Ocular Surface Disease and dry eyes syndrome are a multifactorial condition that requires an eye exam in order to understand the etiology and triggers. It consists of a group of conditions affecting the eyelids, cornea, and tear film. Inflammation in the eyelid margin and tear film are often the culprit. Standard Patient Evaluation of Eye Dryness (SPEED) survey is a validated dry eye survey that can be useful in diagnosing and monitoring dry eye symptoms.

Dry Eye Syndrome   ◘   Meibomian Gland Disease   ◘   Blepharitis

Dry Eye Syndrome is the most prevalent and is due to decreased production of tears by the lacrimal gland.  Inflammation often plays a prominent role in affecting the various glands and tissues of the eye in their ability to produce a normal tear quantity and quality. Bacteria on the skin and eyelashes can cause a condition known as Blepharitis that contributes to an abnormal tear film. There may also be a deficiency in the oil producing glands of the eyelid called meibomian glands or thickening of the oils that may lead to Meibomian Gland Disease. Ocular Surface Disease is caused by a deficiency in one or more of these areas. The goal of our treatment plan is to improve the condition and to make you and your eyes feel better.

☐   WARM COMPRESSES ŸUse a washcloth with warm water or microwave a Bruder Mask or dry rice-in-a-sock for 20 seconds. Place the warm compress over the eyes for 5 minutes. Warm compresses help the eyelid glands secrete the oils necessary for a healthy tear film.

☐   ARTIFICIAL TEARS ŸArtificial tears are needed to supplement the natural tear volume.  Use one drop 4x per day in both eyes. We recommend: Systane, Refresh, Thera Tears, Soothe. When tears are used more than 4x/day use preservative free tears in individual vials.

☐   ARTIFICIAL TEAR GEL/OINTMENTS Ÿ Artificial tears gel/ointment is a thicker formulation that coats the surface of the eye.  In cases of moderate to severe dry eyes, gel or ointment may be used at bedtime.  We recommend the following: Systane Gel, Refresh Gel, Genteal Severe or Celluvisc.

☐   OMEGA-3 SUPPLEMENTS Ÿ Omega-3 fatty acids (fish oil) are beneficial for the eyelid oil glands. Take purified, pharmaceutical grade fish oil as directed. We recommend Nordic Naturals.

☐   XIIDRA, RESTASIS OR CEQUA Ÿ Prescribed eye drop that may help increase tear volume and is reserved for the treatment of moderate to severe dry eyes. Take one drop two times daily. Xiidra may take 1 month while Restasis and Cequa may take up to 3 months to be effective.

☐   ALLERGY TREATMENT Ÿ Allergic conjunctivitis may contribute to dryness of the surface, redness, watery eyes and itching. You can use a prescribed drop or use over-the-counter medications such as Pataday, Alaway or Zaditor.

☐   LID HYGIENE Ÿ Use diluted Johnson & Johnson Baby Shampoo once daily on the eyelid margin to clean away crusting or debris on eyelashes.  Ocusoft lid scrubs or Systane lid wipes also work. Add Hypochlor or Avenova spray to kill bacteria on the lash margin.

☐   MODIFY YOUR ENVIRONMENT Ÿ Redirect air vents away from the eyes. If you use the computer, take frequent breaks. Avoid overhead fans. Consider a room humidifier in your home or office. Drink less caffeine and more water. Consider moisture goggles when sleeping.

☐   PUNCTAL PLUGS Ÿ Small devices made of collagen or silicone placed in the eye’s tear ducts. They allow your naturals tears to stay in your eyes longer. They are easily placed in clinic and are painless.

☐   SERUM TEARS Ÿ Eyedrops compounded from a patient’s own blood after the red and white blood cells and platelets are spun down by centrifuge. Made by a specialty pharmacy or the Eyebank.