A stinging and burning sensation of the eyes can be an indication of a dry eye syndrome. It is advisable at an early stage to have a dry eye examination which can be effectively handled by Dr. Alan Margolis, a board certified ophthalmologist of Margolis Vision. Margolis Vision is conveniently located in Lone Tree, Colorado area.
Your initial dry eye syndrome consultation will entail an eye examination in which the ophthalmologist will diagnose dry eye syndrome by first hearing the patient’s verbal complaints about the eyes. This will be followed by examining the eyes for confirmation of the diagnosis that dry eye syndrome really exists. The following tests may be performed as part of the eye examination:
- Front Eye Examination – A slit lamp, which is a special microscope, is used to examine closely the front of the eye to see the quality of the tears and to look for any damage.
- Inspection of Tear Film – This examines the tear film to determine if the amount and thickness is healthy and in good condition.
- Assessment of Tear Film – The surgeon will assess if there is enough production of a tear film and that tears are spreading properly to the eyes. He will also assess if the tear film is of good quality. The stability of the tear film is assessed by checking the tear breakup time.
- Examination of the Conjunctiva – This is the examination of the thin mucous membrane that covers the front of the eye and lines the inside of the eyelids for possible inflammatory conditions. He will look to see if any trauma is present and determine if it is too dry.
- Examination of the Cornea – The cornea is checked to see if it has dried out and to see any distortions, injuries, leaking, abnormal blood vessels and swelling for proper diagnosis of dry eye syndrome.
Corneal damage is assessed by staining with dyes. During your eye examination the ophthalmologist may use different types of dyes by placing them into the tears like an eye drop. These dyes are used to assess the quality and quantity of tears. Fluorescein is a yellow die that stains the cornea where epithelial (surface) cells have been worn away because of the lack of an adequate protective tear film. Rose Bengal is a red dye that stains the cornea and the conjunctiva where the cells are dead or dying, as well as where healthy cells are inadequately protected by the tear film. Lissamine Green is a green dye which can help differentiate between normal and abnormal surface cells of the cornea and conjunctiva.
Schirmer tests measure the amount of tears produced by the eyes. The ophthalmologist places the end of a thin strip of filter paper just inside the lower eyelid. After a minute, the filter paper is removed and the amount of wetting is measured. Less wetting of the filter paper is more indicative of dry eye syndrome.
The osmolarity (salt content) of the tears may be measured. This is a new test which has been developed to aid in the diagnosis of dry eye syndrome, in which tear osmolarity is increased over normal levels.
If autoimmune diseases or Sjögren’s syndrome are suspected as a cause of dry eye syndrome, blood tests may be performed. These blood tests check for the presence of different autoantibodies that may be associated with dry eye syndrome.
Rarely, a biopsy of the salivary glands may be performed. Certain disease processes, such as Sjögren’s syndrome, affect both the salivary glands, which produce saliva in your mouth, and the lacrimal glands, which produce tears.
Dry Eye Treatment Options
There are numerous options for dry eye treatments that are readily available at Margolis Vision. Enumerated below is a full range of treatments as well as sophisticated eye protection in store for every patient who wants a complete relief from dry eye:
- Eye Drops/Creams/Lubricants/Gels/Ointments – These are artificial tears in the form of eye drops, creams, gels, lubricants and ointments that an eye specialist will prescribe to patients experiencing dry eye syndrome to alleviate the dry and itchy feeling of the eyes.
Eye drops or creams that contain Restasis (Allergan) can help the eye produce more tears and at the same time reduce the inflammation caused by dry eye syndrome. Restasis is recommended for patients with severe dry eye.
Eye creams, lubricants, gels and ointments are ideal to replace the missing water in the tear film and help reduce the symptoms of dry eye. They can provide instant relief from burning, irritated dry eyes including too much exposure of the eyes to air conditioning, computer and other conditions of the environment that affects dry eye syndrome. These products provides moisture to dry eyes helping it to soothe any discomforts.
- Punctal Plugs Panoptx 7 Eye Frames – Punctal plugs are small medical devices inserted into the tear duct to block the duct and prevent drainage of liquid from the eye, thus prevent the eyes from becoming dry. These are usually prescribed by an eye specialist when either non-prescription or prescription eye drops fail to alleviate a dry eye condition. The main purpose of these plugs is to assist in retaining corneal moisture and prevent its evaporation.
- Rudy Project Sunglasses – A variety of Rudy Project eye wear for outstanding protection of your eyes and avoid loss of the eye’s moisture. Dry Eye and prescription sunglasses from a very reliable brand are available for patients at Margolis Vision.
- Tranquileyes and ThermoEyes - Tranquileyes is a soft flexible goggle to help protect dry eyes at night. It can add moisture and help hold the eye lids closed to prevent occurrence of dry eye. ThermoEyes is a thin white foam pad that a patient can soak in a warm water. It can warm the eyes in a humid environment, thereby prevents evaporation of the natural tears. These products are all reusable and are mainly used for comfort and to stimulate tear output.
Dry Eye and Ophthalmology Issues
Ophthalmology faces many challenges today in relation to the causes of dry eye syndrome such as in the issue of cataract surgery. It has been said that cataract surgery has been found to aggravate a pre-existing dry eye and brings about dry eye to patients with healthy corneas. These are just one of the post-operative dry eye claims. Dr. Alan Margolis of Margolis Vision sees to it that these types of post-operative causes for dry eye are not manifested by a thorough examination and diagnosis of the patient before the day of the surgery.
Surgeons like Dr. Margolis make sure to remove any dry eye causes as a pre-operation procedure. Dry eye is the most common problem after a refractive surgery. The ocular surface of patients with a pre-existing dry eye must be treated appropriately prior to a surgery. During a cataract surgery a large part of the corneal nerves are cut, which are very significant in the production of tears for the eyes to function normally. Blocking these nerves can limit the eye’s ability to properly create a tear film which can lead to symptoms of dry eyes.
The uncomfortable effects of dry eye syndrome are unavoidable. Itchiness, blurry vision and light sensitivity are among the symptoms that every patient will endeavor if left untreated. This type of ophthalmology issue can be avoided with the right diagnosis and treatments for the comfort of the patient. The doctor will first determine the major underlying cause and efficiently diagnose the presence or extent of the dryness.
- IOL Choice
Choosing the correct and appropriate IOL or artificial lens implant for a refractive surgery must be done with extra care by the surgeon to avoid any dry eye after the surgery. It is favorable for the patient to talk to a qualified eye surgeon such as Dr. Margolis of Margolis Vision to better understand the correct choices and options of IOL and to avoid dry eye syndrome after the procedures. Improper choice of an IOL can contribute to or cause dry eyes.
- Lasik Outcomes
The occurrence of dry eye after LASIK surgery is very common in patients and ranges from mild to severe cases. It is imperative before the LASIK surgery for a patient to undergo an extensive dry eye detection at an early stage during a consultation with the surgeon. A pre-existing dry eye syndrome can be addressed in the LASIK consultation and be treated first before the surgery.
- Systemic Disease
Systemic disease is one that affects and involves many organs or the body as a whole. It affects a number of organs and tissues. The eye is composed of many different types of tissue. It becomes susceptible to a wide variety of diseases. Signs of a systemic disease may be evident on the outer surface of the eye. Blood vessels in the eye can indicate the condition of the arteries and veins throughout the body. Doctors and surgeons know that various systemic diseases can affect the eye and can cause dry eyes. Systemic diseases can sometimes mimic as dry eye syndrome and surgeons must be very careful in their diagnosis for every patient’s case. An accurate diagnosis must be done by the doctor on what is the root cause of the dry eye before recommending the proper treatments.
Involvement with rheumatology and TFOS
Dry eye is frequently present in rheumatic patients. It is one of the symptoms for rheumatoid arthritis. Sjögren’s syndrome can also occur in people who have another rheumatologic disease. It is an autoimmune disorder of chronic arthritis accompanied with dry eyes.
Dry eye is a global problem and it became the major crusade of the Tear Film and Ocular Surface Society (TFOS). TFOS is composed of eye health professionals around the world. It is getting involved in dry eye awareness through its online campaign with the message: “The simple act of blinking reduces dry eye symptoms by flushing fresh tears over the eye, re-moisturizing and keeping foreign matter and irritants out.”
Please contact Margolis Vision today to schedule your dry eye syndrome examination. Dr. Alan Margolis serves patients in Lone Tree, Castle Rock, and throughout the Denver metropolitan area.