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Dry Eye Treatment at Tower Clock Eye Center
Dry eye disease is more than simply having eyes that feel dry. It is a complex condition involving the tears, eyelids, oil-producing glands, inflammation and the surface of the eye. Symptoms can range from mild irritation to significant discomfort, fluctuating vision and difficulty wearing contact lenses.
At Tower Clock Eye Center, our Dry Eye Clinic provides comprehensive evaluation and personalized treatment for patients with dry eye disease, meibomian gland dysfunction, blepharitis and other ocular surface conditions.
Our goal is to determine what is contributing to your symptoms and develop a treatment plan based on both how your eyes feel and what we see during your examination.
Dry eye is not always completely curable, particularly when it is related to chronic inflammation, autoimmune disease or changes in the tear glands. However, it can often be successfully managed, and there are more treatment options available today than ever before.
Experiencing persistent dry eye symptoms? Schedule a dry eye evaluation at Tower Clock Eye Center.
What Is Dry Eye Disease?
A healthy tear film contains several important components, including water, oils and mucus. These components work together to lubricate and protect the surface of the eye.
Dry eye generally falls into two main categories, although many patients have a combination of both.
Aqueous-Deficient Dry Eye
Aqueous-deficient dry eye occurs when the lacrimal glands do not produce enough of the watery portion of the tears. Reduced tear production can leave the surface of the eye inadequately lubricated and may contribute to inflammation and corneal damage.
Evaporative Dry Eye
Evaporative dry eye occurs when tears evaporate too quickly. This is frequently associated with meibomian gland dysfunction (MGD), a condition affecting the oil-producing glands located along the eyelids.
Mixed Dry Eye
Many patients do not fit neatly into one category. Mixed dry eye, in which decreased tear production and excessive tear evaporation are both present, is extremely common.
What Causes Dry Eye?
A number of factors can contribute to dry eye disease, including:
- Increasing age
- Hormonal changes
- Prolonged computer, phone and tablet use
- Dry, windy or air-conditioned environments
- Certain medications
- Contact lens wear
- Previous eye surgery or eye infections
- Eyelid and meibomian gland disease
- Autoimmune and inflammatory conditions
Patients with autoimmune diseases such as Sjögren’s syndrome and those with conditions such as graft-versus-host disease (GVHD) can develop particularly significant ocular surface disease. Inflammation associated with these conditions may interfere with normal tear production and the health of the eye’s surface.
What Are the Symptoms of Dry Eye?
Dry eye does not always feel “dry.” In fact, symptoms can vary considerably from one person to another.
Common dry eye symptoms include:
- Burning or stinging
- A gritty or sandy sensation
- Redness
- Itching or irritation
- Light sensitivity
- Eye fatigue
- Fluctuating or blurry vision
- Difficulty wearing contact lenses
- A feeling that something is in the eye
- Excessive watering or tearing
- Eye pain
Can Watery Eyes Be a Sign of Dry Eye?
Yes. Watery eyes can actually be a symptom of dry eye.
When the surface of the eye becomes irritated, the eye may respond by producing reflex tears. These tears can overflow onto the cheeks but may not provide the stable lubrication the eye needs.
How Is Dry Eye Diagnosed?
Symptoms are only one part of a dry eye evaluation. Some patients have significant symptoms with relatively subtle findings, while others may have considerable damage to the ocular surface without experiencing severe discomfort.
During a dry eye examination, your doctor may evaluate the tear film, cornea, eyelids and meibomian glands for findings such as:
Corneal Staining
Tiny areas of damage or “dry spots” on the cornea can absorb diagnostic dye. This is sometimes called punctate epithelial staining or superficial punctate keratitis.
Tear Film and Tear Breakup Time
The tear film should remain smooth between blinks. When it breaks apart too quickly, areas of the cornea become exposed and vision may fluctuate.
Meibomian Gland Dysfunction
The meibomian glands are oil-producing glands located along the eyelids. They may become clogged or inflamed or produce oil that is too thick, reducing the protective oil layer of the tear film.
Blepharitis
Blepharitis is inflammation along the eyelid margins. It can cause redness, debris, crusting and irritation and may contribute to an unhealthy tear film.
Your doctor will use these findings, along with your symptoms and medical history, to determine which treatments may be most helpful.
Meibomian Gland Dysfunction and Blepharitis
The eyelids play an important role in maintaining a healthy tear film.
The meibomian glands are tiny glands located within the upper and lower eyelids. Every time we blink, these glands release a thin layer of oil over the tears. This oil helps prevent tears from evaporating too quickly.
When the glands become clogged or inflamed — a condition called meibomian gland dysfunction, or MGD — the protective oil layer may become inadequate. Tears can then evaporate more quickly, contributing to dry eye symptoms.
Blepharitis is inflammation of the eyelid margins and often occurs along with MGD. Bacteria, inflammation, debris and, in some patients, an overpopulation of Demodex mites around the eyelashes may contribute to blepharitis.
Because the eyelids and tear film work together, treating the eyelids is often an important part of treating dry eye.
Dry Eye Treatment Options
There is no single dry eye treatment that works for every patient. Some patients need only improved lubrication or eyelid care, while others benefit from prescription medications, tear-conserving procedures or treatments designed to help a damaged ocular surface heal.
Treatment may also change over time as the condition improves or progresses.
Artificial Tears and Tear Replacement
For many patients, treatment begins by supplementing the natural tear film with preservative-free artificial tears.
Preservative-free drops can be especially useful for patients who need frequent lubrication because some preservatives found in bottled eye drops can further irritate a sensitive ocular surface.
Examples include:
- iVIZIA
- Refresh Mega-3
- Refresh Optive
- Systane preservative-free products
- Other preservative-free tears, gels and nighttime ointments
Not every artificial tear is the same. Some primarily add moisture, while others are formulated to help supplement the oily portion of the tear film. Your doctor may recommend a specific type depending on the cause of your dry eye.
Eyelid Hygiene, Warm Compresses and MGD Treatment
When meibomian gland dysfunction or blepharitis contributes to dry eye, improving eyelid health can make a significant difference.
Treatment may include:
Warm compresses or a Bruder Mask: Heat helps soften thickened oils within the meibomian glands so they can flow more normally.
Lid cleansing: Products such as Cliradex or other eyelid cleansers may help remove debris and improve eyelid hygiene. In selected patients, diluted baby shampoo lid scrubs may also be recommended.
Prescription antibiotic or anti-inflammatory treatment: A short course of a topical antibiotic, steroid or combination medication may be used when significant eyelid or ocular surface inflammation is present.
XDEMVY: Some cases of blepharitis are associated with an overpopulation of Demodex mites around the eyelashes. XDEMVY is a prescription eye drop specifically designed to treat Demodex blepharitis.
The appropriate eyelid treatment depends on what your doctor sees during your examination.
Prescription Dry Eye Medications
When artificial tears alone are not enough, prescription medications can target specific causes of dry eye.
Restasis (cyclosporine) helps reduce inflammation associated with dry eye and can improve the eye’s ability to produce tears over time.
Xiidra (lifitegrast) targets inflammation involved in dry eye disease and can help improve signs and symptoms in appropriate patients.
Tyrvaya (varenicline nasal spray) is different from traditional eye drops. It is sprayed into the nose and stimulates a nerve pathway involved in natural tear production.
Miebo (perfluorohexyloctane) is designed to reduce excessive tear evaporation and may be particularly useful in evaporative dry eye associated with meibomian gland dysfunction.
TRYPTYR (acoltremon) is a newer prescription eye drop that stimulates corneal sensory nerves to rapidly increase natural tear production.
These medications work in different ways, allowing your doctor to choose a treatment based on the underlying cause of your dry eye rather than treating every patient the same way.
Punctal Plugs and Tear Conservation
Normally, tears eventually drain away from the eye through tiny openings called the puncta, located near the inner corners of the eyelids.
For patients who do not produce enough tears, slowing this drainage can allow natural tears — as well as artificial tears placed in the eye — to remain on the ocular surface longer.
Punctal plugs are very small devices placed into the tear drainage openings. Depending on the patient’s needs, different types of plugs may be used.
LACRIFILL Canalicular Gel provides another option for tear conservation. Instead of placing a traditional plug at the opening of the tear duct, a gel is placed into the canalicular portion of the tear drainage system. The goal is similar: reduce tear drainage so the eye can retain more of its own moisture.
Your doctor can determine whether punctal occlusion is appropriate for your type of dry eye.
Treatment for Severe Dry Eye and Ocular Surface Disease
With more advanced dry eye, treatment becomes about more than simply replacing tears.
Persistent dryness and inflammation can cause repeated injury to the corneal epithelium, the delicate outermost layer of the cornea. These areas may appear during an examination as punctate staining or superficial punctate keratitis.
The cornea also contains an extremely dense network of nerves. These nerves provide sensation but also play an important role in maintaining and healing the corneal surface.
When the ocular surface remains unhealthy, the relationship between the tear film, corneal epithelium and corneal nerves can become disrupted. In certain patients, reduced corneal sensation and impaired healing can contribute to neurotrophic keratitis.
Neurotrophic keratitis requires careful monitoring because the cornea may become damaged even when a patient does not experience the amount of pain that would normally be expected.
For patients with significant ocular surface damage, we may recommend treatments designed to protect the cornea and promote healing rather than simply provide temporary lubrication.
Amniotic Membrane Treatment with CAM360 AmnioGraft
Amniotic membrane has been used in eye care to help support healing of a damaged ocular surface. It contains naturally occurring components associated with anti-inflammatory, anti-scarring and regenerative properties.
At Tower Clock Eye Center, we use CAM360 AmnioGraft, a ringless, hydrated, cryopreserved amniotic membrane.
An important difference between CAM360 and some other amniotic membrane products is how the tissue is preserved. CAM360 is not heat-dehydrated. Its preservation process allows the membrane to remain hydrated while still being shelf-stable.
This processing is designed to preserve important biological components naturally present in amniotic tissue.
CAM360 can be placed directly over the cornea and protected with a collagen shield or bandage contact lens while the ocular surface heals.
We may consider CAM360 for patients with conditions such as:
- Significant dry eye disease
- Superficial punctate keratitis
- Persistent corneal staining
- Medication-induced ocular surface disease
- Early neurotrophic keratitis
- Other conditions in which the corneal surface needs additional help healing
Rather than simply adding moisture to the eye, amniotic membrane therapy is intended to help create an environment in which the damaged ocular surface can recover.
Autologous Serum Tears
For some patients with severe or difficult-to-treat dry eye, conventional artificial tears may not provide everything the ocular surface needs.
Autologous serum tears are customized eye drops made using a small sample of the patient’s own blood. The blood is processed to separate the serum, which is then diluted and prepared as sterile eye drops.
Serum contains naturally occurring proteins, growth factors and other components that are also found in healthy tears.
Because of this, serum tears can be particularly helpful for patients with significant ocular surface disease, including severe dry eye, autoimmune-related dry eye, persistent corneal staining or neurotrophic disease.
Bandage Contact Lenses
A bandage contact lens is a soft contact lens used for medical treatment rather than vision correction.
The lens acts as a temporary protective covering over the cornea. It reduces friction from the eyelids during blinking and can provide a more protected environment for damaged corneal cells to heal.
Bandage contact lenses may be used for certain patients with:
- Significant corneal irritation
- Persistent epithelial defects
- Corneal abrasions
- Severe superficial keratitis
- Recurrent corneal erosion
- Neurotrophic keratitis
- Other ocular surface conditions
Because a bandage contact lens remains on the eye for an extended period, patients require appropriate monitoring and, in some situations, additional medications to reduce the risk of infection.
Personalized Dry Eye Treatment at Tower Clock Eye Center
Dry eye treatment is rarely a simple matter of finding the “best eye drop.”
One patient may primarily have clogged meibomian glands and excessive tear evaporation. Another may have decreased tear production related to Sjögren’s disease. Another may have inflammation, eyelid disease and aqueous deficiency at the same time.
That is why the treatment should match the patient.
At Tower Clock Eye Center, we evaluate both your symptoms and the health of the ocular surface. Depending on what we find, treatment may range from preservative-free artificial tears and eyelid care to prescription medications, punctal treatments, serum tears, bandage contact lenses or regenerative treatment with amniotic membrane.
For many patients, successful dry eye treatment involves a combination of therapies and ongoing management.
The goal is not simply to make the eyes feel better. It is to improve the tear film, control inflammation, protect the cornea and maintain a healthy ocular surface for the long term.
Dry Eye Frequently Asked Questions
Find Relief With Personalized Dry Eye Treatment
Persistent dry eye symptoms should not simply be accepted as a normal part of aging or screen use. A comprehensive evaluation can help determine what is contributing to your symptoms and which treatment options may be appropriate.
Schedule a dry eye evaluation at Tower Clock Eye Center.
Call 920-499-3102 to schedule an appointment.
Tower Clock Eye Center provides comprehensive eye care throughout Northeast Wisconsin, with locations in Green Bay, Appleton and Shawano.
