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Dry Eye Q&A’s with Dr. Lagunas

itching eye and scratchingDr. Claudio Lagunas answers the most frequent questions he receives about Dry Eyes.

Q: When should a person come in to see their optometrist for Dry Eye symptoms and when is it enough to take care of this problem yourself?

A: Typically, for mild symptoms, it’s ok to try over-the-counter solutions such as lubricating eye drops, but if that is not solving the patient’s problems or they see their symptoms are not improving, then they definitely should come in and see their optometrist for testing, and or a dry eye examination. This way we can find out the true cause of their symptoms and give them a proper treatment plan.

Q: Is it true that Dry Eye symptoms seem to be more severe in the winter than in the spring and summer months?

A: False. At least not in the Houston area. Here we see Dry Eye symptoms are the same year-round and don’t find the symptoms worse in the winter than the summer. There are also a lot of other factors involved besides just the temperature that can cause Dry Eye symptoms.

Q: Are some people more prone to having Dry Eyes than others?

A: Yes. There are some patients who are more prone for Dry Eye, for example age is a big factor, and age-related issues cause the quality of our tears decreases over time. Patients who take certain medications or who suffer from certain medical conditions suffer more from Dry Eyes. Also, women are more prone to Dry Eyes. In general, though, Dry Eye can affect just about anyone.

Q: I have a friend whose eyes are frequently overly watery. That isn’t Dry Eye, is it?

A: Watery eyes are definitely a symptom of Dry Eye, and it could also be caused by something else. For instance, allergy related issues. Both of which we can treat. If someone tears a lot without any other cause, or emotional component, then it is very likely Dry Eye. It is the eyes natural response to try and protect the eye. Especially if the eye is dry and the quality of the tears is not enough to protect their eyes.

Q: What is the examination like to determine whether someone is suffering from Dry Eyes?

A: There are very specific tests we conduct to determine if a patient has Dry Eye. We actually screen every single patient who comes in to see if we see any Dry Eye symptoms. If they specifically know they may already have Dry Eye, then we will do:

1) a tear break-up time test, LipiView (part of the LipiFlow technology), which lets us look at the glands to see if there is any obstruction of the glands,

2) we will run some functional tests to see how many of the patient’s glands are producing the oil,

3) we will do a blink assessment to see if the patient is a partial blinker or not,

4) and We will conduct an ocular surface disease assessment test.

Q: I understand you are one of the few practices in your area with the LipiFlow technology, can you tell us more about that?

A: LipiFlow is a treatment for meibomian gland dysfunction (MGD). If we see that a patient has an obstruction of their glands…each person has about 25-35 glands in the upper and lower lid. If those glands are blocked for any reason, then the production of oil in the tear is decreased. If enough of those glands get blocked, then this can cause some serious problems.

Some of the new research shows that about 86% of patients with Dry Eye symptoms actually have MGD. Again, once we have diagnosed the glands are blocked, then we will use LipiFlow, the only FDA approved treatment for unblocking the glands. So far we have had some fantastic results from patients who have undergone the LipiFlow procedure.

Q: Are there other typical treatments used to help people suffering from Dry Eyes?

A: Once we have diagnosed the true cause of the Dry Eye symptoms, we will put the patient on the appropriate drop for them. There are a number of different drops. Whether it be a lipid-based drop for patients who need more oil in their tears, or water-based drops because they need more water in their tears.

There are also masks we use very effectively, to heat up the glands, so if they are not completely obstructed, and there is a little bit of blockage, then the heat will open up those pores, release the blockages, and allow those glands to work better.

There is omega-3 and vitamins that have been proven to increase production of tears. There are some medications like Restasis that have been proven to increase tear production.

As you see, there are a number of ways to treat Dry Eye, we first need to find the root cause of the problem so we can best address the situation and find a solution to their symptoms. Each patient is different. Some patients require a lot of the above treatments, some patients only one or two of them.

It can also include warm compresses of the eyelids, discussing environmental factors like water intake, Omega 3 supplementation, limiting fans and AC. Depending on the type of dry eye, as well as the severity, it could include a variety of treatments.

Q: Do you have any recommendations for people to help them avoid Dry Eye?

A: Number 1 is early diagnosis. Since Dry Eye and MGD are progressive disorders, so the earlier we catch it, the longer we can preserve the glands from damage. Eventually, if not treated, the glands will atrophy and just die out. The key is getting tested early and often, and then following your optometrist’s treatment plan.

Q: Is there anything else you would like your patient’s to know about Dry Eye?

A: I want each patient to know that we are the fifth office in Houston to offer have the LipiView, which is part of the new LipiFlow technology. LipiFlow is the treatment, but we are actually using the LipiView as a screening for every patient who comes in, and this lets us view the glands and see if there is a problem.

Many patients don’t require the full blown treatment with LipiFlow, they may only require specific drops, or the heat mask. We really want to make sure Dry Eye or MGD is detected as early as possible and LipiView helps us do that for every patient.

We want everyone suffering from Dry Eye symptoms to know they can come in and get the proper diagnosis and treatment. Relief is possible.