Dry Eye Treatments
Dry eye is usually a chronic condition that cannot be cured but can be brought under control with the correct treatment plan. If left untreated, the low grade inflammation often associated with dry eyes can result in permanent damage to the tear system. The degree of damage will influence any potential level of comfort achievable.
Lid Hygiene & BlephEx
There are numerous wipes, gels and solutions that are designed specifically for cleaning the eyelids to treat blepharitis. Though effective, for the best results we recommend a more intense clean using the very latest in-practice treatment, BlephEx. We at Maddox Eyecare are proud to be one of the first in the country to offer this revolutionary treatment and results, so far, have been very promising.
BlephEx is used to very precisely and carefully spin a medical grade micro-dermal sponge along the edge of your eyelids and lashes. The procedure lasts about 10 minutes and is typically repeated at 3-6 month intervals.
Book your BlephEx treatment today on 01242 282059
Dietry deficiencies, particularly of Omega 3, have long been linked to the prevalence of dry eye in the western world. Omega 3s produce their beneficial effects through anti-inflammatory properties. We recommend supplementation with one of the commercial dry eye preparations as the first course of action before considering prescription medication to control inflammation. The course should last no less than 3 months to gain the full benefit. The commercial preparations are preferred initially as they offer the optimum concentration of vitamins with the perfect balance of Omega 3 and Omega 6. Like most dry eye treatments it is important to continue supplementation indefinitely.
Artificial tears should not be used as the first/only course of action as they make it easier to ignore any underlying condition. This is not to say they don’t play an important role in treatment as they provide comfort, the optimum healing environment, and help flush out any inflammatory mediators.
There are lots of different artificial tears with many different modes of action. Often a period of trial and error is required to find the most suitable for you but knowing the cause of your dry eyes helps. There are also thicker gels for overnight use or severe dry eye.
Book your Dry Eye assessment today on 01242 282059
Lid massage is used to forcibly expel thickened meibum (oil), as often found in meibomian gland dysfunction (MGD), once heated to a more fluid consistency. There are numerous commercially available eye masks designed to heat the eyelids and we can help choose the best for you. Try not to use a warm flannel as they do not stay hot enough for long enough.
Forced Meibomian Expression
For more stubborn case we are able to apply pressure under anaesthesia to help evacuate any stubborn meibomian glands. We use a variety of equipment to help expel the meibum.
Punctal occlusion is used in cases of aqueous deficient dry eye and involves using ‘punctal plugs’ to seal the openings to the tear ducts, the puncta. With nowhere to drain the tears remain on the eye for longer. For a more permanent solution the tear ducts are cauterised (sealed using heat). Punctal plugs are often not the first course of action due to potential issues with infection and intolerance of the plug itself, particular with concurrent blepharitis.
Blephasteam® goggles are a convenient eyelid warming device by Spectra Thea. Two 10 minute treatments are recommended each day and, as they don’t steam up, you can even watch TV or read while using them.
Antibiotics can be used both for their anti-bacterial action and also systemically for their anti-inflammatory and lipid-regulating properties. They are an important tool in the battle against dry eyes.
Acetylcysteine eye drops help to lubricate the eye and reduce the thickness and stickiness of the mucus that the eye produces. NAC has also been shown to be effective and well tolerated in the management of MGD.
Steroids are powerful anti-inflammatory agents that should only be used if supervised by an ophthalmologist in an eye clinic. They are only be used short term as they can raise the pressure within the eye and cause cataracts.
Particularly popular for the treatment of dry eyes in the USA, Cyclosporine A increases tear production and reduces inflammation through suppression of the immune system. Unfortunately, it is only available via hospital eye departments in the UK and the effects of treatment may not be felt for up to 6 months.
It is now believed that meibomian glands may be ‘brought back to life’ by inserting a tiny probe into each gland. The probe is used to break through any keratin blockages that may have been formed. Again, this is relatively new to England with only one specialist offering the procedure. This would be the next step if forced expression did not work.
In very rare cases, where all other medications have not worked, autologous serum eye drops may be required. Special eye drops are made using components of your own blood. It is only available from the National Blood Service through an ophthalmologist and after funding is approved.
LipiFlow is a relatively new procedure from America that is now being offered at one clinic in England. A specially designed machine is used to simultaneously heat the eyelids and forcibly expressing meibum. The procedure is very expensive at around £500 an eye and would need repeating.
If your dry eyes are severe and fail to respond to other forms of treatment, salivary gland autotransplantation may be an option.Salivary gland autotransplantation is an uncommon procedure that is usually only recommended after all other treatment options have been tried. It involves removing some of the glands that produce saliva from your lower lip and placing them under the skin around your eyes. The saliva produced by the glands acts as a substitute for tears.