WHAT IS DRY EYE?
Dry eye is a condition affecting the surface of the eye and involving the eyelids. It is a multifactorial disease resulting into the alteration of the tear film.
The tears are composed of three layers that are involved in the major causes of dry eye syndrom: lack of tear production, abnormal tear evaporation, imbalanced tear composition.
This disease affects all categories of population but increases with age, extensive use of screens, medica-tions, cataract and lasik surgeries, environmental condi-tions (smoke, pollution, air-conditioning…), hormonal imbalances, unsuitable diets, demodex infection, diseases which affect inflammation of the eye-lids (bleph-aritis) like rosacea, seborrheic dermatitis, psoriasis, chronic eye allergies.
The symptoms are numerous:
- Tingling, itching
- Burning sensation, sand or foreign body in the eyes
- Sensitivity to light, wind or tobacco smoke
- Difficulties to open the eyes in the morning, feeling of eyelids stuck
- Absence of tears in situations known to trigger their secretion (during emotion, peeling onions...)
- Difficulty wearing contact lenses
- Impression of a decrease in visual acuity
But dry eye can be asymptomatic.
New standards of diagnosis have been set by an international board of eye-care specialists: DEWS 2 report. In addition to a questionnaire evaluating the number and severity of the symptoms, the dry eye diagnosis includes mostly exams that are non-contact with the eye.
- Interferometry: is an examination to evaluate the thickness of the lipid layer of the tear film be-tween blinking. The color & structure of the lipid layer (colored fringes like an oil stain) makes it possible to evaluate the quality and the thickness of the lipid layer. This test is very useful for diagnosing Meibomian gland dysfunction (tear film evaporation).
- Measure of the tear meniscus-height: Evaluation of the tear film quantity (along the lower eyelid margin). The absence of a tear meniscus is an indication of a dry eye. The normal tear meniscus is 0.2 mm between the lower eyelid and the bulbar conjunctiva.
- NIBUT (Non-Invasive Break Up Time): Non-invasive tear film rupture time is an examination to evaluate the stability of the tear film on the cornea. From blinks, we evaluate the time to the film to break by projecting a grid on the cornea - normal NIBUT > 10 seconds / Eye dry <10 seconds
- Meibography: a non-contact infrared system for a quick and easy way to obtain an overall image of the morphology of the Meibomian glands (which produce the lipid layer). Meibography allows the evaluation of the Meibomian glands loss, atrophy and obstruction. Conventional tests such as Schirmer test, ocular staining, BUT can also be conducted.
Dry eye syndrome being multifactorial, its treatment is complex and can include hygiene, heating and massage of the eyelids, blinking exercises, tear substitutes and Intense Pulsed Light treatment (IPL).
IPL technology is based on a series of pulses of light stimulating and accelerating the metabolism of the lacrimal glands.The treatment is fast and painless. It requires 3 to 4 sessions spaced between 2 weeks to 1 month. This treatment improves the quality of the tear film and the symptoms felt by the patient are significantly improved.
Others clinical improvements are also observed: analgesic, anti-inflammatory (blepharitis, conjunctivitis), antimicrobial (bacteria and Demodex infection), stimulation and tissue regeneration.