The most common eye problem we see is Dry Eyes (no pun intended!). Dry eyes affects 5 out of 10 people, so we do see it every single day. In the past optometric management of dry eyes was for symptoms, but now we are better able to treat the cause.
If your eyes feel dry or gritty or even feel as if there is something in your eyes then you may have dry eyes. Interestingly if you have very watery eyes you may also have dry eyes, this can be a result of tear over production. Symptoms can be very mild to debilitating. Dry eyes can be caused by many things including eye health, environment and general health. It is not because you have cried too much at a sad movie or because you’re staunch and don’t cry enough!
As part of your thorough eye examination we will assess your eyes for dryness. Here’s how we can help you have eyes that are clearer, whiter, more sparkly and feel great! We agree the blephasteam goggles do look a bit weird and even sci-fi inspired, but they are effective! The heat goggles are worn for 10 minutes and during that time the heat and steam treat the eyelids. The main target is the meibomian (oil) glands in the eyelid. These glands are easily blocked by old oil and the heat helps melt this away.
We need the oil in our tear film as it is the outer layer and stops the tears from evaporating. The better your tears, the better your eyes feel and see. The tears are the first refractive layer of they eye which is an optical system- plainly speaking if you have poor tear film it’s like looking through a dirty car windscreen, you can see, but it’s murky!
We have been impressed that glands we thought were so blocked they’d never function have opened up and started working. After the treatment the optometrist will then try and express some of the oil from the eyelids. Sometimes the glands are a bit tender as they have been blocked for some time. This treatment seems so much more effective than other methods we’ve tried.
Afterwards it’s described “as good as a spa treatment” and “wow my eyes feel silky”. From our point of view as the optometrist we’re delighted that your Tear Break Up Time goes from evaporating as you blink to getting close to a normal length of time.
Loved the eye spa! I am telling everyone about it!- Carol
Often once this treatment has been done you are so motivated to keep your eyes feeling great. A wheat eye mask is perfect for this. It takes less than a minute to warm up in the microwave and then can be used over both eyes. We have even heard some of our clients have made it part of their evening ritual!
If you think you’d like to try this treatment, because we’ve mentioned at your eye examination your eyelids have blocked oil glands, or you just like the sound of it, please call to make an appointment. The appointment takes 30 minutes and the cost is $65. Depending on your eyelids we may recommend more than one treatment. If lid debridement is indicated the appointment will take 45 minutes and the cost is $105.
For some people their dry eye is so chronic that it has such a negative impact on their life that it has in some cases lead to depression. For others their dry eye is impacting their vision so much that they cannot see well. At Victoria Street Optometrists we understand dry eye is not something you want to live with.
In our longer appointment time we give a more intensive treatment. The eyelid margins are debrided of dry tissue that is often sealing over the meibomian glands. This debridement feels tickly. We then express the meibomian glands with tiny forceps. The expression is more successful after debridement. We can grade the quality of oil coming out. It is tender when the oil is very old and almost set like concrete in your glands. Often this chronic condition may require us to prescribe some medication for your eyelids.
Dry Eye Supplements
Nearly 75% of Australians take supplements and we figure New Zealanders are more than likely to be doing the same. Omegas are an essential fatty acid as we do not produce them naturally we must get them from our diet. Omegas help reduce inflammation and have health benefits throughout the body. Consumption of omega-3 fatty acids has a positive effect on dry eye. The meibomian glands use the essential fatty acids to produce the oil for the tear film. This outer layer protects against evaporation.
At the same time the two types of omega-3s in TheraTears Nutrition is made with two types of omega-3s. One from flaxseed oil and the other from fish oil. Their formulation has also been found to protect your lacrimal gland and help it make healthy amounts of tear fluid.
If you are not taking any omega-3s we recommend starting with some. Whether it be fish oil, linseed or flaxseed oil as a supplement. Or if you prefer a food to a pill then try chia seeds or LSA (ground up linseed, sunflower and almond), it’s available at the supermarket, fruit and vege shop and health store.
Dry Eye Drops
There are many artificial tears on the market some are better than others. Victoria Street Optometrists recommend those that are preservative free (single unit dose) or a bottle that lasts more than 1 month. We have seen some pretty skanky looking eyedrops pulled from handbags and pockets- we wouldn’t eat after touching the bottle let alone let it near our eyes! Eyedrops relieve the symptoms but do not solve the problem. Eyedrops will accelerate healing if there’s any epithelial cell loss on the cornea as the new cells can travel faster in a wet eye to the site that needs repairing.
Never in our careers have we had sung (by patients) so much praise for an eye drop as we did when Systane Balance was released! We have had people come in and stock up on this drop- they want it at home, at work and to gift to others as its so amazing. Systane Balance Lubricant Eye Drops offers extended dry eye relief designed specifically for patients with dry eye associated with meibomian gland dysfunction (MGD). MGD is when the meibomian (oil) glands in the eyelids are blocked and the tears of the eyes need this oil layer to stop them from evaporating too quickly. This type of dry eye is the most common type we see. This patented formula helps restore a crucial component of tears that locks in moisture to relieve dry eye symptoms associated with MGD. The drops are a suspension so you need to shake the bottle before use and allow a few minutes for your vision to adjust. Systane Balance dry eye drops are inherently different from other drops, offering a higher standard of relief.
The product range Systane has been one we have found excellent, and another option is Systane Hydration. Systane Hydration has been given rave reviews from our dry eye sufferers who have tried it. We have it in stock in either a box of non-preserved single doses, or in a small bottle which is okay to keep for 3 months after opening. Systane Hydration binds to water providing more hydration, lubrication and sustained relief. Any dry and damaged cells are given support to heal and repair when the eye is well lubricated. Systane Hydration can also be used with contact lenses- how convenient is that!
Systane Gel Drops
But wait there is more- Systane Gel Drops offering the convenience of an eyedrop but the protection of a gel. This provides longer lasting relief from dry eye symptoms. This drop is thicker and creates a protective shield over your eyes. It is recommended for severe dry eye and is a great alternative to ointments that can smear your eyes and blur your vision. The bottle is also suitable for 3 months use before it has to be discarded.
TheraTears lubricant eye drops
Dry eye is a result of a loss of water from the tears on the eye surface. The main bulk of the tears are the aqueous (water) layer. Loss of this layer makes the tears too salty or “hyper-osmotic.” TheraTears Lubricant Eye Drops help put back the lost water, lowering the high salt concentration, so that they not only wet but also rehydrate dry eyes. Our tears have an electrolyte solution specially designed to protect the eye surface which theratears eyedrops also replicates. Each drop of TheraTears provides a special, highly lubricating factor, to maximize the instant relief from the symptoms of dry eye. The eyedrops are available in two formulations- a drop for day relief and a gel for night relief or even severe dry eye.
Hylo-Fresh & Hylo-Forte
Hylo-Fresh eyedrops have a unique delivery mechanism to ensure every drop into your eye is sterile. The drops are preservative and phosphate-free. The bottle can be used for 6 months before it has to be discarded. It can be used safely with contact lenses. For those with severe dry eye this eyedrop can be prescribed and dispensed under a subsidy.
Hylo-Forte eyedrops uses the same delivery mechanism and is a thicker formulation. Recommended for severe or persistent dry eye, or post-surgery use.
The most advertised dry eye drop is probably Optrex ActiMist which is a spray! Its innovative delivery system is that you spray your closed, then during normal blinking the spray particles fall into the eye. The spray is liposomal which means an artificial lipid (oil) layer helps prevent tear evaporation. This is great for people who struggle with putting things near or in their eyes. It like systane balance is designed for meibomian gland disease sufferers.
Lid Cleaning Products
Blephadex Eyelid Foam Cleanser is a product we are excited to stock at Victoria Street Optometrists. The bottle of foaming cleaner is a great and easy way to help maintain healthy tears and eyelids. Blephadex’s combination of Tea Tree Oil, Coconut Oil and gentle lid cleaner provides a lasting moisturisation and soothing effect while helping to remove oil, debris and makeup from your eyelids. If you have been told your eyes are dry, but can’t face using eye drops – this is a very easy and simple alternative. We like the fact it should be used every second day not every day!
There is a little mite that has recently been discovered that lives in the eyelash base. It is called a demodex. It loves to live in eyelash bases that have a tuft of skin around it. It has been found in lots of people and the prevalence increases with age. It is not associated with hygiene or lack of hygiene. They are tiny and hide in bright light so not very easy to detect even with our magnification. Blephadex is the best treatment we have found for these mites. The demodex can make your eyelids look red, in the odd case it can appear like an eyelid rash. Your eyes feel dry and irritated.
Thera Tears Sterilid Eyelid Cleanser only takes 60 seconds to use and often done in the shower. It removes oil, debris and other contaminants that can build up on eyelids and eyelashes. The resident bacteria of the skin like to breed in the build ups and this can aggravate the eye. Sterilid is a great eyelid cleanser which kills both gram positive and gram negative bacteria and doesn’t remove the skin’s natural oil layer. It is hypoallergenic with a pH matched to skin formula. Thera Tears Sterilid has an active ingredient that is an extract of teatree oil. This cleanser has no expiry.
If you are suffering or regularly suffer from styes this product is a great way to maintain healthier eyelids and only needs to be used once a week for maintenance. A stye is painful because it is an infection in the oil gland. It responds to heat treatment but to avoid recurrence you need your eyelids in tip top shape.
The Wonders of Manuka Honey!
Manuka honey has long been appreciated in New Zealand for it’s remarkable properties and now is available in a preparation that is safe for your eyes! We stock both the gel and the drops in the OptiMel.
We like OptiMel because it has anti-bacterial and anti-inflammatory properties. What does this mean for you? That the normal bacteria on the lids if you suffer dry eye is breeding and making your eyelids red and irritated, and you are also more prone to getting an infection in the glands. You can treat your eyelids with optimel to make them more comfortable and less likely to get infected. To take prescribed medication for this would often involve 2 treatment creams or a combined one that is notorious for causing allergies. We have been recommending optimel to those with chronic dry eyes, especially those that have just finished a course of anti-biotic eye gel for their eyelids, those using it have noted an improvement!
“Opti-mel definitely calms my eyes”- Richard