The 3 layers of your tear film:
1) inner mucus layer 2) middle aqueous water layer wets the cornea & 3) outer oil layer to prevent tear evaporation
DED: More than 90% of patients have Dry Eye Disease. Your eyes will feel tire, dry, gritty, burning, blurry or watery if any of these layers is abnormal.
Chronic DED causes tear sodium hyper osmolarity & tear film instability, leading to progressive chronic inflammation & damage of your cornea.
Meibomian Gland Dysfunction (MGD): Blocked meibomian glands & abnormal oil secretion creates an unstable tear film with excessive evaporation.
This eventually causes permanent functional & structural damage, including non-reversible MG loss.
“Dry Eyes is the Wrong Diagnosis for Millions” Multiple studies 1, 2 have shown that DED is NOT an aqueous (water) but oil layer deficiency.
8 out of 10 patients, especially those involved in prolonged visual tasks, will have this condition due to lack of blinking and poor blinking patterns.
These procedures give symptom relief in the short-term.
It does not treat the MG disease or reverse MG loss.
1. Hot Compresses
Help temporarily open clogged meibomian glands, softens meibum oils, allowing the oil to flow to prevent tear evaporation.
2. Eye Lid Scrubs
Kills bacteria & clean bacterial biofilm that collect on the eyelashes & lid.
3. Anti-Inflammatory Drops
Reduces inflammation of cornea. Need your doctor to monitor treatment effectiveness & rare eye pressure rises.
4. Artificial Tears
Non-preserved tears with Hyaluronic Acid as lubricant is the best.
(wait 15 minutes after using anti-inflammatory drop)
5. Other Treatments
Some patients may need oral antibiotics,
Restasis anti-inflammatory tears & punctal plugs.
Chronic MGD leads to progressive MG inflammation; blockage & permanent gland loss.
Early treatment helps prevent further MG loss & reoccurrence of MGD.
The goal of treatment is to unblock the MG and to reduce inflammation of the MG and cornea.
You may need one or more of these treatment procedures, depending on the severity of your disease. Clinical trials of IPL & LipiFlow® have shown >80% of treated patients have significant improvements in both MG structure, function and patient dry eye symptoms.
1. IPL (Intense Pulse Light) a series of 3-4 treatments about 3 weeks apart reduces inflammation of MG by destroying bacteria/ parasites, enhance MG cell health & liquefies meibum oils. It has been FDA approved for many years for dermological treatments.3, 4
2. LipiFlow® Thermal Pulsation Treatment for MGD is the only FDA approved procedure that restores MG function. 1, 2
It utilizes controlled vector heat pulsations to flush out & unclog congested meibomian glands, allowing them to resume its own
natural production of lipid oils.
3. Omega 3 Triglyceride Fish Oil Supplement Daily reduces inflammation of MG. Restore MG & cornea cell health.
Natural triglyceride form is much better absorbed than ethyl-ester (alcohol) form.
DHA and EPA from oily fish
(sardines, anchovies & mackerel) are the most useful fatty acids. Therapeutic effect takes about 2 to 4 months.
"Dry Eyes" is the Wrong Diagnosis for Millions. 2015
LipiView: diagnostic device for MGD dry eye
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photography: stock & Dr Albert S. Y. Ng, OD, FAAO
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