The Canadian National Institute for the Blind estimates that roughly 30% of Canadians suffer from symptoms related to dry eyes. These symptoms are irritating and disruptive, and while you might realize something’s wrong, you may not actually be able to pinpoint that this discomfort comes from dry eyes.
Our conscientious doctors at Stoney Creek Eye Care & Eyewear Boutique, with our progressive approach and highly advanced technology, are well equipped to diagnose and relieve your case of dry eyes. Request an appointment to find relief from your dry eye symptoms.
As the name indicates, dry eyes is a chronic condition where the eyes don’t get the moisture they need to keep them clear, protected, and lubricated. Our eyes are lubricated by a thin layer of tears which is called the tear film. This tear film is made up of 3 main components; A mucus layer (closest to the eyes), an aqueous (water layer), and a lipid (oil) layer. Dry eye disease occurs when there is an instability in the tear film, which can lead to ocular surface inflammation and the ocular symptoms of dry eye. Dry eye disease typically stems from one of two basic issues (although there can be an overlap) :
This is when the lacrimal glands don’t produce enough of the aqueous component of the tear film. The aqueous layer is usually the thickest part of the tear film and when the aqueous volume is low, this can lead to dry eye symptoms. Aqueous deficient dry eye can be further divided into Sjogren Syndrome Dry Eye and Non-Sjogren Dry Eye.
For tears to be really effective, the tear film requires a thin layer of oil that floats on top, preventing the tears from evaporating too quickly. This oil is called meibum and comes from the meibomian glands in the eyelids.
Without enough meibum, the aqueous layer of the tears evaporates, and the eye starts to feel dry and uncomfortable. This condition is what’s called evaporative dry eye.
Symptoms of dry eyes can include:
If you’re suffering from dry eye, we can do a complete dry eye workup exam. We’ll discuss your lifestyle and medical history, as factors like computer use and certain medical conditions can increase your risk of dry eye. Then, we’ll use a variety of diagnostic tools to assess what’s causing your dry eyes so we can find the right treatment.
Meibography is a diagnostic tool that captures photos of your meibomian glands, the oil glands in your eyelids. We do meibography 2 ways: with the Oculus Keratograph or with an infrared camera mounted to a slit lamp. Both provide detailed photos of your meibomian glands. Using these photos, we can diagnose problems like meibomian gland dysfunction.
Tear osmolarity is a measure of the salt content of your tears. We use the I-Pen to measure tear osmolarity. It’s a pen-like device that touches your lower inner eyelid for about 2 seconds and then analyzes your tears. High tear film osmolarity or hyperosmolarity can lead to the ocular surface damage associated with dry eyes. Many of the dry eye treatments available are aimed at reducing the tear osmolarity and restoring balance to the tear film
Tear break up time or TBUT refers to how quickly the tear film starts to evaporate or break up after each blink. We can measure tear break up time in 2 ways: with fluoresceine dye on the cornea and a slit lamp or by using the Oculus Keratograph. Patients with dry eyes may have a reduced tear break up time. Dry eye treatments aim to improve the tear break up time and lead to an improvement in dry eye symptoms.
A slit lamp is a microscope used by your optometrist to look at the structures of the eye in detail. Dry eyes can cause ocular surface inflammation. This can be visualized using a slit lamp and often times fluorescein dye on the cornea which would highlight areas of inflammation caused by dry eyes.
At Stoney Creek Eye Care and Eye Wear Boutique, we offer a variety of treatments to alleviate your dry eye symptoms and treat the condition at its source. Our optometrists will work with you to help find sustainable, lasting relief. Some of the treatments available to us include:
E>Eye is a breakthrough medical device that uses patented intense regulated pulsed light to treat chronic dry eye syndrome. Intense regulated pulsed light therapy (IRPL) is a new treatment that improves upon conventional intense pulsed light therapy (IPL). Specifically, IRPL helps to treat meibomian gland dysfunction, the cause of most chronic dry eye symptoms. According to early research, IRPL is one of the most effective long-term treatments for dry eye caused by meibomian gland dysfunction. IRPL is also particularly effective at treating ocular rosacea, another common cause of chronic dry eye.
This treatment targets all aspects of meibomian gland dysfunction by improving gland function, unclogging glands, reducing inflammation, and restoring tear quality. Another unique thing about this treatment is that IRPL can actually help save meibomian glands that are in the process of atrophying, making it one of the only dry eye treatments that can restore the meibomian gland structure.
The E>Eye produces perfectly calibrated light pulses. The spectrum, energy, and time are set to precisely stimulate the meibomian glands. The light pulses are actually applied to the upper cheek area (just under the eyes) and not the eyes themselves, allowing the device to stimulate the parasympathetic nerve that supplies the meibomian glands. The light pulses stimulate the release of neurotransmitters which interact with the meibomian glands, leading to restored function and long term relief of chronic dry eyes.
The treatment protocol involves 3 sessions on day 1, day 15 and day 45. The sessions are very comfortable and completely painless. 90% of patients report reduced symptoms after just 2 treatments. Each treatment session only takes a few minutes at your optometrist’s office. You’ll wear protective goggles and ultrasound gel is applied to your upper cheek area. Your optometrist will then apply 5 flashes of light to the treatment area. This is then repeated with the other eye. Research has shown that the long lasting effect is expected for a minimum of 6 months and up to 3 years or more. Single maintenance treatment visits are recommended if symptoms start to come back in order to maintain long term relief.
IRPL is a promising treatment that has recently come to Canada, and Stoney Creek Eye Care is proud to be one of the few Canadian practices to offer this innovative, non-invasive dry eye treatment.
Mibo Thermoflo is an in-office treatment that warms and massages the eyelids. The gentle heat and pressure help to treat dry eye from meibomian gland dysfunction. As the device moves over the eyelids, it helps dissolve clogs and liquefies the hardened oil or meibum in the meibomian glands. This helps improve the function of the meibomian glands and enhances the quality of the lipid component of the tears for a more balanced tear film. It’s a gentle way to treat meibomian gland dysfunction that many patients find relaxing while providing immediate dry eye relief. A Mibo Thermoflo treatment usually involves 3 treatment visits for optimal results.
Meibomian gland expression is a treatment for moderate to severe cases of meibomian gland dysfunction. First, the eye area is gently heated to help loosen clogs and buildup in the meibomian glands. Then your optometrist will use forceps to squeeze the lids and drain the meibomian glands.
BlephEx cleans and exfoliates the lid margin, or the area between the eyelashes and the inside of the eyelid. It is a very effective treatment for blepharitis as it removes debris that can clog eyelid glands and lead to inflammation. The treatment device looks like a pen with a sponge tip. The sponge tip spins, gently removing debris and exfoliating the eyelids. Because BlephEx helps to improve tear gland function, many patients find the treatment reduces their dry eye symptoms.
In addition to our in-office treatments, we can help you find the right at-home methods. Based on your symptoms and other treatments you may be receiving, we can recommend eye drops, including gentler, preservative-free varieties. We also carry treatments like heated eye masks, blepharitis lid hygiene wipes, and specialized Omega 3 Dry Eye supplements to help relieve and treat a variety of dry eye conditions.
Meibomian gland dysfunction (contributing to evaporative dry eye) is considered the leading cause of dry eye disease.
The meibomian glands are located in the upper and lower eyelids and produce the oil (or meibum) which is a very important part of our tear film. We have about 25-40 meibomian glands in the upper lid and 20-30 in the lower lid.
Meibomian gland dysfunction (MGD) occurs when the quality or quantity of the meibum secreted is compromised. This may be due to a blockage at the opening of the glands or due to hardening of the meibum in the glands. This leads to evaporative dry eyes and all the symptoms associated with it. MGD is a very common condition and it is estimated that 70% of patients over the age of 60 have some form of MGD.
Chronic meibomian gland dysfunction can eventually lead to slow, irreversible damage to some or all of the meibomian glands which results in an increase in chronic dry eye symptoms. Your optometrist can assess the quality and quantity of meibum secretions using a slit lamp and gentle pressure on the glands. With meibography, your optometrist can determine the extent of damage to the meibomian glands. MGD treatment is aimed at not only providing relief from symptoms but also improving the functioning of the glands and protecting the remaining healthy glands.
In-office treatments can kick start the improvement to the meibomian gland functioning in moderate to severe MGD – this is usually followed with at home therapy for maintenance. For mild to moderate cases, at home therapies are often quite effective. Short term prescription medications may also be prescribed by your optometrist.
At Stoney Creek Eye Care & Eyewear Boutique our trusted team of eye doctors is committed to providing you with high-quality eye care, stylish frames, and personalized attention. We offer a wide variety of services, including:
We understand that life is hectic. We want to help make it a little simpler, which is why our centrally-located practice offers extended hours on Mondays and Saturdays. We’re also happy to directly bill most major insurance companies on your behalf. And on top of all that? We’ve got plenty of free parking. Stoney Creek Eye Care & Eyewear Boutique will always do whatever we can to make your life a little easier, located in the Health Science Building.