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Dry Eye Guide

Dry Eye Guide - Content by Dr. Jason Morris

The condition name 'DRY EYE' is inherently confusing as many people with 'Dry Eyes' excessively tear.  They may have symptoms that do not necessarily feel dry.  'Dry Eye' refers more to an imbalance in your tear chemistry.  The thin film of fluid on the surface of your eyes is quite a complex recipe and if that is not produced by your body properly, unstable vision and discomfort and sometimes permanent damage to the ocular tissue can ensue.

For the purposes of mapping a treatment plan and communicating status, I break down DRY EYE into two main forms [1] suspected lipid deficiency [2] suspected aqueous deficiency
Note that these can occur concurrently and are listed as ‘suspected’ as they are sometimes hard to distinguish clinically but are treated differently.

Management options for progressing severity for both forms of dry eye will be highlighted below. If not treated, eyes that are chronically dry progress to having DRY EYE DISEASE. This is an inflammatory condition that generally requires prescription drops or oral medications to manage. Advancing Dry Eye Disease is not only uncomfortable but can cause unstable vision and irreparable damage to ocular tissue.

Concurrent with any treatment, I recommend four easy changes that you can make to help both forms of Dry Eye
meyespa iris  Hydration – drink lots of water!
meyespa iris  Humidity – consider a humidifier in house or work environment for winter or dry environments
meyespa iris  Screen use use – try to limit and take breaks of 5 minutes minimum each hour
meyespa iris  Make-Up – consider hypoallergenic make-up and be sure not to line eye lid margins (tissue between lashes and eyeball)



How do I know what form of Dry Eye that I have?


The BEST way to determine what form of dry eye that you have is an eye exam by an Optometrist!  Special dyes and tests are used to identify your type of dry eye (AQUEOUS vs. LIPID Deficiency) and the best treatment course.   If this this is not possible, start with recommendations on LIPID deficiency based dry eye as it is much more common.


meyespa iris  Recommendations based on a Lipid Deficiency Dry Eye (MOST common)

  The goal of treating lipid deficiency dry eye is to reduce the evaporation of tears from the ocular surface as low moisture causes irritation and damage to the ocular tissue.

  LEVEL ONE: Use non-preserved rewetting drops designed for Lipid Deficiency.  Recommended 2-6 times per day.

     Option 1 - Hyabak® available through mEYE Spa (filtered bottle)
     Option 2 – non-preserved Optive Fusion or Optive Advanced - available through any pharmacy – individual use


  LEVEL TWO: All level ONE recommendations but to an enhanced vigilance also add

          [1] 5-10min of Bruder Mask at bedtime
          [2] Omega 3’s (ideally of Trigyceride form) 1000mg/day to 2000mg/day (note that Omega 3 is not to be used with Coumadin or other Rx blood thinners)


  LEVEL TWO+: (overnight irritation) All level ONE recommendations but to an enhanced vigilance also add a non-preserved eye gel at bedtime -
                        Recommended: Ocunox available at mEYE Spa or select pharmacies


  LEVEL THREE: Burst of prescription topical steroid and/or oral medications would be discussed by Optometrist for inflammatory dry eye disease

 

 

meyespa iris  Recommendations based on an Aqueous Deficiency Dry Eye

  The goal of treating aqueous deficiency dry eye is to dilute the tears so that they are less salty and irritating to the ocular tissue.

   LEVEL ONE: Use non-preserved rewetting drops designed for Aqueous Deficiency.  Recommended 2-6 times per day.
     Option 1 - Thealoz® available through mEYE Spa – filtered bottle
     Option 2 – non-preserved Theratears or non-preserved HypoTears – available through any pharmacy - individual use

  LEVEL TWO: All level ONE recommendations but to an enhanced vigilance also add a non-preserved eye gel at bedtime -
                      Recommended: Ocunox available at mEYE Spa or select pharmacies

  LEVEL THREE: Burst of prescription topical steroid and/or Restasis® would be discussed by an Optometrist for inflammatory dry eye disease