Don’t live in discomfort any longer.
If you have itchy, red, tired, and irritated eyes – don’t just assume it’s allergies. Chances are, you could be experiencing dry eye. Dry eye doesn’t get the last word. Find the right treatment and the right solution to give you the comfort and lasting relief you’re looking for.
Tell Us About Your Dry Eye Problem
Dry eye is a disease.
For that reason, we call it Ocular Surface Disease. 30% of all people have this disease. Sometimes, dry eye can feel like a mild nuisance, but in other cases, it can cause serious damage to the eye,
While there is no magical “cure” for Dry Eye, it’s important to get it treated and managed before the effects worsen and permanently harm the eye. Left untreated, dry eye can worsen over time because it’s a chronic and progressive condition—like arthritis.
Symptoms of dry eye disease
- Dry sensation
- Excess tearing
- Scratchy, gritty feeling
- Light sensitivity
- Blurry vision
Dry is very common, but complex.
It's not what you think it is. Most people think dry eye means their eyes don't have enough water. But that's only true 14% of the time. 86% of the time the problem has to do with a lack of the meibomian oily layer of tears.
Dry eye is “a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.” In other words, it's a condition where the tears are inadequate or unstable, leading to inflammation, pain and loss of tear gland structures.
Root Cause of Dry Eye Disease
Meibomian Gland Dysfunction (MGD) is the source of dry eye conditions for 86% of the time. The other 14% of the time dry eye is due to a lack of the aqueous water layer.
Proper Blinking Is Very Important
When you blink fully the glands squeeze out a small amount of oil onto the eyelid margins. The act of blinking spreads the oil to cover the watery layer and protect it from evaporation.
What Goes Wrong
When these glands become blocked due to improper blinking or atrophy of the meibomian glands, production of the necessary oil to protect the watery layer of the tear film gets compromised. This causes the watery layer to evaporate and leave the corneal surface exposed and inflamed. This process is known as meibomian gland dysfunction, or MGD.
- Fill out our test to determine if you have Dry Eye
- You will fill out the Standard Patient Evaluation of Eye Dryness Survey (SPEED).
- If your score is greater than 6, you have dry eyes, also called Meibomian Gland Dysfunction or MGD for short.
- We will collect a detailed medical history, including medications that make your eyes dry.
- Schedule a dry eye evaluation. Tests will be done to look at the following:
- Blink pattern
- Lipid layer thickness
- Number of oil glands yielding clear oil
- Lipid Layer thickness and amount of glands yielding clear oil
- Meibography infrared photography of the oil glands to detect atrophy
- Evaluation of eyelid inflammation, styes, and chalazia
- Dye testing for irritation of cornea and conjunctiva
- Eyelid closure and eyelid seal evaluation
- Tear Osmolarity. The saltier your tears, the more evaporation you have
- Staining of the eye with fluorescein and lissamine green for inflammation
- Tear production with zone quick phenol red thread testing for adequate moisture
- Screening for ocular allergies, viruses, bacteria, and mite infestation of the eyelids
- Discuss treatment modalities depending on the diagnosis
- BlephEx exfoliative eyelid deep cleansing procedure
- LipiFlow thermal pulsation procedure
- Anti-inflammatory steroid eye drops
- Restasis or Xiidra
- Lubrication eye drops
- Bandage contact lenses
- Amniotic membrane use for enhanced healing
- Eyelid closure and eyelid seal evaluation
- Scleral contact lenses for corneal surface protection and better vision
- Discuss what to do to make sure the MGD heals and does not progress further
- Specific Omega-3 supplements for dry eyes
- Blink instructions
- Eyelid cleansing procedures
- Lubrication eye drops
- Bandage contact lenses
- Ongoing professional care and monitoring
- Refit into contact lenses that are better for dry eyes
- Follow-up visits to recheck comfort level and ocular healing
- Health of meibomian glands
- Oil flow from oil glands
- Stability of tears
- Status of blepharitis
- Corneal health
- Vision stability
- Environmental factors
- Contact lens wearability
- Tear Osmolarity
- Eye redness decrease
- Symptoms relief
- Overall eye appearance
Intro to MGD
When it comes to treating dry eye, over the counter eye drops are known to provide some temporary relief by adding fluid to your eye. However, they won’t give you the long-lasting relief you’re looking for. Think of them as a bandage for your symptoms – they may offer temporary relief, but also mask the main problem that needs to be solved.
At Brill Eye Center, we avoid the palliative approach, like “use drops more often.” We like to take a comprehensive approach that treats your symptoms and gives you relief that lasts.
Think about a person who broke her leg and is complaining about severe pain while in the emergency room. She is given pain medicine for the pain, but it will not fix the broken leg. People with dry eye have a broken lacrimal system.
Our team will go over your medical history and perform a detailed survey of your symptoms. We will carefully listen without judgement to your dry eye journey. We know this is a complex condition with multi-factorial causes.
None of the tests will hurt or make you worse. We rely on objective measures like laboratory values when you get your medical physical. We will prove what your problem is with photos and videos of your ocular state. We will explain the diagnosis in easy terms you will understand.
Our team will discuss the full suite of treatment modalities tailored to your needs. We will recommend the most effective treatment methods to improve your dry eye condition in the shortest period of time to minimize your suffering.
Healing time-frames will vary depending on the severity of your condition.
We'll schedule you for follow up visits with our team to make sure your treatment plan is working effectively. Recommendations will change over the course of your maintenance because dry eye disease is a chronic and progressive condition.
None or only casual observation.
The Guessing Game or "I am not sure."
"Here, try this fist full of drops and tell me if one works."
"I'm baaack. The drops didn't work." "Here's more drops..."
Start over with the next fist full of drops and home remedies. Or, make life easy and choose the Brill Eye Center program.
If your eyes are frequently uncomfortable, it’s time to make a diagnosis of what is wrong. You need to see an eye care professional who can make a diagnosis of what the main problem is. The diagnosis will drive the recommendations for treatment.
Treating symptoms is only a temporary solution. Dry eye is a chronic and progressive disease so it’s important to not just put a bandage on the problem. Here’s a few ideas: Stop smoking, wear sunglasses outside, avoid air directly blowing on you from fans, start a good omega-3 like Easy Tears brand, and make sure you are not a lazy blinker when using your digital displays. Let your eye doctor determine the root cause of your dry eye so you can find more permanent relief.
Many patients don’t know it, but they sleep with their eyelids partially open. If you wake up with pain, scratchiness, the sensation that there is something in your eye, or mucous discharge, it could be caused by Nocturnal Lagophthalmos or a poor sealing of the eyelids. Because the eyelid does not close completely, it allows the tears in your eyes to dry out, making them feel uncomfortable. It’s tricky to diagnose because you can’t watch yourself as you are sleeping to see if your lids are partially open. We can perform tests to see if this is the cause of your irritation.
Over-the-counter eye drops may help alleviate symptoms by temporarily lubricating eyes, but for ongoing conditions, proper diagnosis and treatment provides relief of dry eyes by treating the root cause rather than just the symptoms. These drops usually are designed to supplement the watery layer of the tears, but this is the issue only 14% of the time. If you use these lubricating drops but the problem recurs in a few minutes, you will need a better answer.
It is certainly possible that your eyes are irritated and itchy due to allergens, however, it is important to take note of how long these symptoms last, since they are also a key indicator of dry eye. If the discomfort persists after allergy season comes and goes, it could be a sign of a more serious problem, such as dry eye. Good antihistamine and mast cell stabilizer drops are on the market. Look for Bepreve, Lastacaft, and Pazeo Rx drops as the best ones. Dry eye and allergies can also coexist. Antihistamine medications will also dry the eye out, so beware, the fix may be more complex than you think.
As always with any medical problem, the ways to treat it vary. For most eye care professionals, dry eye patients may represent a nuisance. Their vision fluctuates with glasses and creates contact lens intolerance. Brill Eye Center has the latest proven diagnostic and treatment tools to address the diagnosed condition. We have a passion for dry eye resolution and love to share the information to address your problems. We prefer to use your time wisely and scientifically treat the root cause of your dry eye instead of trying to just mask the problem with merely palliative treatments. If you go to the emergency room with a broken leg, it is better to cast your leg than just mask the pain with drugs and not solve the root cause.