Dry eyes can have many causes. These range from the “simple” – blepharitis – to autoimmune diseases and hormonal disorders. Dry eye is not usually dangerous, but it can severely limit the quality of life of the patients affected by it, and the objective is to generate a healthy tear film that evaporates slowly and has a normal “tear film break-up time”.
Normal tear film
Resists evaporation for over 10 seconds
Morbid tear film
Breaks down after a few seconds (black spots)
Our diagnostic instruments can take the information from all of the methods mentioned above allows us to narrow down the true cause of your dry eyes – something that’s essential to planning a successful treatment.
Tears get produced – but they also get drained into the tear duct. It’s a dynamic process, and it’s good to understand how quickly the tear film is being drained. The amount that’s being drained any given time can be determined by measuring the tear meniscus with a high-resolution camera.
We can determine the quality of the tear film with a Placido disk analysis. You look at concentric rings; a camera at the centre of the rings takes an image of what’s reflected back from the surface of the eye. The presence (or absence) of distortion in these rings provides information about the quality of the tear film.
An analysis of the meibomian glands in the lid margin allows to determine the best therapy for you.
If you have a salt solution and boil off (evaporate away) all of the water, you generate an increasingly salty solution until only the salt is left. It’s the same with evaporative dry eye: the increasing saltiness (osmolarity) indicates the severity of dry eye.
There are many causes of dry eye – and there are just as many ways to treat it. Working out the best approach for you requires diligent examination. This involves:
The therapy then offered is based on the causes of the dry eye and can range from “simple” tear replacements, approaches that treat eyelid inflammation, the implantation of punctal plugs, to suppression of the immune response in the eye with topical drugs. Every treatment plan is 100% tailored to your individual needs.
In most cases, the dry eye is a chronic change that often goes unnoticed for decades. At the point where most patients start to notice the first symptoms of dry eye, the disease has often been around for 15–20 years. Reversing those effects also takes time. Typically, such therapy lasts for several months, and it can take a few weeks before you start to notice the benefits. This is entirely normal.