Dry eye is an extremely common condition which can cause a significant impact on one’s quality of life. Usual symptoms of dry eye include a sensation of discomfort, irritation, grittiness and fluctuating vision. These symptoms are often worse in windy conditions, in air-conditionined or heated environments and when watching television, using computers or reading.
The most common cause of Dry Eye is Meibomian Gland Dysfunction. In Meibomian gland dysfunction, the oil glands in the eyelids (Meibomian glands) become blocked, the oils that they make are thick and these oils are unable to make their way to the surface of the eye. Normally the oils from the Meibomian glands form form an oily layer on top of the tears which prevents them from evaporating. With Meibomian Gland Dysfunction, the tears evaporate rapidly and the surface of the eye becomes dry and inflamed and symptoms of dry eye occur.
To date, there is no known treatment which can permanently cure MGD. There are several treatments available to improve how the glands function and to control the symptoms that MGD cause.
In most cases, over the counter artificial tear eyedrops used several times a day are sufficient to improve symptoms. These eye drops lubricate the surface of the eye, helping the dryness and symptoms of dry eye.
Warm compresses and eyelid massage (lid hygiene) is an important initial treatment for MGD. A hand washer heated in warm water or a commercially produced product (such as the EyeBag) are applied to the eyelids to heat and melt the oil in the Meibomian glands. Then the eyelids are massaged from outward to inward with a finger to express the oils. This is done twice a day. In most cases, lid hygiene and artificial tears are sufficient to control symptoms of Meibomian gland dysfunction.
In more severe cases where the dryness of the eye has resulted in an inflamed surface of the eye, a short course of steroid eye drops can be used to improve symptoms. Less commonly, longer acting anti-inflammatory drops or ointment may be required (such as cyclosporin).
Antibiotic tablets such as doxycycline or azithromycin can be used to improve the function of the meibomian glands and reduce the inflammation associated with MGD.
In cases that don’t respond adequately to the above treatment options, IPL may provide improvement in Meibomian Gland Dysfunction and Dry Eye. IPL was initially used by dermatologists to treat a range of skin conditions but was found by accident to improve symptoms in patients with MGD. IPL works by improving the function of Meibomian glands. The oil in these glands becomes less thickened and the oil is able to more effectively leave the gland and reach the surface of the eye where it can stop tears evaporating.