Treatment of Dry Eye in 2021

2848 Bellmore Avenue

suite 001

Bellmore, New york 11710

516.409.2020

 Dry Eye Syndrome Treatment with Scleral Prosthetic Lenses and the PROKERA® and AmbioDisc® Amniotic Membrane Treatments

 

To come for a FREE Scleral Lens or PROKERA® or AmbioDisk® consultation, call our office today at 516.409.2020. Read below for more information on these incredible treatment options. The results can be life changing for the chronic, severe dry eye sufferer. Stop suffering. Call today!

 

 

What Is DED?

 

Some people do not produce enough tears or the appropriate quality of tears to keep the eye healthy and comfortable. This is known as Dry Eye Disease or DED.

 

Tears are produced by two different methods. One method produces tears at a slow, steady rate and is responsible for normal eye lubrication. The other method produces large quantities of tears in response to eye irritation or emotions. A healthy eye constantly produces tears that lubricate. Excessive tearing occurs when a foreign body, dryness, or other irritant challenges the eye or when a person cries for emotional reasons.

 

What Are the Symptoms of DED?

 

The usual symptoms include:

 

Stinging or burning eyes

Scratchiness

Stringy mucus in or around the eyes

Excessive eye irritation from smoke or wind

Excess tearing

Difficulty wearing contact lenses

 

Excess tearing from "DED" sounds illogical, but if the tears responsible for maintenance lubrication do not keep the eye wet enough, the eye becomes irritated. When the eye is irritated, the lacrimal gland produces a large volume of tears that overwhelm the tear drainage system. These excess tears then overflow from your eye.

 

What Is the Tear Film?

 

A film of tears, spread over the eye by a blink, makes the surface of the eye smooth and clear. Without our tear film, good vision would not be possible.

 

The tear film consists of three layers:

 

An oily layer

A watery layer

A layer of mucus

 

The oily layer, produced by the meibomian glands, forms the outermost surface of the tear film. Its main purpose is to smooth the tear surface and reduce evaporation of tears. The middle watery layer makes up most of what we ordinarily think of as tears. This layer, produced by the lacrimal gland, cleanses the eye and washes away foreign particles or irritants. The inner layer consists of mucus produced by the conjunctiva. Mucus allows the watery layer to spread evenly over the surface of the eye and helps the eye remain moist. Without mucus, tears would not stick to the eye.

 

What Causes DED?

 

Tear production normally decreases as we age. Although DED can occur in both men and women at any age, women are most often affected. This is especially true after menopause. DED also can be associated with other problems. For example, people with dry eye, dry mouth and rheumatoid arthritis are said to have Sjogren's syndrome. A wide variety of common medications — prescription and over-the-counter — can cause DED by reducing tear secretion. Be sure to tell Dr. Scheno the names of all the medications you are taking, especially if you are using:

 

Diuretics (High Blood Pressure, Heart Disease)

Beta-blockers (High Blood Pressure, Heart Disease)

Antihistamines (Allergy Medicine)

Sleeping pills

Medications for "nerves"

Pain relievers (Even OTC products like ibuprofen and naproxen

 

Since these medications are often necessary, the DED condition may have to be tolerated or treated with "artificial tears."

People with DED are often more prone to the toxic side effects of eye medications, including artificial tears. For example, the preservatives in certain eye drops and artificial tear preparations can irritate the eye. Special preservative-free artificial tears may be required.

 

How Is DED Diagnosed?

 

Dr. Scheno is usually able to diagnose DED by examining the eyes. Sometimes tests that measure tear production may be necessary. One test, called the Schirmer tear test, involves placing filter-paper strips under the lower eyelids to measure the rate of tear production under various conditions. Another uses a diagnostic drop (fluorescein or rose bengal) to look for certain patterns of dryness on the surface of the eye.

 

How Is DED Treated?

 

Eye drops called artificial tears are similar to your own tears. They lubricate the eyes and help maintain moisture.  Artificial tears are available without a prescription. There are many brands on the market, (we recommend Systane or Endura) so you may want to try several to find the one you like best. Preservative-free eye drops are available if you are sensitive to the preservatives in artificial tears. If you need to use artificial tears more than every two hours, preservative-free brands may be better for you.

You can use the tears as often as necessary — once or twice a day or as often as several times an hour.   Some people with DED complain of "scratchy eyes" when they wake up. Using an artificial tear ointment or thick eye drops at bedtime (such as Refresh P.M.) can effectively treat this symptom. Use the smallest amount of ointment necessary for comfort, since the ointment can cause your vision to blur. 

 

Prescription Approaches

 

Newer prescription medications such as Restasis TM and Lotemax TM are very effective at treating moderate to severe DED. Ask Dr. Scheno which treatment is right for you.

 

Conserving the Tears


Conserving your eyes' own tears is another approach to keeping the eyes moist. Tears drain out of the eye through a small channel called a punctum into the nose (which is why your nose runs when you cry). Dr. Scheno may close these channels with silicone plugs. The closure conserves your own tears and makes artificial tears last longer.

 

Other Methods


Tears evaporate like any other liquid. You can take steps to prevent evaporation. In winter, when indoor heat is on, a humidifier or a pan of water on the radiator adds moisture to dry air. Wrap-around glasses may reduce the drying effect of the wind, but are illegal to wear while driving in some states.  A person with DED should avoid anything that may cause dryness, such as an overly warm room, hair dryers or wind. Smoking is especially bothersome. Other new options are a Scleral Contact Lens System and/or PROKERA® Amniotic Membrane Therapy . A scleral lens device is a transparent corneal prosthetic dome, filled with a sterile saline solution that serves as an artificial tear reservoir, providing constant lubrication to the eye, and allowing oxygen to reach the cornea. The device, about the size of a dime and composed of gas permeable material, creates a smooth surface over the damaged cornea and helps to heal the cornea by eliminating lid shear, which is the movement of the lid across the eye surface that in a dry eye can irritate the cornea because of the friction it causes. To learn more about scleral lenses for dry eye, visit our sister website.

What is PROKERA®?

PROKERA® is a therapeutic device used by eye doctors around the world to protect, repair and heal damaged eye surfaces.

PROKERA® is made by clipping a piece of amniotic membrane tissue in between two rings made out of a clear, flexible material.

What is amniotic membrane tissue?

Amniotic membrane is part of the placenta and is the tissue closest to the baby throughout development in the womb. Amniotic membrane protects the baby from any harm and has natural therapeutic actions which help the baby develop. The tissue has healing properties that aid in ocular surface repair.

What does PROKERA® do?

The amniotic membrane tissue in PROKERA® has natural therapeutic actions that help damaged eye surfaces heal. Eyes treated with PROKERA® have quicker healing, less pain, less scarring, and less inflammation. The amniotic membrane in PROKERA® is thin and clear like the tissue on the surface of your eye and protects your eye's damaged tissue while inserted. 

What does PROKERA® treat?

PROKERA® is used by eye doctors to treat eye diseases such as keratitis, corneal scars, chemical burns, corneal defects, partial limbal stem cell deficiency and many other ocular surface diseases with inflammation. 

Is PROKERA® safe?

PROKERA® is a safe, effective treatment provided by a tissue bank regulated by the FDA. The tissue has passed many quality control tests before it is provided to your doctor. Ask your doctor if you are concerned about the risks involved with using a human tissue.

Another option is a PROKERA® Amniotic Membrane Treatment:

 

Watch a video on the benefits of the PROKERA® below:

©2021 Dr. Christopher R. Scheno, O.D., P.L.L.C.

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