Now offering Dry Eye Procedures!
Written by Josephine Ko, OD, FAAO. Published on October 11, 2022.
Northeast Optometry, 60 Massachusetts Ave, Arlington, MA 02474
Dry eye procedures now treatable November 2022.
Northeast Optometry now offers ILux2, a thermal expression device, and BlephEx, an eyelid cleaning device to eliminate scurf and biofilm irritating the eyelids. Book a medical appointment with Dr. Josephine Ko, Optometrist at NEO, for a formal dry eye evaluation to see what’s right for you. (Imaging of the eyelids will be performed during your appointment.)
What causes dry eye?
Nowadays with our work and school environment, many people are affected by an eyelid condition called Meibomian gland dysfunction, or “MGD.” It is a dry eye condition caused by obstruction of the oil glands within the upper and lower eyelids, also known as a form of posterior blepharitis. Many people are familiar with dry eye being associated with tear production, which in medical terms, is referred to as aqueous deficiency. Excessive tearing is actually a sign of dry eye disease. The brain receives feedback from the corneal nerves signaling the lacrimal gland to release tears to lubricate the ocular surface. MGD is a form of evaporative dry eye where there is a lack of oil secretion into the tear film layer which can also cause an imbalance to the homeostasis of the tear film barrier(1). Over 85% of dry eye disease is caused by meibomian gland dysfunction (2).
Dry eye is an imbalance of the tear film layer:
While most patients with mild dry eye disease can be managed with simple treatment, severe disease requires complex interventions to prevent progression to corneal ulceration and conjunctival scarring. It is important to maintain the tear film homeostasis because, “tear film deficiency is thought to alter resistance to infection, so dry eye disease is both a cause and effect of blepharitis” (2).
The TFOS DEWS II 2017 report classifies dry eye as, “a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film and accompanied by ocular symptoms in which tear film instability, hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.”
Dry eye is easily diagnosed during the routine eye exam and can be managed with ILux2 and/or BlephEx. As current research shows, long term obstruction of meibomian glands leads to atrophy and loss of the glands. We want to preserve and maintain the glands to create a good tear film stability for good ocular health. Many people from teenage years to adulthood are developing MGD due to their decreased blinking with long hours of computer use, while other factors may include age and sex from hormones, ocular or systemic autoimmune conditions, medications, low-humidity environments and low intake of omega-3 fatty acids (2). With so many people affected by this condition, it is crucial to have it addressed as soon as possible during your eye exam with your optometrist.
Reference Articles
Saama Sabeti, Ahmad Kheirkhah, Jia Yin, Reza Dana, Management of meibomian gland dysfunction: a review, Survey of Ophthalmology, Volume 65, Issue 2,2020, Pages 205-217,ISSN 0039-6257 (https://www.sciencedirect.com/science/article/pii/S003962571930253X)
Findlay Q, Reid K. Dry eye disease: when to treat and when to refer. Aust Prescr. 2018 Oct;41(5):160-163. doi: 10.18773/austprescr.2018.048. Epub 2018 Oct 1. PMID: 30410213; PMCID: PMC6202299.
Jennifer P. Craig, Kelly K. Nichols, Esen K. Akpek, Barbara Caffery, Harminder S. Dua, Choun-Ki Joo, Zuguo Liu, J. Daniel Nelson, Jason J. Nichols, Kazuo Tsubota, Fiona Stapleton, TFOS DEWS II Definition and Classification Report, The Ocular Surface, Volume 15, Issue 3, 2017,Pages 276-283,ISSN 1542-0124,https://doi.org/10.1016/j.jtos.2017.05.008. (https://www.sciencedirect.com/science/article/pii/S1542012417301192)