So is it possible to cure dry eyes permanently? No. But there is so much good news to be had! So let us ask the question this way instead; are there ways to make dry eyes a LOT better? Yes, absolutely. In this blog, I'll get you as close to a cure as possible!
This is the eye school blog, with me Dr. D, where I teach you about products and treatments related to dry eye syndrome and eye beauty. I’m an eye doctor that treats patients with dry eye and I pay special attention to makeup and skincare, I even have an esthetician that I work closely with in my practice. I’m obsessed with helping you achieve beautiful, comfortable healthy eyes.
In the past 12 years of treating dry eye disease, I’ve spent lots of time seemingly treating in circles - anti-inflammatories, artificial tears, and warm compresses help for a bit, but never seem to cure the disease. However, in the past few years, new treatments allowing for a more interventional dry eye approach have completely changed the outcomes I’m seeing in my patients.
It’s All About What Actually Works Just for You!
First, before being able to cure dry eyes, we must find YOUR cure, you have to know what caused your dry eye as these contributing factors are different for everyone.
Dry Eyes come from a number of factors in your internal environment: diet, medicines, autoimmune diseases, hormonal state, dermatological diseases like rosacea and psoriasis play a role. Controlling as many factors as possible will help you to have less inflammation in general.
Secondly, external environmental factors matter as well. That's why dry eyes are usually worse in the winter - environment matters! My patients who work on the computer 12 hours a day and then get to retire and stop the excessive screen time typically see an improvement in their dry eye symptoms from that simple change in daily tasks. Take note of when your dry eye symptoms are worse and tailor your at home routine to address those issues. I’ll include my top tips for your environment on screen.
Reframe your thinking from finding a cure for dry eyes to treatment solutions
The treatment of dry eye disease can tend to get confusing, but I believe we overcomplicate it. Simply put, we have to optimize our environment, control inflammation (often with biochemical intervention, i.e. rx medicine), and clear obstruction of the meibomian glands. Working on your at-home therapies can optimize the environment and control inflammation. Here are my favorite treatments to help clear the glands.
Lid exfoliation is done to clear the lids of mechanical debris like blepharitis, but also works to clear the invisible biofilm. Think of this like the plaque on your teeth. You brush every day, but you go every 6 months to have the bacterial biofilm, i.e. the plaque -removed. Your lids are just as susceptible to biofilm, and if you have demodex infestation, reddened eyelids from blepharitis, or Meibomian gland dysfunction. Two types of eyelid exfoliation are chemical and mechanical, not unlike what we see in skincare. ZEST provides a really nice chemical exfoliation of the lids while Blephex is a great tool for the more advanced cleansing of the lids.
Advanced Treatment Is As Close As You’ll Get To Dry Eye Cure
Light therapies have been shown to kill demodex mites, improve the secretion of the meibomian glands, reduce ocular surface inflammation, and reduce the inflammatory effects of rosacea. They can rejuvenate the meibomian glands and are very effective at improving the signs and symptoms of dry eye disease. I use the Lumenis M22 IPL regularly in my clinic for the treatment of the glands.
Intense pulsed light has been used for over 20 years with over 50 studies demonstrating its efficacy in dry eye disease. IPL targets pigment, so it is very effective in patients with rosacea at decreasing the amount of telangiectasias present on the skin. We know that the presence of ocular surface inflammation increases with increased telangiectasias on the face. By treating the face for these abnormal blood vessels, ocular surface inflammation decreases.
In addition, IPL changes the secretion of the meibomian glands and even rejuvenates glands that have begun to atrophy. It decreases the population of demodex mites, and I’ll link my favorite youtube video of all time above that shows IPL killing a demodex mite. After IPL, tear breakup has been shown to increase, and symptoms scores also improve.
All About Heat and Expression for Dry Eye Treatment
Heat + Expression is critical to clearing the obstruction related to meibomian gland dysfunction. And oh how I love my device, TearCare..let me count the ways. TearCare is a blink-assisted warming device that delivers heat to the meibomian glands. The sterile, disposable wearable elements are attached to a small, portable heating hub that delivers 45°C of heat to the eyelids for 15 minutes.
The heat temperature is adjustable, and patients can keep their eyes open throughout the entire time. Within three minutes after the heating session, meibum clearance is performed manually with a clearance tool, allowing the clinician to spend as much time as is necessary to evacuate the meibomian glands. Each of the four eyelids are compressed individually, one section at a time.
When compared with at-home warm compresses twice a day for four weeks, TearCare was superior in improving tear break up time one month after the procedure. A second procedure at six months was found to be beneficial in improving signs and symptoms of MGD and DED9. Initial results of the OLYMPIA trial, which compared TearCare to LipiFlow, showed that 76% of females noted improvement in symptoms after one month, compared to 56% of females who received Lipiflow.10
These new technologies are rapidly bridging the gap we’ve had for a long time in the treatment of Dry EYe Disease. Used appropriately with an at-home regimen curated by you and your doctor as well as the right biochemical interventions in the form of dry eye medications, you can get a lot closer to feeling like you’ve found your dry eye cure.
Let me know what, if anything has cured your dry eye down below or if you’re still searching.