Dry eye is a common condition that is characterized by instability or insufficiency of the tear film, inflammation/damage, and neurosensory abnormalities of the ocular surface. The surface of the eye is covered by the tear film, which is a thin layer of tears meant to protect and lubricate the eye along with other important functions. Blinking can help to maintain a healthy tear film and replenish necessary tears and oils that promote comfort and vision.  Several systems are responsible for producing tears and if any of these systems were to break down, it can result in a reduction of the quantity and quality of tears: thus, resulting in dry eye disease. 

Treatment Options:

1. Artificial tears: It is recommended to treat with artificial tears at least 2-4 times daily for long term dry eye management. If treating with tears more than 4x daily, we recommend using preservative-free tears. At night, gel drops or ointment before bed can provide extra protection overnight and improve comfort in the morning.

2. Omega 3 supplements: Meibomian glands are responsible for production and maintenance of the tear film. Omega 3s can help to improve the quality of the oil in the glands and aid in maintaining a healthy tear film. It is important to find a good quality Omega for the best and most effective results/benefit.

3.  Lid scrubs and warm compresses: Blepharitis is a common condition that is characterized by a build-up of bacteria and debris in the lashes. Cleaning the lids and lashes with lid scrubs daily can promote good lid hygiene and prevent any bacteria from getting into and clogging oil glands. Meibomian glands help to produce and maintain the integrity of the tear film. The consistency of the oil in these glands should be smooth like olive oil. When the glands get clogged, they become viscous like toothpaste resulting in instability and insufficiency of the tear film. Warm compresses paired with lid massages help to heat the glands and aid in gland expression to remove any bacteria.

4.  Punctal plugs: A low-quality tear film means that the tears are evaporating quickly and not staying on the surface of the eye for long enough. A healthy tear breakup time is ~ 10 seconds. When the tears drain off on the surface of the eye, they drain through the tear duct or puncta. Inserting a small silicon plug into the puncta will prevent the tears from draining and help them stay on the surface of the eye longer. It is a quick, painless in-office procedure that takes less than 5 minutes. Will typically start with 1-week temporary dissolvable plugs, as a trial, before graduating to 4 month temporary plugs or permanent plugs.Prescription eye drops: These drops are meant to be used twice daily for long term management. Restasis works to regulate the inflammatory processes in the eyes which affect the production of tears. Xiidra helps to improve tear production and decrease inflammation by blocking certain protein interactions. It can take ~ 3 months to experience relief from dry eye symptoms for both medications.

5. IPL Therapy: Traditionally used in derma-spas, IPL therapy was used to treat fine lines, dark spots, and wrinkles and was found to play a significant role in long-term improvement of dry eye symptoms. Treating underneath the lower eyelids, the light energy transforms into heat. Thus, heating up the oil glands and promoting an improvement in tear film production and overall function. Recommended therapy for the best effect is 4 treatments over the course of 6-8 weeks.