Dry Eye Syndrome

Dry eye syndrome (DES), also known as dry eye illness or dysfunctional tear syndrome, is a common cause of ocular irritation that drives patients to seek medical treatment. It is estimated that between 5% and 50% of the world's population is affected.  According to 2013 research, an estimated 16.4 million Americans suffer from dry eye syndrome.  The prevalence of DES rises with age, particularly among postmenopausal women. Individuals 50 years of age or older have a prevalence that is more than three times higher than those 18 to 49 years of age for both sexes. Meibomian gland dysfunction is thought to be the most common cause of dry eyes.  As the population ages, prevention and treatment of dry eye syndrome are projected to become more important.

The most common cause of dry eye condition is a problem with a gland called the meibomian gland. This gland secretes oil, which is required for the tear film that protects the eye. If the gland becomes blocked or cannot produce enough oil, the tear film that coats the eye evaporates quickly, resulting in dry eye syndrome. Warm compresses, eyelid washes, specific ointments, and squeezing the gland to relieve the obstruction are all treatments for blocked glands. Thermal eyelid pulsation devices, such as the LipiFlow system, use heat and pressure to treat the obstruction.  New studies using intense pulsed light demonstrate some improvement for mild to moderate dry eyes. There is insufficient medical evidence to determine if these systems outperform standard therapy. As a result, they are classified as investigational and are not covered by medical insurance.

Physical expression of the meibomian glands to relieve the obstruction, administration of heat (warm compresses) to the eyelids to liquefy solidified meibomian gland contents, eyelid scrubs to relieve external meibomian gland orifice blockage, and medications such as antibiotics and topical corticosteroids to mitigate infection and inflammation of the eyelids are all current treatment options for meibomian gland dysfunction.  Artificial tears are very commonly recommended to help with eye comfort and may be a sufficient therapy for mild cases of dry eyes.  Changes in diet and sleep are also found to be helpful.

These therapy methods, however, have demonstrated moderate clinical success and frequently necessitate a trial-and-error approach. Physical expression, for example, can be quite painful due to the amount of power required to express clogged glands. Warm compress therapy can be time-consuming and labor-intensive, and there is no evidence that drugs help.  While dry eye symptoms often improve with treatment, the disease is usually challenging to manage and can cause significant patient and physician frustration. Dry eyes can induce visual morbidity and can jeopardize the outcomes of corneal, cataract, and refractive surgery.

"When a lot of remedies are suggested for a disease, that means it can't be cured."  -  Anton Chekhov