According to the National Health and Wellness Survey, 16.4 million adults in the United States have been diagnosed with dry eye, and it is believed that many millions more have the disease but have not yet been diagnosed. Dry eye is a multifactorial disease, meaning that it can be caused by a wide variety of factors. Treating dry eye means understanding the many contributing elements that result in ocular surface disease and dry eye symptoms. Vista Eye Care prides itself in offering a comprehensive Dry Eye Clinic which uses the latest technology to identify the causes of dry eye. The information obtained then allows us to develop a customized treatment plan for each individual patient.
Dry Eye Disease Risks
Dry eye can be caused by a variety of environmental factors such as aging, smoking, computer/device use, contact lens wear, or a history of refractive surgery. Living in a dry environment, such as here is Thornton, Colorado, also makes dry eye more commonplace. Certain medications such as antihistamines and dermatological agents can exacerbate dry eye symptoms. Patients with systemic health conditions such as diabetes, arthritis, and Sjögren’s syndrome are more likely to have dry eye symptoms. Perhaps more than anything else, patients with Meibomian gland dysfunction are more likely to have dry eye symptoms as their eyelid oil glands don’t produce tear oil of sufficient quantity or quality.
Symptoms of Dry Eye
Patients with dry eye tend to have symptoms of eye burning, irritation, redness, tearing, or a sandy feeling in their eyes. These symptoms tend to be more pronounced after they spend time outdoors, work at a computer, or read. Some patients wake up in the morning with eye dryness, some have dryness progress more towards the end of the day, and others have generalized symptoms. No matter the time these symptoms are experienced, they are distracting and can cause significant pain and blurred vision.
Ocular Surface Disease Evaluation
Vista Eye Care’s dry eye exam is called an Ocular Surface Disease Evaluation, or OSDE. The OSDE is an opportunity for the dry eye patient to share their symptoms, have a medically-specific series of diagnostic tests performed, and then have our doctors develop a treatment plan. Every patient is different, and rarely are simply “eye drops” a practical solution to dry eye disease. We aim to treat the cause of the eye dryness and reduce, or eliminate the symptoms.
While many environmental factors affect dry eye, it is believed that as many as 90% of dry eye cases are due to the chronic, progressive inflammation and obstruction of oil glands in the eyelids. These oil glands, called Meibomian glands, are responsible for contributing a thin oil layer to the tear film which acts to protect the tears against evaporation and prevent desiccation of the ocular surface. Meibomian gland dysfunction (MGD) results when oil becomes trapped in these glands. We screen patients that complain of dryness, patients over 30 years of age, and contact lens wearers for MGD. For those patients with mild to moderate MGD, we perform a purpose-driven exam called an Ocular Surface Disease Evaluation to determine if there is something that can be done to save the glands and restore their crucial function. Often times, in-office treatment (such as LipiFlow) can help treat MGD, and prevent extreme eye dryness and discomfort. Vista Eye Care’s OSDE consists of the following:
- Patient Surveys
We start with a comprehensive dry eye symptom survey adapted from peer reviewed journals which give us insight as to the severity and lifestyle impact of the patient’s dry eye symptoms. Our Contributing Factors to MGD form and SPEED Dry Eye Questionnaire are available in our office, or they can be accessed on our Forms page here.
- Comprehensive Ocular Surface Evaluation
Using a variety of tests, we will evaluate the quality of the tear layer, check for contributing factors, review the patient’s medication list, review the patient’s health history, check the eyes’ ability to drain tears, and evaluate the structure and function of the Meibomian glands. Based on the results from this evaluation, we will then be able to develop a comprehensive dry eye treatment program.
- Treatment Program
Depending on the type of dry eye diagnosed, we can approach treatment many different ways. Eye dryness will generally boil down to either a tear quality issue, or a tear quantity issue. For those eyes that have a quality issue, Meibomian gland dysfunction is frequently to blame, and treatment aims at unclogging those glands and restoring their function. For those eyes that have a tear quantity issue, punctal occlusion (allowing the patient to preserve more of their own tears) and topical medications are frequently utilized. For those eyes that have a combination of tear quality and tear quantity deficiencies, a combination of therapies is often needed.
Dry eye is a serious eye disease that can negatively impact a patient’s quality of life. Vista Eye Care’s Ocular Surface Disease Evaluation is the cornerstone of our Dry Eye Clinic. Our OSDE offers a comprehensive evaluation and a variety of treatment options to those patients who would like a solution to this chronic, progressive disease. Please call our office today at (303) 450-2020 to schedule your OSDE.