Not all dry eye is the same, and there is no one-size-fits-all treatment. It is important to book an appointment for a comprehensive dry eye examination to determine the right combination of treatments for you.
Dry eye treatments include diverse strategies involving drops, lid care, nutrition, lifestyle changes and in office procedures. This is a quickly evolving area of research, and our doctors are continually working to keep up with and invest in recent advances to make new treatments available to you. Treatments include:
- Artificial Tears are non-medicated drops, gels, and ointments that help to improve your tear film. There is an overwhelming variety of artificial tears on the market and your optometrist can help recommend appropriate drops for your type of dry eye.
HOW TO INSTILL EYE DROPS: Pull down your lower eyelid to make a pocket, drop a single drop into the pocket, and gently close your eyes. If you also use medicated eye drops, please wait to instill artificial tears at least 15 minutes before or after you put in medicated drops.
- Warm compress and lid massage can help to melt and distribute the good oils that become stuck in your meibomian glands, preventing evaporation of your tears.
HOW TO DO A WARM COMPRESS: Warm compress can be done using wet heat (a towel moistened with warm water), or using a dry heat mask heated in the microwave or a hot water bath. However, in order to be effective research indicates the compress needs to reach at least 40°C and retain that heat for a minimum of 10 minutes. Most people find that this is not possible with a moist towel, and dry heat masks are needed to retain high enough heat for long enough. Heat your compress to 40-45°C or as warm as you can tolerate without causing skin discomfort; test on the inside of your arm before applying. Lay back, apply to compress over your eyes and relax! It is normal to experience blurred vision after applying the compress- this is temporary and means it is working to bring the good oils onto the surface of your eye.
After you have applied the warm compress, attempt to massage the oils and debris out of your lids using a cotton swab or your fingers. Use a vertical upward motion on your lower lids and a vertical downward motion on your upper lids, following the natural shape of your meibomian glands towards the lid margins.
- Eyelid hygiene helps to remove bacteria, oil and debris that cause blepharitis. There are many eyelid cleansers on the market including lid wipes, foams, and gels. Your optometrist can help to discuss the most appropriate options for you.
HOW TO DO EYELID HYGIENE: Use the product to gently clean along your eyelids, eyelid margins and between your eyelashes. If you are doing warm compresses we recommend doing eyelid cleansing after you have applied the warm compress and lid massage.
- Omega-3 Fatty Acids are anti-inflammatory and help to improve dry eye inflammation when taken regularly. We recommend looking for an omega 3 supplement with a high component of DHA and EPA omega-3 fats. Depending on the study, dosages of 1000-4000mg of EPA and DHA have been shown to improve the signs and symptoms of dry eye.
- Prescription eye drops can be used to manage dry eye inflammation. These include lifitegrast, cyclosporine, and steroids such as loteprednol. These medications are most appropriate for dry eye with signs of significant inflammation; book an appointment to discuss with your optometrist if a prescription medication is right for you.
- Environmental and lifestyle changes can also help alleviate symptoms. Take frequent breaks from electronic devices, wear eyeglasses or sunglasses to protect your eyes from wind and air conditioning, increase hydration (drink plenty of water!), and consume a diet rich in omega-3 fatty acids; good dietary sources include fish, shellfish, flax seed, and walnuts.
- In-office treatments are also available:
- ZEST. ZEST is a comfortable and refreshing in-office lid cleaning system using a natural okra-based gel. ZEST kills and removes demodex mites and debris that cause blepharitis and dry eye. ZEST treatments are done in office by our trained lid hygienist.
- BlephEx and in office lid expression. BlephEx is a painless in office cleaning treatment for the eyelids that uses a spinning micro sponge. It is designed to remove the chronic “biofilm” of built up bacteria, mites, oil and debris that cause blepharitis and meibomian gland dysfunction. BlephEx treatments are done in office by our trained lid hygienist, and are followed by a visit with your eye doctor and manual meibomian gland expression, as well as instructions on at home lid hygiene maintenance. For more information visit http://www.rysurg.com/
- Punctal plugs. Punctal plugs are inserted into the eyelid drainage sites where tears drain out of your eyes, helping you to retain tears on your ocular surface. We offer Parasol Punctal Plugs, which are safely and painlessly inserted, and can either remain permanently or be removed at a later date.
- Scleral contact lenses. In cases of severe dry eye that have not responded to other treatments, larger rigid contact lenses can create a tear reservoir that holds moisture over your eyes throughout the day (as well as correct your vision!). We fit custom made scleral lenses that are designed and fit to your eye.
- Referrals for surgical treatments and additional procedures:
- Thermal Pulsation Devices (iLUX, lipiFlow)
- PRP drops or Autologous serum
- Intense pulsed light (IPL)
- Radiofrequency (RF)
- Low level light therapy (LLLT)
- Amniotic membranes
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