Topical antibiotics

Topical antibiotics reduce resident bacteria which have overgrown on eyelids and lashes.  Reducing bacteria helps inflammation associated with bacterial waste products, which are harmful to the eye.  An abundance of bacteria can lead to infection, and injury to the eye.

Oral antibiotics

Oral antibiotics also help reduce bacteria for the lid and ocular structures, but for the rest of the body as well.  Oral antibiotics can pose more systemic side effects, and are reserved only for more advanced meibomian gland disease.

Restasis®

A prescription eye drop that helps stimulate tear secretion, or produce more tears, Cyclosporine-A blocks cytokines in the inflammatory process. Restasis® can be used for acute and chronic dry eye disease.

Punctal Plugs

Punctal plugs work by blocking drainage of tears through occlusion therapy of the tear ducts. Plugs are available in a range of parameters including 1-week, dissolving collagen plugs all the way through permanent silicone plugs.

PRN Omega Dry Eye

Oral supplements that contain the proper amount of Omega-3 fatty acids can help improve meibomian gland functioning and the lipid layer of tears.

BlephEx

Microblepharoexfoliation is an in-office procedure performed with a handheld device that gently removes and reduces the inflammatory biofilm on eyelids. The eye can produce more tears naturally after treatment. BlephEx can be used on eyelids not responding to conservative lid hygiene treatment with warm compresses and eyelid cleansers. Prescription eye drops are also not effective in removing biofilm. Regular hygiene can keep the biofilm from returning.