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The Dry Eye Workup and Moving into 2020!

Goodness, how fast time flies! It’s been over a year since my last blog. I’m sorry it took so long to get this out! We have been running on all cylinders here at Valley Eye Clinic, improving and perfecting our services, working on improving patient experience, and getting out into the community!

I thought I would take a moment to update on how we are treating dry eye at this time.  2020 is my year (hopefully), for more regular blogs with information specifically on ocular surface disease, but also any topics you would like to here more about.  You can always email us at valleyeyeclinicdsm.com to request information!

As Ocular surface disease (we as an industry are moving away from the term “dry eye”, as that word is more a symptom, rather then the all-encompassing term “ocular surface disease”, one symptom of which is “dry” eyes.  We have been greatly improving our ocular surface disease workup, and I wanted to list that out here, so when you come to see us for your ocular surface disease evaluation, you can know what to expect!

We start by having you list you main symptoms. What are they? Dry eyes? Gritty eyes? Red eyes? Fluctuating vision throughout the day? What do you struggle MOST with? We also like to obtain a list of current health diagnoses as well as current medications, as many conditions (especially autoimmune), as well as medications (most often antihistamines, anti-depression meds, anti-anxiety meds, birth control and ance medications) can greatly increase symptoms of dryness and irritation.

Next, we take a tear sample. We use technology called TearLab, that actually measures how salty your tears are. The higher the score, the WORSE the condition, as the more salt there is in the tears, the less liquid (aqueous) is likely there.  When you score high, or poorly, on this test, we often know your eyes are not producing enough tears.

Next is the gland photo. We use technology that allows us to view your meibomian glands. These are the glands in the eyelid that actually secrete oil, which act as a natural buffer against the tears on your eyeball, decreasing evaporation. Poor oil secretion lacks it a more quickly evaporating tear film, and thus faster and more prolonged symptoms.  The more gland that you have, the more optimistic we are at providing relief when you follow our dry eye treatment regiment.

Also important is the quality and type of oil your eye is producing when I put pressure on the glands.  Very little pressure should show good oil, (think of olive oil, or canola oil, or whatever yellowish oil you cook with) to be expressed from the lids.  We are looking for good, liquidy oil.  Many people however, have oil that is thick, or pasty, or almost like toothpaste! This type of oil is NOT going to prevent evaporation, and treatment is needed to return this oil to it’s regular consistency. 

So, after this workup we know if your eyes are producing enough tears, if you have meibomian glands still in your lids (blogs later on how this can change), and what type of oil your eyes are producing.  This info along with your health history and medications if vital to put together a treatment plan for you!

What does that treatment look like? Stay tuned for future blogs, or take a look further on our website about treatments. 

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