Dry Eye Clinic | Premium Vision Surgical Centre

 

DRY EYES:

The Most Common Yet Most Under-treated Eye Disease

Tears are formed by tiny glands that surround the eye. The tear film is comprised of three layers:  oil, water, and mucous. The lower mucous layer serves as an anchor for the tear film and helps it adhere to the eye. The middle layer is comprised of water. The upper oil layer seals the tear film and prevents evaporation.

The tear film serves several purpose. It keeps the eye moist, creates a smooth surface for light to pass through the eye, nourishes the front of the eye, and provides protection from injury and infection.

 

 

Dry Eye is most often defined based on the quantity or quality of your tears. Millions suffer from Dry Eye, a chronic disease that can worsen over time. There are two forms of Dry Eye – Evaporative Dry Eye and Aqueous Dry Eye.

Nine out of 10 individuals (86%) suffer from the evaporative form of Dry Eye. LipiFlow® is a revolutionary treatment that allows your doctor to directly treat the cause of your Evaporative Dry Eye. Every time you blink, tears spread across the front surface of the eye. Your eyes depend on a flow of tears to provide constant moisture and lubrication to maintain eye health and comfort.3 When the volume or consistency of the tear system becomes imbalanced, you might experience dry eyes. When tears do not adequately lubricate the eye, a person may endure; Sensitivity to light, blurred vision, a burning sensation, discomfort in windy or dry conditions, a gritty sensation, redness, and eye fatigue.

The SPEED II Questionnaire is made to assess the severity of dry eye symptoms. A normal will score 5 or less. If you score 6 or more, you probably have some degree of dry eyes.

Dry eyes, extremely common condition

PVSC is an accredited Dry eye centre of excellence

Dry eyes accredited certificate  1

SPEED II Questionnaire

SPEED Questionnaire TY Modified 20130301 1

Types of Dry eyes

  1. Lipid or Oil Deficiency  Dry eyes

  2. Aqueous Or water Deficiency  Dry eyes

  3. Incomplete (and/or)  Infrequent blinking

  4. Mix of the above types

Types of dry eyes with test results 20150419 1

Treatment of Dry Eyes

Depends on the type a cause

This diagram will summarize the different lines of treatment for the different types dry eyes.

Punctal Plugs

A punctal plug is a small medical device that is inserted into the tear duct (puncta) of an eye to block the duct. This prevents the drainage of liquid from the eye. They are used to treat dry eye.

 

LipiFlow®: A Different Approach

In a clinical study, 79% patients reported improvement of their overall dry eye symptoms within four weeks, ranging from 10% to 100% improvement.  LipiFlow® is a new procedure designed to treat the root cause of Evaporative Dry Eye, blocked Meibomian glands. Opening and clearing these blocked glands can allow them to resume natural production of lipids (oils) needed for a healthy tear film. Some treatments attempt to add more liquid to your tears, but without the complex natural oil, tears continue to evaporate faster than produced. At the heart of the LipiFlow® Thermal Pulsation System is the Activator (eyepiece). The Activator uses patented, precisely controlled heat applied to the inner eyelid with adaptive pressure encouraging your body to resume the natural production of lipids (oils) needed for your tear film. Its single-use design and built-in sensors ensure a safe, sterile treatment. The treatment is performed in a doctor’s office — and in some cases, on the same day as your evaluation. Imagine returning to doing the things you enjoy, without worrying about your eyes. LipiFlow® could be your first step to relief.

 

Omega-3 and dry eye

Omega-3 fatty acids seem like a cure-all for just about anything that ails patients nowadays. They’re hailed for promoting better heart health, reducing inflammation, providing more lustrous hair and skin, and even promoting better mood. The question is, how beneficial are omega-3s for dry eye patients?

Get a good brand of Omega 3

 

The research

Some recent research has tried to pin down the specific effects of omega-3 supplementation on dry eye. In a pilot, double-masked study published in March 2011 in Cornea, investigators gave patients various doses of fish oil and flaxseed oil (TheraTears Nutrition, Advanced Vision Research, Woburn, Mass.) for 3 months. Investigators measured patients’ subjective symptoms and tested for tear breakup time and corneal staining as well as performing other tests.
Of the 36 patients included, 70% of the patients receiving treatment became asymptomatic. In the placebo group, 37% of the symptomatic patients became asymptomatic. Schirmer’s testing and fluorophotometry seemed to indicate that omega-3 use increased tear secretion, according to investigators. Although those results are promising, they only begin to reveal how omega-3 might help dry eye and which patients would benefit the most. At the 2012 ASCRS•ASOA Symposium & Congress, Frank A. Bucci Jr., M.D., founder, Bucci Laser Vision, Wilkes-Barre, Pa., presented the results from a study sponsored by Physician Recommended Nutriceuticals (PRN, Plymouth Meeting, Pa.), which makes PRN Dry Eye Omega Benefits. The multicenter, blinded, randomized study randomized 60 patients to receive the PRN product, a Nature Made omega-3 product (Pharmavite, Northridge, Calif.), or TheraTears Nutrition. Investigators measured red blood cell membrane saturation of the omega-3 products at baseline, 1 and 3 months follow-up. Investigators found that red blood cell saturation was significantly greater for the PRN product compared with the other two products. Knowing how well an omega-3 product can be absorbed in the body is crucial in ensuring it will provide key health benefits to the eyes and elsewhere, Dr. Bucci said.
Although there have been other studies related to dry eye and omega-3 supplementation, there has yet to be a large-scale clinical trial that pinpoints how omega-3 fatty acids work to treat dry eye and what kind of dosing is appropriate.

Despite what research may find, what is key is how patients respond to omega-3 use. “It’s all meaningless if patients don’t feel better. Certain types of dry eye patients seem to benefit more than others from omega-3 supplementation. “I recommend fish oil mostly for evaporative dry eye.

What product works best?

We need a pharmaceutical-grade, mercury-free supplementation. “With a cheaper version, there’s more risk for contaminants. We’re recommending this at a high dose, so it’s essential to be safe,” he said. We prefer a higher quality omega-3 product that absorbs more quickly in the body, comes from fish sources versus flaxseed, and does not contain alcohol.
There has been recent talk in the popular press about krill oil as an omega-3 source that can be better absorbed by the body, some patients successfully use krill oil.
In the rare instances where a patient does not like fish oil, is allergic to it, or has another physician concerned about its use because the patient takes anticoagulant therapy, we recommend the use of flaxseed oil, which the patient can obtain as a gel cap or even sprinkle in powder form on food.

Health Benefits of Omega 3.

Our western food is very deficient in Omega 3 and full of Omega 6. This results in multiple problems in the body including dry eyes, hearth disease,

Epidemic of Omega 3 deficiency

These are the diseases that are linked to the Omega 3 deficiency

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