Dry Eye

Dry eye is a very common disease related to many of the pathologies that present eye problems. It has been shown that 40% of consultations with the ophthalmologist are directly or indirectly related to dry eyes.

To give us an idea of ​​the magnitude of the population affected by this disease, dry eye syndrome is one of the most common diseases in medicine.

Dry Eye

Dry eye is a very common disease related to many of the pathologies that present eye problems. It has been shown that 40% of consultations with the ophthalmologist are directly or indirectly related to dry eyes.

To give us an idea of ​​the magnitude of the population affected by this disease, dry eye syndrome is one of the most common diseases in medicine.

What is dry eye?

Syndrome Dry Eye is a eye disorder that occurs when our eyes are not able to lubricate properly. This is due, in almost all cases, to one or both of these reasons:

  1. Insufficient tear production.
  2. The tear is of poor quality.

This produces great inconvenience that ends by affect the quality of life who suffers from it, and may also lead to vision problems. For this reason it is vital to conduct an in-depth study of the symptoms that are causing dry eyes and propose a individualized and effective treatment for each person.

La tear is in charge of protect, nourish, humidify y lubricate the surface of the eye. It provides nutrients for the cells of the ocular surface and contributes to the defense system of our eyes. Thanks to this hydration the flickering is done smoothly, but when the lubrication fails, the discomfort is felt quickly.

This syndrome is one of the ophthalmic pathologies that most patients bring to our office. In Área Oftalmológica Avanzada We are specialist ophthalmologists in dry eye and we explain more about this condition, its symptoms, causes and treatment of dry eye.

How to know if I have a dry eye?

To know if we are suffering from dry eye you just have to look at some discomfort characteristics of this disease as:

  • Grit feeling In the eyes.
  • Irritation ocular.
  • Stinging.
  • Redness and feeling of strange body on the ocular surface.
  • Fatigue or heaviness in the eyelids.
  • Increase in tearing due to poor eye lubrication, because the body, as a protective measure, increases the production of tears to counteract the symptoms, but they do not have sufficient quality.
  • In some cases, dry eye can cause blurred vision.

Before any of these signals it is recommended go to a specialist for an ophthalmologic review Determine if it is this syndrome.

Causes of dry eye

¿Why do i have dry eye?, this is a frequent doubt among patients. Recall that in most cases, as we said at the beginning, it is motivated by insufficient tear production or it is of poor quality. But what does this mean?

The syndrome of Dry Eye, named like that because it describes the dry mucous membranes in the eyes, is produced by a decrease in basal tear secretion, which the body creates on a regular basis - like a micro-rubber - to “bathe”, humidify and lubricate the surface of the eye. It is placed under the upper eyelid, in the outer edge and works like oil in a machine, so that the flickering pass smoothly over the eye without "scratching" and without damaging it.

When basal secretion is reduced, the eyelid grazes the cornea and conjunctiva causing microerosion continues that ends up making cells jump, expose sensitive nerve endings of the eye and causes discomfort or pain like the one you feel when you have something in your eye.

This micro erosion is responsible for it activate the mechanisms of reflex tear secretion, a mechanism that causes the formation and production of a lot of tear to abundantly bathe the eye and try remove anything on its surface, giving rise to that excessive tearing which Dry Eye patients complain about.

Next to the tear deficit, the syndrome of Dry Eye is also explained by rapid tear evaporationcaused by a alteration in the meibomian glands. The glands of the eyelids that secrete lipids (fats), necessary so that the tear of the eye does not evaporate quickly and to avoid, thus, the exposure of the ocular surface to the air, an aggression that causes the typical discomforts of this syndrome. 80% of dry eye cases are due to a condition known as dysfunction of the Meibomian glands.

Some of the risk factor's What can lead to this condition are:

Hormonal changes They can lead to dry eyes, such as menopause or pregnancy.

  • Live in very dry environments, windy or overuse the air conditioner.
  • Wear contact lenses frequently or for prolonged periods of time.
  • Being exposed frequently to cigarette smoke.
  • Medication intake for conditions such as diabetes, arterial problems, allergies or anxiety, as well as frequent consumption of sleeping pills. It is important to inform the ophthalmologist of any medical treatment that is ingested periodically.
  • In some patients, dry eye syndrome may present as a side effect of laser surgery to correct vision problems.

The causes of dry eye they are varied and are often related to aspects that go beyond ophthalmology like a incorrect feeding, the arrival of the menopause, skin diseases, certain pictures allergic, anxiety, Stress y environmental factors. Therefore, in our center, in addition to the advice of an ophthalmologist, we also have the possibility to consult directly with specialists from each of the identified areas related to the factors that cause this condition, such as: the gynecologist, the dermatologist, the Psychologist and nutritionist.

Dry eye symptoms

The dry eye symptoms They can be very varied. Among the most prominent are:

  • The administration of others drugs: antiglaucomatous (drops for the treatment of glaucoma) and antiallergics.
  • Alterations in flickering dynamics: flaccid eyelids, excess skin in blepharocalasia, eyelid retraction and exophthalmos in the hyperthyroid
  • Malposition of the eyelid edge: entropion y ectropion.
  • Folds of the conjunctiva (Conjunctivacalasia).
  • Be a bearer of contact lenses.
  • Presence of systemic diseases which can affect the tissues of the ocular surface such as Acnes, Rosacea, Rheumatic disorders, Diabetes, hormonal changes, antidepressant treatments.

In this list we must add the disorders that cause the presence of stress-anxiety and alterations in eating habits and nutritional as well as the be a smoker.

Deserve special mention environmental factorsAs presence of wind, dry environments y with dust (fans and air conditioners) and an excess of ultraviolet radiation for living the places with high level of heat stroke y poor protection of glasses with UV filters.

Transmission

In recent years we have encountered the limitation of therapeutic options. Basically we only had artificial tears and when the inflammatory process was very evident, we associated corticoids to try to reduce it, with the disadvantages that this type of drugs supposes.

In Advanced Ophthalmology Area we not only offer the dry eye treatment with a traditional approach, composed of options such as artificial tears, tear plugs to keep the little tear that occurs in the eye area, ointments o plasma of the patient's own blood to regenerate the affected tissue. In addition, we have a global approach that includes the first comprehensive treatment of dry eye syndrome with personalized and emotional accompaniment, carried out with the most advanced technologies and techniques.

The situation has changed in recent years and we already have new alternatives for dry eye treatment in a joint way, trying to control all the factors that come into play. We currently do a multifactorial approach, from the systemic state from the patients, nutritional aspects, level of stress-anxiety, to the modern systems of stimulation of the meibomian glands, like the platforms IPL de Pulsed light.

To make the treatment more understandable we divide it into 3 sections:

  • Treatment of palpebral free edge.
  • Treatment of Meibomian glands.
  • Treatment of ocular surface and nerve endings.

Palpebral free edge

For the treatment of the palpebral free edge we highlight:

  • Heat application for the dry eye
  • Exfoliation of the palpebral free edge.
  • Elimination of parasites such as Demodex.

In our experience, the heat application for dry eye treatment, both in compresses and in thermal pulses (radiofrequence), it has not given us good results in an individualized way.

On the contrary, the free edge cleaning with Blephex systems and the hyperkeratosis exfoliation which is observed in this area, they have been very effective. In most cases, it must be completed with the opening of the exit hinges of the Meibomian glands, by means of gland probing with the Maskinn system or similar.

If the demodex presence, we perform the root cleaning of the eyelashes with the Blephex and a cream of tea tree oil in concentrations of 30% -50%.

Meibomian gland treatment

This is the gland responsible for lubricating the eye y The goal of the treatment of the Meibomian glands is to recover their functionality.

To stimulate the activity of the Meibomian glands we have the new systems of pulsed light IPL, very effective and safe, with a very high success rate.

El IPL for dry eye It has also demonstrated an antimicrobial effect that helps balance conjunctival flora and Meibomian glands, contributing to symptomatic improvement. We can complete this effect with the Doxycycline administration oral or similar, which help normalize microbial flora and to improve the lipid metabolism of the Meibomian glands.

Eye surface and nerve endings

In the third group of treatment, at the level of the ocular surface and nerve endings, it is important to assess.

  • El state of tissue deterioration.
  • The presence of inflammation.

These two factors are usually associated, since in most cases of dry eye there is a inflammatory answer with activation of immunological systems mediated by T lymphocytes. Cytokines that damage tissues are released, contributing to the tear film instability that, when breaking early and leave the ocular surface exposed to ambient air, produces desiccation y more inflammation, closing a negative vicious circle.

Yes, try this double component we use substances that help regenerate tissues of the ocular surface, such as the autologous serum and enriched platelet derivatives.

La inflammation we treat it with local corticosteroids or, modernly with the Ciclosporin A in concentrations of 0.05%, very effective and without the side effects of corticosteroids. In this line there is also the Lifitegrast, a new inhibitor of integrins and the action of T lymphocytes, which has just been approved by the FDA and has shown very good results in clinical studies.

Technology for dry eye treatment

Some of these solutions include the use and application of the following technologies:

Keratograph

The Keratograph allows us to make a in-depth study of the state of the eye Dry in each person. Based on the information extracted we perform the diagnosis and we propose an adapted treatment for each patient based on individual needs. These are some of the data we will work with:

  • Break time of the tear film (BUT).
  • Height of tear meniscus.
  • Interferometry.
  • Meibography.

Thermaeye Plus

El IPL for dry eye It serves for stimulate the meibomian glands painlessly and without entering the operating room. Stimulates circulation and acts on nerve endings that control fat production and secretion. These, through flickering, move to the ocular surface improving the patient's condition.





Meibomian gland probing

It's a surgical procedure non-invasive to open the outlet duct of the Meibomian glands, extract the fat content inside and apply an antibiotic to normalize the microbial flora. It is painless and is performed with superficial sedation.

Exfoliation of the free edge of the eyelids and glandular drainage

Consists in remove the membrane that clogs the Meibomian glands through exfoliation, then a massage to empty the contents of the glands, applying cold and antioxidants to reduce eyelid inflammation and irritation.

Endoret: Plasma drops rich in growth factors

El Endoret in ophthalmology is applied in the form of drops that we create from the patient's own blood to treat dry eye. These stimulate the tissue regeneration of the eye from plasma extraction rich in growth factors y cytokines that are found in the patient's own blood.

Changes in diet to improve dry eye

Recent studies allow us to state that a poor diet is also a risk factor for the appearance of dry eye. Diets low in omega 3 and in Antioxidants, and those rich in omega 6, produce oxidative stress that generates inflammatory effects on the Meibomian glands, the cornea and the conjunctiva.

Aware of this, we have incorporated nutrition experts among our ranks to help patients in a more personalized way, advising them with appropriate diets that allow for better ocular lubrication.

Dry eye treatment requires the intervention of specialists to reduce symptoms and ensure a better quality of life, so we invite you to consult an ophthalmologist if you have discomforts that may indicate the existence of this condition.

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Dry Eye
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Specialists in the diagnosis and treatment of dry eye. Ophthalmological reference center with more than 30 years dedicated to cure this pathology.
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Área Oftalmológica Avanzada
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