Dry Eye

Our Services

The Annoying Trio: Dry Eye / Blepharitis / Meibomian Gland Dysfunction or MGD

Are your eyes red, irritated, burning, stinging, scratchy?

The team at Del Negro & Senft Eye Associates will diagnose and treat your dry eye symptoms so you can get back to living your life free from irritation.

WHAT IS DRY EYE SYNDROME?

The eye depends on the flow of tears to provide constant moisture and lubrication to maintain vision and comfort. Tears are a combination of water (for moisture), oils (for lubrication), mucus (for even spreading), and antibiotics and special proteins (for resistance to infection). These components are secreted by special glands located around the eye. When there is an imbalance in this tear system, a person may experience the symptoms of dry eye syndrome.

CONTINUE READING ABOUT DRY EYE SYNDROME

BLEPHARITIS

Blepharitis, also known as eyelid margin disease, is a persistent and common condition that causes inflammation of the eyelids. The dryness that results from this condition might also result in discomfort and, occasionally, blurred vision.

Symptoms:

  • Eyelid and eye surface irritation
  • Itching of the eye
  • Redness of the eye
  • Gritty sensation like sand in the eye
  • Sensitivity to light
  • Crusting of lashes upon waking

With Blepharitis, oily particles and bacteria accumulate near the base of the eyelashes of both the upper and lower eyelids. This may cause itchiness, irritation, redness, and burning or stinging of the eyes. This condition frequently occurs in people who have a tendency toward dry eyes, oily skin, or dandruff. Acne, rosacea, and eczema are frequently associated with some form of lid margin disease. The condition can be difficult to manage because it tends to recur.

CONTINUE READING ABOUT BLEPHARITIS

UNDERSTANDING MEIBOMIAN GLAND DYSFUNCTION OR MGD

Many commonly attribute their eye discomfort to dry eye, when a leading cause of the burning, scratching and redness is Meibomian Gland Dysfunction or MGD.

MGD occurs when there is a compromise to the function and/or structure of the Meibomian glands. These glands, located in the eyelids, produce the protective oily (lipid) layer of the tear film. This oil helps protect the surface of the eye from disease and prevents the watery part of the tears from evaporating when your eyes are open. Without these oils, the eyes become more susceptible to the negative effects that dry climates, air conditioning, computer use, reading and other daily activities can have on the long-term health of our eyes.

TREATING MGD WITH LIPIFLOW

The Advantages are Clear

Our Dry Eye Team has many years’ experience diagnosing and providing relief to those suffering from the frustrating symptoms of dry eye.

A Customized Treatment Plan will be developed by your physician to make you comfortable so you can get back to enjoying your daily activities.

Advanced treatments such as BlephEx™ and Lipiflow® are options for ideal candidates.

Request an Appointment

Our goal is to contact you by phone within 24 hours of submission. If you find yourself in an EMERGENCY situation, please CALL 732-774-5566 instead.

What is Dry Eye Syndrome? (continued)

In addition to a decrease in the production of lubricating tears by the tear glands, dry eye syndrome can be caused by the drying out of the tear film. This can be due to air conditioning, heat, or other environmental conditions. Other conditions that may cause dry eye syndrome are:

  • The natural aging process
  • Side effects of certain medications such as antihistamines and medications that treat high blood pressure and elevated cholesterol
  • Diseases that affect the ability to make tears, such as rheumatoid arthritis and collagen vascular diseases
  • Structural problems that prevent the eyes from closing properly
  • Blocked meibomian glands that secrete the natural oils needed for proper lubrication in the tear film

 

HOW COMMON IS DRY EYE SYNDROME?

“Dry eye” is an extremely common eye condition, with incidences and symptoms that increase with age. In the United States, approximately six million women and three million men experience moderate or severe dry eye symptoms, and scientists estimate that an additional 20 to 30 million people in this country have mild cases of dry eye. Diabetes is the number one systemic disease implicated in dry eye.
 

CUSTOMIZED DRY EYE SERVICES PROGRAM:

Improve overall eye and lid health with the customized treatment program your doctor develops specifically for you.

  • PRN Dry Eye Omega Benefits® (Omega-3s)
  • Warm compress (heat mask) – Combines moisture and heat to open clogged meibomian glands and prevent the evaporation of tears
  • Wash lashes with baby shampoo
  • Wipe eyelids with medicated lid scrubs – Pads saturated with eyelid cleanser that effectively removes oil, debris, pollen, and scaling or flaking skin from the eyelids that may cause irritation. Recommended for routine daily eyelid hygiene and mild-moderate conditions
  • Lubricating Tears- The primary treatment for dry eye syndrome--we offer many samples of artificial tears because no one brand works for everyone. Some contain more preservatives than others, and an individual may find these preservatives irritating. Luckily, preservative-free artificial tears are available and may be less irritating. If you have chronic dry eye, it is important to use the drops even when your eyes feel fine, to keep them lubricated.
  • Restasis® or Xiidra® Drops that helps increase your eyes’ natural ability to produce tears, which may be reduced by inflammation due to Chronic Dry Eye
  • Gel Tears- If your eyes dry out while you sleep, you can use a thicker lubricant, such as an ointment or gel, at bedtime.
  • Punctal plugs (tear savers) – Small plugs placed in the puncta (opening of the eyelids that drains into the tear ducts). This helps to keep natural tears or artificial tears on the eye longer. Our doctors may recommend punctal plugs to improve lubrication as a means of treating dry eye.
  • Topical antibiotics
  • Doxycycline – Oral antibiotic which can help to reduce the inflammation in the glands
  • Steroid eye drops
  • BlephEx™ in-office treatment with Lid Hygenix™ Foam Eyelid Cleanser – Painless treatment reduces scurf and bacterial debris, the main causes of inflammatory lid disease, and improves the overall health of the eyelid
  • LipiFlow – LipiFlow® is a treatment performed in-office designed to remove blockages from the Meibomian glands, allowing them to properly function and produce the oils that make up the top protective lipid layer of the tear film.

Blepharitis (continued)

 

Causes of Blepharitis

Although everyone has bacteria on the skin’s surface, in certain people this bacteria thrives in the skin at the base of the eyelashes. Large amounts of bacteria around the eyelashes can cause dandruff-like scales and particles to form along the eyelid margins and lashes.

Since the eyelids are difficult to clean, this overgrowth of bacteria, biofilm, scurf and debris can accumulate over many years, and the exotoxin-induced inflammation can cause significant damage to the eyelid and tear glands.

Blepharitis also is associated with meibomitis— dysfunction and inflammation of the nearby oil glands of the eyelids (called meibomian glands). If Blepharitis is left untreated, eyelid glands can become clogged and infected. This can cause styes, dry eye syndrome, corneal ulcers and unsightly crusted scales and debris on the eyelids.

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Lid margin disease may not be cured, but it can be controlled with a few simple daily hygienic measures:

  1. At least twice a day, place a warm, wet washcloth over the closed eyelids for about 5 minutes. Rewet it as it cools, two or three times. This will soften and loosen scales and debris. More importantly, it helps liquefy the oily secretions from the eyelids’ oil glands that help prevent the development of a chalazion (stye), an inflamed lump in the eyelid oil gland.
  2. With your finger or a cotton swab or commercial lint-free pad, gently scrub the base of the lashes about 15 seconds per lid using warm water and diluted Baby Shampoo.

When medications are necessary, they may include:

  1. Artificial tears to relieve symptoms of dry eye. (These are eye drops which are available without a prescription)
  2. Antibiotics (ointments or drops) to decrease bacteria on the eyelids. Occasionally, even oral antibiotics are employed in this task.
  3. Steroids (ointment or drops) to decrease inflammation.

However, medications alone are not sufficient in the treatment of these conditions. The application of warmth and careful cleansing of the lashes daily is key to controlling lid margin disease.

When traditional treatments don’t offer relief.

What is BlephEx™?

We are pleased to offer a revolutionary treatment as part of our comprehensive Dry Eye Services Program. BlephEx is designed to provide a deep cleaning to compromised lids 3-4 times a year to fight against the annoying and inconvenient symptoms of dry eye. 

BlephEx stands for microblepharoexfoliation, a painless procedure that safely and effectively removes the scurf and excess bacteria and biofilm that is responsible for the majority of low-grade inflammatory blepharitis, the primary cause of chronic dry eye disease.

With the BlephEx treatment Dr. Glatman can precisely and safely clean and exfoliate your eyelids and lashes, which will almost immediately improve your symptoms. More importantly, by completely removing the exotoxin-laden biofilm along the lid margin, they can help you avoid the long-term inflammatory damage to your tear glands, preventing chronic dry eye syndrome.

If you are a candidate for the treatment, Dr. Glatman can perform this painless, in-office procedure in under 10 minutes. The BlephEx handpiece is used to gently and carefully spin a medical grade micro-sponge along the edge of your eyelids and lashes, removing scurf and debris and exfoliating your eyelids. The disposable micro-sponge is used for each individual eyelid so bacteria is not spread between the lids. The eyes are then rinsed thoroughly with saline afterwards. LipiFlow® is also helpful in treating blepharitis. Detailed information regarding this treatment is located in the section “Understanding Meibomian Gland Dysfunction or MGD.”

View Video

Understanding Meibomian Gland Dysfunction or MGD (continued)

Treating MGD with LipiFlow®

LipiFlow® is a treatment performed in-office designed to remove blockages from the Meibomian glands, allowing them to properly function and produce the oils that make up the top protective lipid layer of the tear film. LipiFlow® is supported by safe and effective results. 3 It is designed to minimize patient discomfort during a 12-minute treatment that gently massages the eyelids. LipiFlow® Activators are single-use sterile devices that safely and comfortably deliver a combination of heat to the inner lids and simultaneous therapeutic motion to the outer lids, removing blockages from the Meibomian glands. 3 The Activators are contoured to avoid contact with the cornea, protecting the delicate structures of the eye.

Once the blockages are removed, the glands can resume normal oil or lipid production. This oil is essential for a healthy tear film, providing stable vision and ocular comfort. As normal gland function recovers, maximum results are usually experienced 6-8 weeks after treatment and could last for up to twelve months. 3

With more than 400,000 treatments worldwide and growing, 4patients are experiencing the proven benefits of the LipiFlow ® Thermal Pulsation System:1

  • LipiFlow® is safe and designed to be a comfortable, FDA-cleared 5, in-office2 treatment for the inner and outer lid treatment of MGD.
  • After an initial anesthetic eye drop, LipiFlow® applies precise heat to the inner eyelids and gently massages the Meibomian glands to loosen the oil trapped within the glands.
  • Once loosened, LipiFlow’s® single-use activators push the contents up and out while protecting the delicate structure of the eyelids.
  • This treatment is designed to restore the natural oil flow to the tear film that covers the eye’s surface.

To learn if you are a candidate for this in-office treatment, please contact, 732-774-5566.

Impact of Blocked Meibomian Glands

Longterm Effects of Untreated MGD

REFERENCES:
  1. Nichols KK, Hanlon SD, Nichols JJ. A murine model for characterizing glandular changes in obstructive Meibomian gland dysfunction. ARVO. 2014. Abstract #13-A0002.
  2. LipiFlow® Thermal Pulsation System Instructions For Use.
  3. Blackie CA, Carlson AN, Korb, DR. Treatment for Meibomian gland dysfunction and dry eye symptoms with a single-dose vectored thermal pulsation: a review. Current Opinion in Ophthalmology. 2015;26(4):306-13.
  4. Data on file.
  5. K161357, 510K Summary.

 

Content courtesy of Johnson & Johnson Surgical Vision, Inc.
For additional safety information: https://dryeyeandmgd.com/