DRY EYE SYNDROME
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Dry eye syndrome, also known as keratoconjunctivitis sicca, is a fairly common eye condition, especially in people of advanced age. It was found that about 1 in 7 people between the ages of 65 and 84 report symptoms of dry eye occasionally or continuously.
Waking Up With Dry Eyes?
The syndrome is caused by a disorder of the tear film, which is the essential component of the ocular surface responsible for lubricating the eye, maintaining the right level of oxygenation of the ocular structures, and removing debris from the surface of the eye.
In dry eye syndrome, the production of the tear film is insufficient (hypolacrimia) or the tears produced are characterized by excessive evaporation (dyslacrimia).
This results in damage to the interpalpebral ocular surface and the appearance of a variety of symptoms such as ocular burning, foreign body sensation, burning sensation, pain, photophobia, and blurred vision.
In addition, dry eye patients are more prone to contracting potentially blinding infections such as bacterial keratitis and higher risks of complications if they undergo laser refractive surgery.
How to Prevent Dry Eye Syndrome
Adequate tear production is vital for eye health. To avoid developing dry eye syndrome, take the following precautions:
● Avoid direct contact with wind, hot air, direct sunlight, or smoke since these situations might irritate the eyes.
● Avoid straining your eyes. If you work for many hours on the computer, make sure your eyes are positioned at the proper distance from the screen. Take regular breaks to avoid straining the eye muscles.
● Follow a healthy diet by favoring foods such as salmon and fresh tuna rich in omega 3 oils that help in the production of the tear film.
● If the air is excessively dry, use a humidifier.
● Use an over-the-counter medication such as artificial tears, gels, or ointments.
● Stop smoking.
Be warned, though these precautions only act on the symptoms of the condition and not on its root causes.
What Causes Dry Eye Syndrome
The pathophysiology of dry eye has been carefully studied in the past years. Until recently, it was thought that the condition was simply due to insufficient tear production, but in reality, it could actually be caused by a variety of factors such as:
● Inflammatory diseases
● Environmental conditions (allergies, cigarette smoke, dry climate)
● Hormonal imbalance (postmenopausal women and patients undergoing hormone replacement therapy)
● Excessive use of contact lenses
● Prolonged intake of systemic medications, such as diuretics, antihistamines, antidepressants, psychotropics, cholesterol-lowering agents, beta-blockers, and oral contraceptives
● Some systemic ailments such as diabetes, thyroid illness, rheumatoid arthritis, and systemic lupus erythematosus
● Previous eye surgery such as cornea transplant, extracapsular cataract procedures, and refractive surgery.
It is now understood that keratoconjunctivitis sicca is a disease mainly due to Meibomian Gland Dysfunction (MGD).
This paradigm shift has led to the development of new highly effective therapies in the treatment of dry eyes, such as glandular stimulation through IRPL (Intense Regulated Pulsed Light).
IRPL Pulsed Light for the Treatment of Dry Eye Syndrome
The meibomian glands are found on the upper and lower eyelids and produce an oily fluid called meibum that covers the ocular surface when a person blinks.
In patients with MGD, sebaceous secretions are denser and have a higher melting temperature than in normal persons. This then causes inflammation and often bacterial proliferation, which aggravates the problem.
Most of the standard treatments, such as the application of anti-inflammatory drops or oral antibiotics, aim to reduce the inflammation associated with this disease. However, only heat can decrease the abnormal viscous meibum and dilate the glands.
Intense pulsed light, which is used for many years in dermatology practices as a treatment for rosacea and acne, has proven to be an extremely effective treatment for treating meibomian gland dysfunction.
The therapy is quick (a few minutes per eye), completely painless, and safe. Before the treatment, a protective mask is placed over the patient’s eyes.
A thick coating of gel is applied to the eye area from the cheekbones to the temporal region. Under each eye, from the nasal to the temporal region, a series of 5 IRPL (Intense Regulated Pulsed Light) flashes with wavelengths of light ranging from 400 to 1200 nm are applied.
A second session should be performed two weeks after the first. After which, the doctor may prescribe a further course one month later.
Generally, the complete cycle lasts 4 months, but in most cases, the benefit on the meibomian glands, and therefore on the dry eye syndrome, is already noticeable after a few hours.
Waking Up With Dry Eyes?
The syndrome is caused by a disorder of the tear film, which is the essential component of the ocular surface responsible for lubricating the eye, maintaining the right level of oxygenation of the ocular structures, and removing debris from the surface of the eye.
In dry eye syndrome, the production of the tear film is insufficient (hypolacrimia) or the tears produced are characterized by excessive evaporation (dyslacrimia).
This results in damage to the interpalpebral ocular surface and the appearance of a variety of symptoms such as ocular burning, foreign body sensation, burning sensation, pain, photophobia, and blurred vision.
In addition, dry eye patients are more prone to contracting potentially blinding infections such as bacterial keratitis and higher risks of complications if they undergo laser refractive surgery.
How to Prevent Dry Eye Syndrome
Adequate tear production is vital for eye health. To avoid developing dry eye syndrome, take the following precautions:
● Avoid direct contact with wind, hot air, direct sunlight, or smoke since these situations might irritate the eyes.
● Avoid straining your eyes. If you work for many hours on the computer, make sure your eyes are positioned at the proper distance from the screen. Take regular breaks to avoid straining the eye muscles.
● Follow a healthy diet by favoring foods such as salmon and fresh tuna rich in omega 3 oils that help in the production of the tear film.
● If the air is excessively dry, use a humidifier.
● Use an over-the-counter medication such as artificial tears, gels, or ointments.
● Stop smoking.
Be warned, though these precautions only act on the symptoms of the condition and not on its root causes.
What Causes Dry Eye Syndrome
The pathophysiology of dry eye has been carefully studied in the past years. Until recently, it was thought that the condition was simply due to insufficient tear production, but in reality, it could actually be caused by a variety of factors such as:
● Inflammatory diseases
● Environmental conditions (allergies, cigarette smoke, dry climate)
● Hormonal imbalance (postmenopausal women and patients undergoing hormone replacement therapy)
● Excessive use of contact lenses
● Prolonged intake of systemic medications, such as diuretics, antihistamines, antidepressants, psychotropics, cholesterol-lowering agents, beta-blockers, and oral contraceptives
● Some systemic ailments such as diabetes, thyroid illness, rheumatoid arthritis, and systemic lupus erythematosus
● Previous eye surgery such as cornea transplant, extracapsular cataract procedures, and refractive surgery.
It is now understood that keratoconjunctivitis sicca is a disease mainly due to Meibomian Gland Dysfunction (MGD).
This paradigm shift has led to the development of new highly effective therapies in the treatment of dry eyes, such as glandular stimulation through IRPL (Intense Regulated Pulsed Light).
IRPL Pulsed Light for the Treatment of Dry Eye Syndrome
The meibomian glands are found on the upper and lower eyelids and produce an oily fluid called meibum that covers the ocular surface when a person blinks.
In patients with MGD, sebaceous secretions are denser and have a higher melting temperature than in normal persons. This then causes inflammation and often bacterial proliferation, which aggravates the problem.
Most of the standard treatments, such as the application of anti-inflammatory drops or oral antibiotics, aim to reduce the inflammation associated with this disease. However, only heat can decrease the abnormal viscous meibum and dilate the glands.
Intense pulsed light, which is used for many years in dermatology practices as a treatment for rosacea and acne, has proven to be an extremely effective treatment for treating meibomian gland dysfunction.
The therapy is quick (a few minutes per eye), completely painless, and safe. Before the treatment, a protective mask is placed over the patient’s eyes.
A thick coating of gel is applied to the eye area from the cheekbones to the temporal region. Under each eye, from the nasal to the temporal region, a series of 5 IRPL (Intense Regulated Pulsed Light) flashes with wavelengths of light ranging from 400 to 1200 nm are applied.
A second session should be performed two weeks after the first. After which, the doctor may prescribe a further course one month later.
Generally, the complete cycle lasts 4 months, but in most cases, the benefit on the meibomian glands, and therefore on the dry eye syndrome, is already noticeable after a few hours.