There are a number of treatment options for dry eye, since the underlying cause of the condition can be attributed to many different factors. Dr. Liu has extensive experience diagnosing dry eye and its causes, which enables her to guide patients to the appropriate treatment regimen.
Lifestyle modifications are usually the first line of treatment and may include:
- Limiting screen time
- Wearing sunglasses
- Avoiding windy conditions
- Using a humidifier at home
- Taking a break from contact lens wear
- Being meticulous about makeup removal
- Placing warm compresses on your eyes to stimulate oil gland function
- Scrubbing the eyelid margins to thoroughly remove debris at the eyelash root
- Adding an Omega-3 supplement to help fight inflammation and provide essential fatty acids that aid the function of your eyelid oil glands
Dry Eye Medications
If lifestyle modifications are ineffective or impractical, the next step for many patients is non-prescription medications:
- Artificial tears can be used as often as needed to replace your natural tears
- Artificial tear gels are thicker and remain on the surface of the eye longer
- Artificial tear ointments are best used to lubricate the eyes overnight when vision is less important since these medications tend to blur your vision
When required, prescription medications can also be added:
- Restasis to help increase your eyes’ natural ability to produce tears
- Xiidra to target a source of underlying inflammation that may fuel dry eye disease
- Cequa is the highest FDA approved concentration of immunosuppressant to increase tear production
- Oral Doxycycline is an antibiotic that when used in low doses can improve the function of the meibomian oil glands
Intense Pulsed Light (IPL)
Intense pulsed light (IPL) technology is a broad-spectrum light treatment used to improve the function of the meibomian glands that release oil into your tear film to prevent your tears from evaporating too quickly. IPL is able to kill bacteria and mites that live on the eyelids, melt the thick gland secretions to allow for easier oil release, and close abnormal blood vessels to decrease inflammation. A hand-held applicator is used to deliver a strategic level of light pulses to the skin surface across the cheeks, nose, and on the eyelids. After the light therapy is administered, an eyelid massage is performed to help break up the oil and encourage oil flow from the meibomian glands. Most patients achieve optimal results from four treatment sessions lasting 15 to 20 minutes each, spaced one month apart . There is little to no downtime after each treatment and since the IPL treatment uses the same light wavelength that is used for photofacials, you have the added benefit of improved skin texture and coloration in the areas treated.
Punctal Plugs/Punctal Cautery
Punctal plugs are tiny devices that are placed in the eye’s tear drains (called puncta) to slow the drainage of your tears so they can lubricate your eye for longer. There are two types of punctal plugs, temporary and permanent. The temporary punctal plugs usually are absorbed in 3 to 4 months and the permanent punctal plugs do not absorb. Both types of punctal plugs can be placed in the office under the microscope quickly and painlessly. If there is improvement in dry eye with punctal plugs but they keep falling out or if they cause eye irritation, punctal cautery can be performed to permanently close the tear drain. Punctal cautery can be performed in the office by administering a little local anesthetic and applying heat to the tear drain to close it.
Although often overlooked, your eyelids can be a critical contributor to dry eye. When the eyelids are not in the right position and functioning properly, all of the other treatment options are usually not sufficient to alleviate the dry eye. Based off of her specialized training in the eyelids, Dr. Liu is able to assess the contribution of your eyelids to the dry eye and discuss with you what type of procedure may be needed to improve the intimate relationship between the eyelids and the eye.