Dry Eye
Dry eye syndrome (also known as dry eye disease) is one of the most common eye conditions worldwide. According to a research report in the Journal of Global Health¹, the global prevalence of dry eye syndrome can be as high as 50%. Causes of dry eye syndrome include: long-term use of computer products, wearing contact lenses, aging, hormonal influences, taking certain drugs, external environment, etc. If symptoms such as persistent eye dryness, eye itching, and photophobia are found, if ignored, the cornea may be worn, causing inflammation and ulcers, vision loss, and even blindness in severe cases. The ophthalmologists at our Dry Eye Centre offer exams, IPL, iTEAR, and other treatments.
Source: 1. Ophthalmology and Visual Sciences, The Chinese University of Hong Kong
Source: 1. Ophthalmology and Visual Sciences, The Chinese University of Hong Kong
Dry eyes are caused when the eye does not produce enough tears or when the tears evaporate excessively, resulting in the surface of the eye not remaining moist and hence feeling dry.
The tear layer on the surface of the eyeball is divided into three layers: oil layer, aqueous layer, and mucus layer
If one of the layers decrease in production, it may cause dry eyes. Eyes may feel dry, have a gritty sensation or stinging.
Types of Dry Eyes
If the lacrimal gland is damaged, degraded or becomes abnormal, the secretion of tear will decrease. Aqueous-deficient dry eye may be caused by ageing, e.g. the elderly and menopausal women (hormonally influenced) produce fewer tears or those with autoimmune diseases.
The dysfunction of the meibomian glands near the eyelashes is the main cause of evaporative dry eye. These glands secrete lipid of the tear film onto the ocular surface, slowing down the evaporation of the aqueous layer of the tear film. When there is an abnormal secretion of the meibomian glands, the tears will lack a lipid layer and water will evaporate rapidly, causing the evaporative dry eye.
Most patients have mixed dry eyes, including both symptoms of insufficient tear secretion and increased tear evaporation rates.
Causes
Aging
The human body's tear secretion function gradually degrades with age, which is one of the main causes of dry eye syndrome.
Hormonal influences
Post-menopausal women are more likely to have dry eyes than men of the same age.
Patients with immune system diseases
Examples include diabetes, thyroid-related diseases, lupus, rheumatoid arthritis and Sjogren’s syndrome.
Prolonged use of electronic products
Blinking less frequently, resulting in tear evaporation.
Long-term contact lens wear
Reduces sensitivity of the corneal surface and deprives the cornea of oxygen, leading to reduced tear secretion and, most likely, dry eyes.
External environment
Dry weather or windy outdoors, indoor air conditioning and heating can reduce humidity and accelerate the evaporation of tears.
服用藥物
Taking medications such as antihistamines, antidepressants, certain blood pressure medications, and birth control pills increase the risk of dry eye.
Eyelid issues
Severe dry eyes can be caused by abnormal or insufficient blinking reflex or incomplete eyelid closure during sleep.
Cataract surgery / laser vision correction surgery
The wound is made by cutting through the cornea or cutting the nerve of the cornea, resulting in change of sensitivity of the corneal surface and tear film stability.
Symptoms
Persistent dry eye
Red eye
Itchy eye
Foreign body sensation
Stinging & aching
Burning sensation
Stringy mucus in or around eyes
Sensitivity to light
Eye fatigue
In serious cases, patients will experience eye redness, hyperaemia, keratinisation, corneal abrasion, etc.
Dry eye disease examination method
A variety of tests and measurements with international standards are used to analyse the ocular surface and diagnose dry eye, from the analysis of tear quality to the meibomian gland.
- Testing for the lipid layer of the tear film
- Test for measuring the lipid layer
- Break-up time test for aqueous layer
- Blepharitis
- Tear volume assessment
Dry Eye Treatment
Intense Pulsed Light
Intense pulsed light therapy is also known as colored light therapy (IPL). The Dry Eye Disease Center uses the latest IPL technology to treat dry eye patients suffering from "Meibomian Gland Dysfunction". Intense pulsed light therapy uses pulsed light to cause a thermal effect to help open up blocked tarsal plates, restore oil secretion to normal, and reduce tear evaporation.
The ophthalmologist presses the patient's eyelid plate with his hands to drain the blocked oil, making the treatment of dry eye more effective. During colored light therapy, patients must wear protective eyewear, and ophthalmologists must carefully adjust the energy to reduce risks. The number of treatments needs to be at least 3-4 to be most effective.
Post-treatment Care
Patients are not advised to drive on the day after treatment and can resume other normal routines and daily life. They need to strengthen eyelid cleaning and hot compress, avoid eating irritating foods, and need to strengthen sun protection within one week after treatment. Intense pulsed light therapy is a painless and gentle treatment that is suitable for everyone.
Dry eye is a chronic disease that requires long-term treatment while patients’ living habits are also crucial for relieving the symptoms.
Artificial tears
The use of artificial tears can alleviate dry eye symptoms, avoid corneal damage, and keep the surface of the eyeball smooth.
Artificial tears are divided into 3 types:
Drop type: Eye drops have a basic moisturizing effect and are usually used 4 times a day. There are also individually packaged artificial tears. If you have special needs or if you use them more than 4-6 times a day, you can use them according to the doctor's advice. Since they do not contain preservatives, they need to be discarded 24 hours after opening.
Gel type: It is more viscous than the ointment type and has better moisturizing effect. It can prolong the retention time of water. It will slightly blur the vision after use. If you are worried about affecting your work, you can also use it before going to bed, but the problem of blurred vision is lower than that of the ointment type.
Ointment type: The ointment type has the longest effect. After use, you can close your eyes for 5 minutes and rotate your eyes to make the distribution even. Since it will cause short-term blurred vision, it is recommended to use it before going to bed.
iTEAR Autologous Tear Booster
採用非入侵性振動技術uses non-invasive vibration technology to stimulate autologous tear secretion through external nasal nerve stimulation. Read more. iTEAR Autologous Tear Booster.
Features:
- Restore your own tear secretion ability
- Clinically proven that after 30 days of use,the native tear secretion level is significantly increased by 56%[1], restoring the own tear secretion ability, truly relieving dry eyes from the root cause, or reducing dependence on eye drops.
- Improve tear film stability
- Clinically proven to help slow down the evaporation of tears after 30 days of use.improve tear film stability (TBUT*+33%)1, soothes symptoms of dry eyes caused by corneal dryness * Tear break up time (TBUT) is a direct measurement method for measuring the stability of the tear film. It refers to the time from a complete blink (the movement of opening and closing the eyes and face) to the appearance of the first dry spot on the tear film.
- Drug-free, preservative-free, all natural
- Recognized by international authoritative organizations
- International Tear Film and Ocular Surface Association[2]and FDA[3]all agree that stimulation of the nasal nerve can help one's own tear secretion.
How to use:
- Just place the vibrating head of iTEAR gently at the junction of the soft and hard bones of the nose, and it will vibrate the nose through a unique vibration frequency, effectively promoting the secretion of tears.
- Use on each alae nasi for 30 seconds, once in the morning and evening
-Change of mean Schirmer score at baseline to day 30 is from 6 to 9.4mm.
-Tear break up time (TBUT) is improved from 5 to 6.7 sec in day 30.
-The mean Schirmer score changed from 6 to 28 mm after stimulation.
2 Jones L et al. Ocul Surf (2017), 15:575-628.
3 De Novo Classification Request For iTEAR100 Neurostimulator. Available at
https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN190026.pdf Accessed on 19 JAN 2022.
Hot compress
Hot compresses on the eyes can prevent dry eyes and relieve the discomfort caused by dry eyes. You can use a hot pack or hot towel at about 40 degrees Celsius and apply it on the eyes for about 10-20 minutes, at least 1 to 2 times a day. If you have time, you can do it 4 times a day.
20:20:20 rule
After using electronic products for 20 minutes, rest for 20 seconds, look at the scene 20 feet away, and close your eyes to let tears moisten the surface of the eyeballs.
Infestation of eyelashes with mites (ophthalmodermatitis)
Demodex mites often live in the eyelash follicles, and the secretions and excretions they produce can easily cause ophthalmitis. People of any age can be infected, especially those over 70 years old. Because the immune system of older people is weak, they are prone to ophthalmitis. Mites can be transmitted through cosmetics, so girls who often use cosmetics are also more susceptible to infection. Once you suffer from eye dermatitis, it will affect the quality of your tears, resulting in the inability to moisturize the surface of your eyes, leading to dry eyes, excessive secretions, red eyes, foreign body sensation and other discomforts.
Mite treatment methods
♦ Tea tree oil
Apply diluted tea tree oil to your eyelids. Treatment will take at least a month to ensure that all adult worms and eggs are killed. However, be aware that tea tree oil can irritate your eyes, and excessive use can dry out your eyes and surrounding skin.
♦ Colored light or red light laser treatment (IPL)
It can penetrate deep into the pores to kill mites and has relatively fewer side effects than tea tree oil. It is considered a new treatment method.
Dry Eye FAQs
What should do if I have dry eyes?
Manage your screen time properly and follow the 20:20:20 rule: Take a 20s break after 20 min of using electronic devices and view from 20ft away. Close your eyes and let the tears moisten the eye surface.
If you wear contact lenses, it is advisable to reduce the amount of time you wear them, for example by removing them immediately after returning home. If the symptoms become severe, you should consult an ophthalmologist.
How can I relieve the discomfort of dry eyes?
- In case of eye discomfort, artificial tears (in preservative-free or contact lens formulations) can be used to temporarily relieve the condition.
- Blink more often to evenly distribute the tears and moisten the eye surface.
- Hot compresses can help prevent dry eyes and relieve discomfort. Apply a hot pack or hot towel at about 40°C to the eyes for about 10-20 min at least 1 or 2 times a day, or up to 4 times a day if you have time.
Can I treat dry eyes on my own?
Artificial tears, blinking and hot compresses are only meant to relieve dry eye symptoms and prevent further damage to the cornea, but they do not cure dry eyes on their own. To treat dry eyes, you should seek treatment from your ophthalmologist, such as IPL therapy, medicated eye drops, tear duct plugs, etc.
How long does it take for dry eye syndrome to heal? Will it get better?
IPL treatments require at least 3 to 4 sessions to be most effective. Dry eye is a chronic disease that requires long-term treatment while patients’ living habits are also crucial for relieving the symptoms.
What is Tear Secretion Test (Schirmer's Test)? What is the normal value?
Tear secretion examination is a common examination method in ophthalmology, which is used to detect lesions caused by excessive tear secretion.
A normal person's tear secretion volume in five minutes can reach more than 10mm; if the tear test collects a basic tear volume of less than 5mm in five minutes, it indicates dry eye syndrome.
