Dry Eye Clinic

Dry Eye Evaluations

At Total Optical, we offer a comprehensive dry eye evaluation to determine the type of dry eye you have, and its level of severity. This allows your optometrist to recommend the best treatment option for you. The evaluation takes one hour and involves an in-depth assessment with advanced equipment. Some of the tests that will be done during the evaluation:

  • Assess your tear volume and tear evaporation using the Oculus Keratograph (See Right), to find out whether you are aqueous-deficient or have MGD, and the severity of your condition.
  • Image your oil producing glands in your eyelids.
  • Measurement of the quality and thickness of the oil layer of your tears.
  • Assess your blinking rate and blink completeness.
  • The optometrist may also measure how ‘salty’ your tears are.

The optometrist will then plan and discuss with you a treatment regimen suited to your unique condition. Unsure if you need a dry eye evaluation?

total optical 3dry eye diagram image
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The Facts

What is Dry Eye Disease

The surface of your eyes is protected by a tear film; a layer of tears produced by glands in your eyelids. The tear film is important for a number of different reasons:

  • It has antimicrobial properties which protect your eyes from infection
  • It creates a smooth optical surface for the front of the eye to give you clear vision (just as you would need a smooth surface with no scratches on your glasses or windscreen to allow you to see clearly)
  • The liquid layer is full of nutrients that feed the outer layers of the eye

Dry Eye Disease (DED) is a chronic condition where the tear film produced by your eyelids is either of a poor quality, or not enough of it is being produced. This causes a number of irritating and sometimes painful symptoms:

  • Sore, red eyes
  • Blurred vision
  • In severe cases it can lead to a higher risk of eye infections

There are three parts to your tear film. The mucous layer is the one closest to the eye, then above that come the aqueous or water layer, and finally the top layer is the lipid or oil layer. Dry Eye Disease is caused by a problem in the top two layers – either the water layer, the oil layer, or both.

Dry Eye Disease treatments are aimed at improving the quality of your tear film, and they range from ‘beginners’ to ‘advanced’, depending on the severity of your condition.

The optometrist begins by diagnosing your particular type of dry eye – whether it is caused by lack of the aqueous (water) layer, or not enough of the lipid (oil) layer, before prescribing a treatment regimen on that basis. This is done during your initial dry eye evaluation.

Aqueous-Deficient Dry Eye Disease

Aqueous-deficient Dry Eye Disease is a deficiency in the aqueous (watery solution) part of your tear film, which is produced by glands in the top lids.

Eye Drops

Artificial tears are not a treatment in themselves, as they do not fix the cause of the disease. However, artificial tears are important in the short-term to provide symptom relief, and help make your eyes feel more comfortable and reduce redness and inflammation.

Punctal Plugs

The aqueous (watery) layer is produced by glands in the top lid, and more of this solution should be released onto the surface of the eye every time you blink. In addition, as you blink, the older tears drain out through small openings, or “puncta”, in the inner corners of your eyelids. As your eyes are not producing enough of this solution, in order to ‘save’ the small amount of tears your eyes produce, your optometrist may recommend punctal plugs. These plugs are inserted into the small opening, effectively blocking the drainage of the tears and ‘holding on’ to that solution to keep your eyes moist.

Blephasteam Treatment

Blephasteam is a unique eyelid-warming device that provides moisture and heat therapy to help relieve symptoms of dry eye and associated eye diseases such as posterior blepharitis, meibomitis, ocular rosacea, chalazion, and contact lens intolerance

Treatment For:

Meibomian Gland Dysfunction

Meibomian Gland Dysfunction (MGD) causes the oil in the glands to become thick and pasty (like butter) and block the glands’ opening onto the eyelid. Over time this can lead to gland atrophy. MGD treatments aim to improve the quality of the oil, returning it to a smooth and runny consistency (think vegetable oil vs butter).

All About:

Lipiflow

Lipiflow has obtained the well-deserved title ‘game-changer’. It has truly revolutionised MGD therapy. Lipiflow has provided much-needed relief to many of our patients with severe dry eye disease, who had suffered for many years with their condition without any effective therapies.

Combined Therapy

For severe dry eye patients, your optometrist may design a combined treatment regimen involving more than one of the above treatments. This would be discussed at your Dry Eye Evaluation.