What is dry eye disease?

Dry eye disease affects millions of Americans and is underappreciated and often undertreated. In dry eye disease, the eyes do not produce enough tears or have poor quality tears. Remember that tears are made up of a mucus layer, an aqueous layer, and an oily layer, each having a specific role. When an imbalance of the tear components occurs, the tear cannot effectively soothe the surface of the eye, leading to inflammation and damage to the ocular surface.

Because dry eye is multifactorial, a thorough history-taking and clinical evaluation is important to identify the potential causes for one's dry eyes. Some causes of dry eyes are as follows:

medications
autoimmune disorders like Sjogrens syndrome, rheumatoid arthritis and lupus
hormone changes
eyelid malposition and blinking problem
skin problems like rosacea and blepharitis
medical treatments like chemotherapy and corneal surgeries
contact lens wear
ocular allergies
vitamin A deficiency
overexposure to smoke, wind, A/C, forced-air heat, and dry climate
prolonged use of digital devices

These factors can lead to ocular discomfort, visual disturbance, and ocular inflammation. Signs and symptoms of dry eye include the following:

eye redness
eye dryness and itching
a stinging or burning sensation in the eyes
grittiness or feeling like there is something in the eyes
light sensitivity
difficulty wearing contact lenses
difficulty driving at night
eye watering in response to ocular irritation
blurry vision

Once the causes of the dry eye have been determined, there are multiple approaches to managing dry eye disease. We can

treat the symptoms
or treat the underlying cause.

Often, the initial treatment plan is to manage the symptoms with the use of artificial tears or home therapy like warm compresses. Because dry eye is usually a chronic and progressive condition, these therapeutic methods can become time-consuming and ineffective as time goes on. Steroid eye drops are sometimes prescribed for inflammation, but their use is short term due to potential complications like cataracts and high eye pressure. Eyes on Queen Creek aims to identify the underlying causes of one's dry eye and recommend individualized therapies to tackle these causative factors.

A holistic approach to treating dry eyes

Eyes on Queen Creek believes that a holistic approach to treating dry eyes is necessary to be successful in managing this chronic condition. Patients can actually do better than just using artificial tears. We can start looking at diet and water intake, toxic ingredients in the products we use, environmental modifications, and possible co-management with other health specialists. We can also look into advanced therapies like intense pulsed light, low level light therapy, thermoelectric heating and tear stimulation to target the causes of dry eyes.

Tackling the conditions that cause evaporative
dry eye

Meibomian gland dysfunction (MGD), which is present in 85% of dry eyes, occurs when the oil producing glands on the eyelids provide inadequate or poor quality secretion. Because the oils these glands produce are essential to keeping the tears from evaporating, having an inadequate lipid tear layer leads to dry eyes and blurry vision.

Meibomian gland dysfunction is linked to medical conditions, such as:

bacterial infection
Demodex mite eyelid infestation
rosacea
and Sjogren's syndrome.

It also has been found as a result of the following:

low androgen levels
retinoid use
and eyelid tattooing

Epi- C Plus: a powerhouse to treat conditions that cause MGD

Epi-C Plus (FDA cleared as per K092734) is an advanced technology that uses both OPE IPL and LM LLLT to treat conditions that lead to dry eyes.

OPE IPL

Intense Pulsed Light therapy has been used since 1992. It has many uses, including the treatment of spider veins, hyperpigmentation, acne scars, and rosacea. In the treatment of conditions causing evaporative dry eye disease, light is used to reduce inflammation by targeting unwanted blood vessels and to rid of the bacteria and mites that cause MGD. Epi- C's patented Optimal Power Energy (OPE) IPL delivers pulses at the right intensity to ensure a safe, painless, and effective treatment.

Giannaccare G, Taroni L, Senni C, Scorcia V.Intense Pulsed Light Therapy In The Treatment Of Meibomian Gland Dysfunction: Current Perspectives.Clin Optom (Auckl) . 2019 Oct 17;11:113–126.

LM LLLT

Low level light therapy has been out for over 40 years and was originally used by NASA to treat astronauts in space. Nowadays, LLLT is used to reduce pain, inflammation, and edema. It works by photobiomodulation, which uses light to trigger photochemical changes on a cellular level. The photobiomodulation therapy enabled by the LM LLLT uses specific light frequencies that have unique benefits. The red mask is specifically great for reducing inflammation and oxidative stress, while the blue mask kills bacteria that cause acne and blepharitis.

Hamblin, M. AIMS Biophys. 2017;4(3):337-361.

Sulek A, Pucelik B, Kobielusz M, Barzowska A, Dabrowski JM. Photodynamic Inactivation of Bacteria with Porphyrin Derivatives: Effect of Charge, Lipophilicity, ROS Generation, and Cellular Uptake on Their Biological Activity In Vitro. International Journal of Molecular Sciences. 2020; 21(22):8716.

Studies have pointed out that there is an added benefit when both the IPL and LLLT are used in concert. IPL destroys unwanted blood vessels, and LLLT repairs damaged cells and improves the function of normal cells. Depending on the clinical findings and the severity of MGD, the doctor will recommend the type of treatment and the number of treatment sessions at the conclusion of the consultation.

Stonecipher, Karl. Combined low level light therapy and intense pulsed light therapy for the treatment of meibomian gland dysfunction. Clin Ophthalmol 2019 Jun 11:13:993-999.

MiBo Thermoflo: using thermoelectric heat to restore the function of obstructed meibomian glands

Healthy meibomian glands secrete lipids with the consistency of olive oil. Obstructed glands are clogged by thick, cloudy-yellow, waxy secretions. MiBo Thermoflo applies heat and pressure to improve meibum quality and evacuate the glands. It applies heat at a consistent temperature that is needed to melt waxy secretions, which may be difficult to achieve with at-home heat masks.

Connor C, Narayanan S, Miller L.The efficacy of MiBo Thermoflo in treatment of meibomian gland dysfunction. Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5678.

After a series of tests done during a dry eye consultation, we can identify whether the problem is an underproduction issue, evaporation issue, or a combination of both. To see if you're a good candidate for IPL, LLLT or MiBo Thermoflo, contact the office to schedule a consultation.

Let’s Work Together

E-Mail: eyesonqueencreek@gmail.com

20260 S Ellsworth Rd.

Queen Creek, AZ 85142

Tel: 480-847-1015