Dry eyes can be treated medically or surgically depending on its severity.
At Clinica London we have a specific Dry Eye Clinic run by Miss Jane Olver, with the assistance of the Clinica nurses.
We call it the Tears Clinic because people with dry eyes have a problem with their tears; either they are not producing enough tears or their tears are of poor quality and rapidly evaporating. Also patients with dry eyes often get reflex watering and sometimes the watering is so bad that we have to check the tear ducts are functioning normally.
We assess the degree and cause of your dry eyes then make an individualised treatment plan addressing the eyelids, the tears, your diet, as daily self help at home and adjunctive treatments to help you, at Clinica London.
Medical treatment of dry eyes
Addition of tear supplements and treating any underlying blepharitis or meibomian gland dysfunction is the mainstay of medical treatment. There is a plethera of available lubricating eyedrops and gels and eyelid heating, massage and cleaning options for home self care use, as well as medically prescribed drops and antibiotics, with adjunctive treatments in the Tears Clinic such as MiBo ThermoFlo and BlephEx to help the meibomian glands and lid margins.
Mild dry eyes are treated with over the counter artificial tear solutions, preferably preservative-free. Your oculoplastic surgeon can advise on the specific type and name of drops to use depending on the findings on examination. Lubricating eye drops can be put in as often as every 15 -30 minutes, providing they do not contain preservatives, or as little as twice a day in a mild dry eye, depending on patient symptoms. Eye ointment is very effective but can blur the vision for a few minutes after, and may be preferable for night-time use.
Persistant dry eyes may need thicker gels or need the tears conserving with minor surgery.
Blepharitis and meibomian gland dysfunction:
Dry eyes associated with blepharitis and meibomian gland dysfunction are treated by addressing the underlying lid disease.
More serious conditions affecting the conjunctiva and resulting in severe dry eye include Sjogrens syndrome, Stevens Johnson syndrome, ocular pemphigoid, may also need systemic oral therapy by their physician.
Reducing or avoiding dry eyes:
Self care at home:
- Blink regularly when reading or staring at a computer screen or watching a film in the cinema for a long time.
- Increase air humidity at work and at home with a humidifier.
- Wear sunglasses outdoors to reduce exposure to wind and sun.
- Use omega 3 rich nutritional supplements or eating foods containing essential fatty acid
- Avoid dehydration by drinking plenty of water each day
- Hot compresses and eyelid massage with hot flannel
- Heating the eyelids with a heated eye bag or mask
- Topical Lubricant drops and gels
- Topical and oral antibiotics as prescribed for between 2 weeks and 8 months
Adjunctive treatments done in the Clinica Tears Clinic:
- Heating the eyelids with MiBoThermoFlo to help unblock the meibomian gland
- Lid margin gentle deep cleaning with BlephEx which removes the plaque like debris
- Teatree Oil treatment
Surgical conservation of tears
Occlusion of the tiny tearduct openings at the inner corner of the eyelids (the puncta), e.g. silicone punctal plugs (permanent) or gel cannalicular plugs (dissolvable). Silicone punctal plugs can be inserted under local anaesthesia, only requiring anaesthetic eye drops. The punctum is gently dilated and then the plug slipped in. Occasionally a small injection of local anaesthesia is needed to enable the plug to go in painlessly.
Punctal cautery is a surgical procedure which permanently closes the punctal openings. This is done under local anaesthsia in a minor operating theatre.