Are your eyes tired, red, sore, itchy or burning by day end? Did you know that eyes that water excessively is a sign of dry eyes?
Tears are necessary to maintain the health of the front surface of your eye and for providing stable clear vision. Tears consist of multiple layers. Each layer contains specific molecules and proteins that not only maintain the health of the cells on the ocular surface by providing nourishment and removal of waste products but also protect these cells from the environment. The role of the outermost lipid layer is predominantly to minimize the evaporation of the saline layer. Evaporative dry eye is very common in Alberta. Because our environment is dry, we are more symptomatic than others who live in humid areas. Consequences of an insufficient quantity or quality of tears can produce discomfort, a burning sensation, inflammation, vision instability, and even scarring to the cornea. Over the counter lubricating drops briefly relieves some symptoms of dry eye, but are rarely able to treat the cause. As there are many possible causes of dry eyes, so too are there multiple solutions to correcting it and alleviating your symptoms.
At Sun Valley Eye Care, we use Tripollar Radio Frequency Thermotherapy to deliver focused energy to the skin surface and subcutaneous layers. This treatment has been a mainstay in dermatology for years to improve skin condition. The energy heats the skin's fibroblast which causes the collagen fibres to contract inducing immediate skin tightening. For Ophthalmic application, the treatment is a new approach to apply very controlled heat to the skin around the eyes that has decades of proven safety track record and development in the Tripollar RF system.
Compared to using a heat mask or heating packs, the RF energy is delivered thru the skin surface to the subcutaneous layers. This requires lower intensity heat, which reduces the risk of heating and clouding the cornea. Additionally the TriPollar device has control over the temperature and tightly regulates the heating of the skin to ensure that we are able to heat the skin to 40C and maintain it there throughout the treatment. From our experience, this has resulted in increased meibomian gland production, more frequent symptom resolution as well as a much lower cost but highly effective strategy.
Meibomian glands are small glands that sit on the margins of the top and bottom eyelids. In healthy eyes, 40 glands are located on each of the top lids and 30 sit on each of the lower lids. The force of a full blink causes oil to be expressed from these glands and then spread across the surface of the eyes. This aids in lubrication and maintaining a healthy amount of tears on the eyes. Over time, however, oil can become thicker and glands can become clogged. Eventually, severely clogged glands can be lost completely, decreasing the amount of oil delivered to the surface of the eye. This process of gland loss is due to several factors, including the aging process, inflammatory conditions such as rosacea or meibomian gland dysfunction, and poor habits such an incomplete blinks while doing focused work.
To maintain as many functional glands as possible, meibomain gland expression can be performed in which your optometrist will use a tool to apply a certain amount of pressure to the lids in order to express thicker oils that may be building up within the lids. By opening these glands, and practicing full blinks, the amount of oil delivered to the surface of the eye can be increased, relieving evaporative dry eye symptoms.
Punctal Plugs are tiny biocompatible devices that can be inserted into tear ducts to slow down or block the draining of the tears. This increases the amount of tears on the ocular surface. This may be appropriate for you if your tear quantity is low. We can measure both your tear quantity and tear quality to guide you in a personalized dry eye treatment plan.