Dry Eye Disease

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• Aging:  As we age, tear production decreases. Men and women of any age can be affected. However, after menopause and during pregnancy, women are especially susceptible
• Contact Lenses:  Wearing contact lenses often increases tear evaporation. This can result in irritation, increased protein deposits, infection, and pain. Dry eye has been shown to be the leading cause of contact lens discomfort.  
• Medications:  A variety of common medications reduce tear secretion. These include decongestants, antihistamines, diuretics, beta-blockers, sleeping pills, antidepressants, pain relievers, and alcohol consumption.  
• Environment:  Occasional or continual exposure to various environments can reduce eye lubrication. These include sunny, dry or windy conditions; areas with heaters, dehumidifiers, fans or air conditioners; work settings; high altitudes, smoke or air pollution and sand, dust or airborne pollen,  recycled air environments
• Auto Immune Disease:  Diseases such as Lupus, Rheumatoid arthritis, Sjogren's, MS and others can have dry eye as a symptom.  Sjogren's Syndrome is a more severe form of dry eye and can be accompanied by dry mouth.

Redness 

Mucous Discharge

Scratchy, Gritty Feeling 

Burning 

Sticking of eyelids

Stinging 

Blurred Vision 

Fluctuating Vision

Itching 

Excess Tearing (watery eyes) 

Irritation from Wind or Smoke 

Tired Eyes 

Light Sensitivity 

Contact Lens Discomfort 

Contact Lens Solution Sensitivity 

Soreness 

Lid Infections  

Sensitivity to Artificial Tears 

Sensitivity to cosmetics

High dose omega 3 supplementation has been shown to reduce inflammation in the body.  In the ocular region it has been shown to help improve tear quality.  Our practice recommends omega 3's in the triglyceride form.  PRN (Physcian Recommended Neutraceuticals) Dry Eye Omega.  This product can be purchased at our office or via mail order.

Warm eye compresses have been shown to increase secretion of the meibomian glands.  We recommend Bruder Eye Masks.  They are ergonomically designed for the eye, are filled with special beads coated with silver nitrate to prevent bacterial growth, are hand washable and easy to use.  We stock these in our office for purchase.

Cliradex is used to treat Demodex infections. It comes in two forms: wipes and foam.  The wipes contain a higher concentration of tea tree oil and are used for initial treatment.  Cliradex light, the foam version, is used for maintainence of the condition. The active ingredient in Cliradex is derived from Tea tree oil, a naturally occuring substance which is antimicrobial, antifungal and antiparasitic.  Over repeated applications it reduces the population of live mites and prevents future repopulation.  This product is only available in doctors offices and we stock both varieties for patient convenience.

Tear Lab is a test that we perform to help diagnose and monitor dry eye.  A small sample of tears is collected using a disposable test card.  The test measures the osmolarity of the tear film, which is the concentration of the tear film.  The more concentrated the tear film the drier the eye.

Punctal occlussion is a treatment that involves placing tiny pieces of collagen or silicone into the punctal opening on the lower and/or upper eyelids.  The blockage can be temporaty or long term depending on the product used.  The  idea is to reduce the drainage of tears to increase the amount of moisture bathing the corneal tissues. This procedure is primarily used to treat aqueous deficient dry eye.

This procedure is used to treat severe meibomian gland dysfunction that is not responding to traditional treatments.  The procedure involves disposible units being placed under the eyelids.  The units apply simultaneous heat and compression to the eyelid margins for a period of 16 minutes.  The goal is to clear out the congested meibomian glands to allow healthy secretions to return. For some patients a single treatment is sufficient, but multiple procedures are required for others. We comanagement this procedure with other optometric physicians in the region.

This state of the art technology involves inserting a medical device onto to the ocular surface that contains amniotic membrane.  Amniotic membrane contains stems cells. A stem cell is a non-differentiated cell that can become any type of cell in our body.  When applied to the ocular surface, it regenerates cells in the cornea and conjunctiva. It is like a contact lens that has super healing properties.  We use this treatment for conditions, such as corneal abrasions, chemical burns, herpetic eye disease and many more.This treatment is reserved for severe dry eye patients who are still symptomatic with max treatments.  This product is available in a cryo-preserved versus a dehydrated form.  We currently use cryo-preserved Prokera lenses which are more efficacious.

All dry eye patients can benefit from artifical tear supplementation.  There are many varieties on the market.  Bottled forms can be used up to six times per day.  More frequent use requires a preservative free form.  Gel and ointment forms are available for more severe disease. Refresh Optive Advanced and Systane Balance are oil based artifical tears and are good for patients with oil deficiencies.  For patients with mild dry eye disease,  artificial tears  work well; however, they do not provide adequete relief for severe disease due to limited duration.

Doctor Winn will perform a thorough evaluation and determine which aspects of your tear film are deficient.  We will then customize a treatment plan tailored to your eyes and  get you on the path to more comfortable vision.