Welcome to Case of the Day!
Today, we’re going to talk about an interesting lady who came in with a complaint of dry, irritated eyes. She had been to one of the major universities in the country for her dry eyes and didn’t think she was getting relief.
She read about a new system called LipiView and LipiFlow, a new treatment and the first FDA-approved treatment for dry eyes or meibomian gland dysfunction. She read that we had this system at the Cataract & Refractive Institute of Florida and wanted to see if we could help her with her irritated eyes.
The LipiView is a scanning interferometer that scans the surface of the tear film on your eye. It takes a video of your eye, and as we watch the video from the machine, you can actually see the oily layer on the surface of the eye, if there is an oily layer present, and how much is there. You can also watch the blinking pattern of someone’s eyes.
After we did the LipiView test on this woman, it was noted that she was not blinking her left eye more than usual, and it was not even halfway done. On that left eye, which is the eye she was complaining about, she had a lot of scarring on her cornea. After this test, it turns out it’s just that she was not blinking that eye, and therefore, the eye was drying out and getting irritated.
The lipid layer of her tear film was normal, and so was her tear osmolarity, so actually, she did not have really dry eyes per se. She just had very poor blinking on one side that was causing dry eye-like symptoms.
That brings us to dry eyes. What are dry eyes? Dry eyes occur when the tear film on the surface of your eye is inadequate and, therefore, leads to symptoms. Those symptoms could be redness and irritation of a variety of types. People complain of a foreign body sensation, that they feel scratchy, that they have blurred vision (a lot of times this intermittent blurred vision), or that they could have mucus or their eyes feel sticky.
The most common thing that people come in and complain about is that their eyes burn and water. Often, people are surprised when they are diagnosed with dry eyes when their eyes are watering. When this happens, Dr. Croley explains what dry eyes are and how their eyes could be watering when their eyes are dry.
Your tear film is made up of three layers. There is a mucus layer on the bottom surface on the outer coating of your eye, then there’s a middle water layer, and then there’s an oily layer or a lipid layer. You have to have all three of those layers in the proper amounts for your tear film to be normal and for your eyes to be healthy.
If you’re missing some of those tear components, your eye will not be covered with the proper amount of tears, and the cells of your eye will then become irritated. Some of these cells actually die. All this irritation caused by dead cells on the surface of the eye causes eye inflammation. Over time, this chronic inflammation makes your eye get worse.
If you have something in your eye, scratch it, get pink eye, get an eye infection, or do something to your eye, your eye waters. That’s normal. If your eye is dry out to the point that those cells are irritated, inflamed, and unhappy that they’re sitting there in this dry environment, they’re going to send a signal to your lacrimal gland, which is the big gland that produces the liquid part of your tears. When this signal is received, the gland just pours out water, not necessarily in a controlled manner. The initial treatment for dry eyes is to put in artificial tears to calm your eyes.
LipiFlow is the first FDA-approved treatment for dry eyes, and it actually treats the meibomian glands. What happens is that an apparatus is put on your eye. Part of it slips inside your eyelid, and part of it goes on the outside of your eyelid. The inside part heats the lid to a few degrees above body temperature. This makes the lipid layer more liquefied. On the outside, there’s a balloon that gradually pops up and down and expresses and tries to clean out the glands in your lids so that they function better. In a study by the FDA, 80% of people who had this treatment felt that their eyes were better after the treatment.
In the future, we’ll discuss other treatments for dry eyes. If you have any questions about dry eyes, please feel free to contact us online. If not, may God bless you with healthy eyes and great vision.
Get Your Vision Checked Today
At the Cataract & Refractive Institute of Florida, our board-certified ophthalmologist, Dr. James E. Croley III, uses state-of-the-art tools and techniques to help his patients manage their eye conditions. Dr. Croley is a member of the following professional organizations:
Schedule an appointment online or call our office near you!
CAPE CORAL
- 613 Del Prado Boulevard, 33990
- (239) 772-2122
LEHIGH ACRES
- 1150 Lee Boulevard, 33936
- (239) 368-1020
BONITA SPRINGS
- 4061 Bonita Beach Road, 34134
- (239) 949-1190
