Dry Eyes Clinic

Do you suffer from any of the following?
• Red, dry, fatigued eyes
• Scratchy, gritty feeling, foreign body sensation
• Itching & burning sensation
• Blurriness or sensitivity to light
• Watering of eyes

 

 



Cosmetic procedures like Blepharoplasty are customized as per individual patient needs and can be performed in patients with unsightly lower eyelid fat bags or with excess skin fold/fat in the upper eyelid. The lower eyelid can be operated through an internal approach leaving absolutely no skin scar while the upper eyelid scar is hidden in the eyelid fold.


Confused about the cause for your symptoms???

You might be suffering from Dry Eye Syndrome!

What is Dry eye syndrome?

Dry eye syndrome is a condition caused by a lack of sufficient lubrication on the surface of the eyes. The consequence of this ranges from slight persistent irritation to the severe discomfort and reduction in vision. The Tear Film and Ocular Surface Society has defined Dry Eye as “a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface”

If my eyes are dry, how do they water a lot?
Dryness of the ocular surface cause irritation and strangely enough, you may find that your eye will actually become watery. this watering is reflex watering and does not help in maintaining a healthy tear film over the eye surface. Also, many people who suffer from dry eye find it hard to keep their eyes open for a long time. They may also find that

reading, watching television and mobile or computer screens worsens the irritation.

What are the causes for getting dry eyes?
There are numerous causes of dry eye but grossly this condition is divided into Aqueous tear deficiency (ATD) or Evaporative dry eye (EDE). The tear film is composed of 3 layers; aqueous, oily and mucin. Aqueous deficient dry eye occurs due to decrease in production of the watery layer of the tears whereas in evaporative dry eye the tear production is adequate but the tears evaporate too quickly. This is due to decrease or altered oily layer of the tear film which acts like a surfactant to maintain the tear film over the eye surface or from incomplete blinking.

 

 

 

 


Research says that majority of people suffer from EDE but upto 1/3rd of the dry patients also suffer from combined ATD and EDE and there are common entities between the two, inflammation being one of it. Dry eye symptoms due to increased screen time with mobile phones, computers or any visual display terminals is considered to be the '21st century epidemic' and has been termed Computer Vision Syndrome.


Why choose our centre for the dry eye evaluation?
The numerous causes of dry eye syndrome possess a challenge to the treating eye specialist. When doing a dry eye assessment, it is vital for the treating ophthalmologist to have detailed knowledge about dry eye and and deliver a treatment program customized to the individual's specific needs.
An effective treatment of the condition must not only involve treating the symptoms, such as lack of tear production or Meibomian function, but must also address the cause of the inflammation itself.
Our experts at the Dry Eye Clinic do a detailed evaluation of your dry eye problem followed by a battery of tests including

• Schirmer's test
This test is done to determine whether the eye produces enough tears to keep it moist. This This is a perfectly safe test done using a strip of filter paper placed in the eye and the extent of wetting at the end of 5 mins is noted. A negative (more than 10 mm of moisture on the filter paper in 5 minutes) test result is normal. Any reading less than 10mm denotes aqueous deficiency dry eye and needs treatment.

 

 

 


• Tear film break-up time
This test denotes the quality and sustainability of the tear film. This again a simple test done on during the slit lamp examination. The ocular surface is stained with a fluorescein dye and the patient is asked to look straight without blinking and the time interval between the last blink and the appearance of a dry spot on the corneal surface is noted. Reading less than 10 secs denotes poor stability of the tear film and needs to be treated.

 

 


The Latest advance in this test is the non-invasive, no touch TBUT which is available at our clinic. The tear analysis scan on the SIRIUS system helps us not the TBUT in real time and on an undisturbed ocular surface.

 

 

• Tear meniscus height
This test is like a screening and prognostic test which gives us the pointers for aqueous deficiency dry eye.

 

 


Biomicroscopic examination of the eyelid and digital pressure meibum expression

Slit-lamp biomicroscopic examination of the eyelid is a common method for assessing the meibomian glands. This is a non-invasive examination of the eyelid for evidence of irregular lid margins and provocation of meibum expression through application of digital pressure to the eyelid. The changes in eyelid appearance and meibum expression have been shown to correlate with dysfunction of the meibomian glands. This is an indirect measure of meibomian gland structure and function.

 

 

Meibography
Evaporative Dry eye is caused by altered lipid layer of the tear film. The Meibomian glands in the eyelids are responsible for this lipid layer secretion and the openings of these glands are present at the eyelid margin. Any alteration in these glands can be picked up by the meibography test. Meibography is a specialized imaging study developed exclusively for the purpose of directly visualizing the morphology of meibomian glands in vivo.

 

 

 

 

Inflammadry testing
This is the first and only rapid, in-office test that detects MMP-9, an inflammatory marker that is consistently elevated in the tears of patients with dry eye disease and presence of which helps us plan the specific management of the patient.

 

 

 

Corneal staining pattern
Topical stains are useful for their ability to detect tear and ocular surface abnormalities associated with MGD and dry eye

 

 

This helps us understand the cause of dry eye in an individual and provide them with a tailormade plan which helps relieving dry eye.

How do I know I have dryness and how can it be cured?
Dry eye syndrome may not be curable for all people, but usually can be managed to provide relief of the symptoms. Since there are so many different causes of dry eyes, there are several treatment options available such as the following:

 

Environmental Changes: What you can do
• Taking work breaks during working on computers
• Frequent blinking
• Avoiding extended periods of exposure to cold temperatures or direct exposure to AC vent air.
• Adjusting font, colour, contrast and refresh speed of your computer screen
• maintaining ergonomically sound posture while working on computers
• Using air purifiers to eliminate indoor air particles
• Using a humidifier to reduce dry air from heating/cooling systems
• Wearing sunglasses (wrap around frames will help to reduce exposure to wind and dust)
• Staying properly hydrated by drinking adequate water
• Maintaining lid hygiene

 

 

Treatment: What your Doctor can do
Using eye drops or lubricating artificial tears
Prescription eye drops that reduce inflammation and increase tear production
Contact lens rewetting drops
Warm compresses
Manual expression of eyelid glands by doing eyelid massage
Inserting small plugs into the drainage ducts in the eyelids to reduce tears draining away too quickly
Nutritional supplements (omega=3 fatty acids, flaxseed oil)

Each dry eye patient needs a customised treatment plan to achieve freedom from the symptoms as if not treated this condition has a negative effect on the quality of life of the individual. We at Ramkrishna Netralaya guide and help patients to understand their problem in a better way and treat the same in a wholesome manner.

For getting your own dry eye assessment and personalized dry eye management program, book an appointment with us today!