Dry / Gritty Eyes

Sore, burning, gritty or even watery eyes are symptoms of ocular surface disease, also referred to as dry eye disease.

Dry eyes are a pain! The discomfort, having to use drops all day and not

being able to read or use the computer comfortably for a period of time can have a big negative impact on everyday life.  No two patients with dry eye are the same the treatment needs to be tailored to the individual.

For some patients, the solution may be as simple as using the right type of lubricating  drops.  Patients with persistent symptoms will benefit from assessment through our Dry Eye Clinic and individually tailored Dry Eye Treatment Packages to get the dryness under control.

What causes dry eyes?

Eyes get dry if they are not sufficiently lubricated. There are three main factors that play a role in keeping the eyes moist.

1.  Tear production

Watery part of the tear film is produced by the lacrimal gland. (the words lacrimal gland links to eye anatomy pages under patient resources) Insufficient production of tears from the lacrimal gland can be due to age or particular medical conditions such as rheumatoid arthritis or certain medications.

2.  Quick tear evaporation

The tear film that covers the surface of the eye is very thin. To prevent it from evaporating between blinks, a thin oily layer covers the surface of the tear film. This oil is produced by the oily glands around the eye.  Most of the oil comes from Meibomian glands (link to anatomy) which are arranged vertically within the eyelid and open just behind the eyelashes.  In many people, these glands are not functioning well (see posterior blephariti – this is a link) and there is insufficient oil to prevent tear evaporation.

3.  The eyelids

The eyelids spread the tear film across the surface of the eye with each blink. If the eyelids are not closing properly or if the blink is too infrequent or inadequate, the tear film will not be adequately distributed across the surface of the eye.

What is the treatment for dry eye?

Treatment will depend on the underlying cause and severity of symptoms.

The lacrimal gland cannot be made to produce more tears and the mainstay of therapy is replacement of tears with lubricating drops and gels.

If the symptoms are mild and infrequent, use of over-the-counter lubricating drops as needed might be sufficient.

For more severe symptoms, oral medication and prescription eye drops are required. Some patients benefit from occlusion of the tear drainage pathway with a punctual plug.

The function of the Meiboimian glands can be improved with specific types of antibiotics and use of hot compresses and massage.  Click here for clear instructions on how to perform lid massage correctly.

Blephasteam is one of the most effective and safe in-office treatments that improve the function of Meibomian glands. It is also a quick and convenient treatment for busy people who struggle to do regular hot compresses and lid message at home.

 Read more about blephasteam

IPL  (Intense Pulsed Light) is the latest in technological advances in dry eye treatment, but the technology has been used for skin rejuvenation and treatment of dermatological conditions for a long time.  IPL may be particularly beneficial for patients with Rosacea.

The IPL technology uses intense light of a particular wavelength that targets the abnormal capillary blood vessels that are implicated in the inflammatory response around the Meibomian glands. The heat generated by the light treats these blood vessels, heats the glands from within the eyelid and possibly stimulates the autonomic nerve endings that regulate the rate of production of the oils.

IPL treatments require no preparation beforehand and you are free to resume normal activities immediately following the treatment, except sunbathing, using a tanning bed and using products (face creams) containing retinol or its derivatives. Sunscreen should be used while undergoing the treatment course, but not worn to the IPL appointment.  Not all skin types are suitable for IPL due to light’s effect on the pigment within the skin cells. People with significant amount of pigment in their skin (darker skin) are not suitable for IPL .

The treatment course is over 3-4 sessions, the first two sessions 2 weeks apart and any subsequent sessions a month apart. Some patients benefit from a maintenance treatment every 6-12 months. Treatment may also improve your skin as IPL is sued widely in skin rejuvenation.