Dry Eye Unit

Dry eye syndrome is a chronic condition that affects millions of people around the world. It occurs when the eye does not manufacture enough tears or when the tears it generates are not of the right quality to lubricate the ocular surface. This problem, although commonly underestimated, can cause very annoying symptoms and negatively impact the quality of life of those who suffer from it. At our clinic, we offer a comprehensive and personalized approach to the diagnosis and treatment of dry eye, using the most advanced technologies to relieve symptoms and improve eye health.

What is Dry Eye Syndrome?

Dry eye syndrome occurs when there is an imbalance in the quantity or quality of tears that hydrate and protect the ocular surface. Tears are essential for maintaining the health of the cornea and conjunctiva, as well as ensuring clear and comfortable vision. There are two main types of dry eye:

• Aqueous deficiency dry eye: This occurs when the lacrimal glands do not produce enough tears to keep the ocular surface properly hydrated.
  
• Evaporative dry eye: This is the most common form and occurs when the lipid layer of tears, produced by the meibomian glands, is altered, causing tears to evaporate too quickly.

Causes of Dry Eye

Dry eye can be caused by a variety of factors, some related to lifestyle and others to underlying medical conditions:

• Older age: Tear production tends to decrease with age.
• Prolonged use of screens: Blinking less frequently when using the computer, mobile phone or television can facilitate the evaporation of tears.
• Environmental factors: Wind, dry air, and exposure to drafts can accelerate the evaporation of tears.
• Use of contact lenses: They can interfere with the distribution of the tear film, and also their regular use causes some anesthesia in the cornea and this interrupts the reflex act of tear secretion.
• Medications: Certain drugs, such as antihistamines, antidepressants, decongestants, and birth control, can reduce tear production.
• Autoimmune disorders: Diseases such as Sjögren's syndrome, rheumatoid arthritis, or lupus can damage the lacrimal glands and cause severe dry eye.
• Eye surgery: Surgical interventions such as LASIK surgery can alter tear production temporarily, causing dry eye symptoms.
• Meibomian gland dysfunction: This condition affects the quality of tears by reducing the production of lipids, causing them to evaporate too quickly.

Symptoms of Dry Eye

Dry eye symptoms vary in severity and can affect one or both eyes. The most common include:

• Burning or stinging sensation
• Itching or eye irritation
• Gritty or foreign body sensation in the eyes
• Eye redness
• Intermittent blurred vision
• Watery eyes (paradoxically, the eyes can produce more tears in response to irritation)
• Sensitivity to light (photophobia)
• Difficulty wearing contact lenses

These symptoms may worsen in dry or air-conditioned environments, or after spending a lot of time in front of a digital screen. If left untreated, chronic dry eye can cause damage to the ocular surface, increasing the risk of corneal infections and scarring.

Diagnosis of Dry Eye

At our clinic, the diagnosis of dry eye is made through a thorough evaluation that includes:

• Schirmer's test: Measures the number of tears produced without external stimulus (by first instilling a drop of topical anesthetic) in a given period, using special strips of paper placed on the edge of the eyelid.
• Tear Film Rupture Test (BUT): Assesses the time it takes for the tear film to break down after blinking, which is crucial for detecting evaporative dry eye.
• Fluorescein or Rose Bengal staining: Special dyes are used to reveal damaged areas on the ocular surface, helping to identify dry spots or inflammation.
• Meibography: This technique allows the structure of the Meibomian glands to be visualized to detect any abnormality in lipid production.
• Lipiview is a non-invasive diagnostic device used to evaluate the lipid layer of the tear film in patients with dry eye syndrome, particularly those with meibomian gland dysfunction. It uses interferometry to measure the thickness of the lipid layer and can also record blinking, providing information about the quality and stability of the tear film. This helps to personalize the treatment in cases of evaporative dry eye.

Dry Eye Treatment

Treatment for dry eye depends on the severity and underlying cause of the problem. At our clinic, we customize treatment for each patient, using a combination of methods to relieve symptoms and restore balance to the tear film:

1. Artificial Tears
   Artificial tears are the most common initial treatment for mild cases of dry eye. They exist in different formulations, and are chosen according to the patient's needs. Some are designed to mimic natural tears, while others have a denser composition to provide long-lasting lubrication.
   
2. Anti-inflammatories and Immunomodulators
   -In more severe or chronic cases, it is necessary to reduce inflammation of the ocular surface and lacrimal glands:
   -Topical corticosteroids: They are used for short periods to reduce severe inflammation of the ocular surface.
   -Topical cyclosporine A: An immunomodulator that reduces inflammation and improves tear production in patients with chronic dry eye.
   
3. LIPIFLOW. Thermal Therapy and Expression of Meibomian Glands
   In patients with meibomian gland dysfunction, treatments such as thermal therapy, which applies controlled heat to liquefy dense, pasty secretions, and gland expression, which helps restore lipid flow in the tear film, are used.
   
4. Non-Perforated Punctal Plugs
   These small devices are placed at tear drainage points to block the drainage of tears and increase their permanence in the eye. They are an effective solution for patients who do not respond adequately to other treatments.
   
5. Autologous Serum
   For severe cases that are resistant to conventional treatment, autologous serum, prepared from the patient's own blood, is used as a substitute for tears. It has anti-inflammatory properties and contains growth factors and proteins that help regenerate the ocular surface.

Tips for Daily Care

In addition to medical treatments, there are steps patients can take to reduce dry eye symptoms in their day-to-day lives:

• Avoid prolonged use of screens without visual breaks.
• Use humidifiers in dry or air-conditioned environments.
• Protect your eyes from the wind and sun by wearing wraparound sunglasses.
• Take frequent pauses to blink consciously.
• Stay well hydrated to aid in tear production.

Commitment to Eye Health

Dry eye is a chronic condition, but with proper treatment and a comprehensive approach, symptoms can be effectively managed, improving patients' quality of life. In our clinic, we specialize in personalized dry eye management, using the latest technological and pharmacological innovations to ensure the best possible outcome for each patient.

If you feel symptoms of eye irritation, dryness, or discomfort, we invite you for a detailed evaluation to determine the best treatment strategy for you.