Ocular Surface Disease is a group of conditions affecting the eyelids, cornea, and tear film.
DRY EYE SYNDROME: Dry Eye Syndrome is caused by a decrease in production of tears by the lacrimal gland or increased evaporation of tears from the ocular surface. Inflammation plays a role in affecting the glands and tissues of the eye in their ability to produce a normal tear quality.
BLEPHARITIS: Bacteria on the skin and eyelashes can also cause a condition known as blepharitis.
MEIBMOIAN GLAND DYSFUNCTION: There may also be a deficiency in the oil producing glands of the eyelid Meibomian Gland Dysfunction.
Other contributing factors include ALLERGIES and at times SYSTEMIC DISEASES. The goal of our treatment plan is to improve the condition and to make you and your eyes feel better.
Here is our checklist of basic treatments for ocular surface disease. Your Ophthalmologist or Optometrist may recommend one or more of the following:
☐ WARM COMPRESSES Use 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 Artificial 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.
☐ LID HYGIENE 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.
☐ ARTIFICIAL TEAR GEL/OINTMENTS Thicker formulations that coats the surface of the eye are useful overnight and are placed at bedtime. We recommend: Systane Gel, Refresh Gel, Genteal Severe, Celluvisc, Refresh PM and Systane Nighttime
☐ OMEGA-3 SUPPLEMENTS Omega-3 fatty acids (fish oil) are beneficial for the eyelid oil glands. Take purified, pharmaceutical grade fish oil or Hydroeye, a blend of GLA and omega 3 fatty acids, antioxidants and other key vitamins and minerals that support a healthy tear film.
☐ XIIDRA, RESTASIS OR CEQUA Prescribed eye drops help increase production. Take one drop two times daily. Xiidra may take 1 month while Restasis and Cequa may take up to 3 months to be effective. TYRVAYA is a new nasal spray that can also help tear production.
☐ ALLERGY TREATMENT Allergic conjunctivitis may contribute to dryness of the surface, redness, watery eyes and itching. Over the counter Pataday is effective in relieving these symptoms.
☐ MODIFY YOUR ENVIRONMENT 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 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 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 eye bank.
☐ TEARCARE An in-office procedure involving software-controlled localized heat to the eyelids followed by gland expression by your doctor.
This article was originally written on 5/29/2023 by Angelique Pillar, MD.