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samedi 15 septembre 2018

Understanding Dry Eye Syndrome

Dry eye syndrome is caused by a chronic lack of sufficient lubrication and moisture on the surface of the eye. Consequences of dry eyes range from subtle but constant eye irritation to significant inflammation and even scarring of the front surface of the eye.

In addition to being called dry eye syndrome, dry eye disease, or simply "dry eye," alternative medical terms used to describe dry eyes include:

Keratitis sicca. Generally used to describe dryness and inflammation of the cornea.
Keratoconjunctivitis sicca. Used to describe dry eye that affects both the cornea and theconjunctiva.
Dysfunctional tear syndrome. Used to emphasize that inadequate quality of tears can be just as important as inadequate quantity.

Dry eyes can become red and irritated, causing a feeling of scratchiness.

Prevalence Of Dry Eye

Dry eyes are very common, and dry eye syndrome is a major reason for visits to the eye doctor. A recent online poll revealed that nearly half (48 percent) of Americans age 18 and older regularly experience dry eye symptoms.

Also, results from a 2012 Gallup poll show that more than 26 million Americans suffer from dry eyes, and this number is expected to increase to more than 29 million within 10 years.

Other sources estimate that nearly five million Americans age 50 and older have clinically significant dry eye syndrome, and dry eyes affect nearly twice as many women as men.

Dry Eye Symptoms

Symptoms of dry eyes and dry eye syndrome include:

Burning sensation
Itchy eyes
Aching sensations
Heavy eyes
Fatigued eyes

Sore eyes
Dryness sensation
Red eyes
Photophobia (light sensitivity)
Blurred vision

Another common symptom is something called a foreign body sensation — the feeling that grit or some other object or material is "in" your eye.

And as odd as it may sound, watery eyes also can be a symptom of dry eye syndrome. This is because dryness on the eye's surface sometimes will over-stimulate production of the watery component of your tears as a protective mechanism. But this "reflex tearing" does not stay on the eye long enough to correct the underlying dry eye condition.

In addition to these symptoms, dry eyes can cause inflammation and (sometimes permanent) damage to the surface of the eye.

Dry eye syndrome also can affect the outcomes of LASIK and cataract surgery.

What Causes Dry Eye Syndrome?

An adequate and consistent layer of tears on the surface of the eye is essential to keep your eyes healthy, comfortable and seeing well. Tears bathe the eye's surface to keep it moist and wash away dust, debris and microorganisms that could damage the cornea and lead to an eye infection.

A normal tear film consists of three important components:

An oily (lipid) component
A watery (aqueous) component
A mucous-like (mucin) component

Each component of the tear film serves a critical purpose. For example, tear lipids help keep the tear film from evaporating too quickly and increase lubrication, while mucin helps anchor and spread the tears across the surface of the eye.

Each tear component is produced by different glands on or near the eye:

The oily component is produced by meibomian glands in the eyelids.
The watery component is produced by lacrimal glands located behind the outer aspect of the upper eyelids.
The mucin component is produced by goblet cells in the conjunctiva that covers the white of the eye (sclera).

A problem with any of these sources of tear film components can result in tear instability and dry eyes, and there are different categories of dry eyes, depending on which component is affected.

For example, if the meibomian glands don't produce or secrete enough oil (meibum), the tear film may evaporate too quickly — a condition called "evaporative dry eye." The underlying condition — called meibomian gland dysfunction — is now recognized as a significant factor in many cases of dry eye syndrome.

In other cases, the primary cause of dry eye is a failure of the lacrimal glands to produce enough watery fluid (aqueous) to keep the eyes adequately moistened. This condition is called "aqueous deficiency dry eye."

The specific type of dry eye often will determine the type of treatment your eye doctor recommends to give you relief from your dry eye symptoms.

DRY EYE NEWS

Eyes Are Dry Most Often When Springtime Allergens Are In The Air

May 2015 — Ever notice that your eyes are dryer in April than during other months? This happens to be the same month when springtime allergens are peaking, and a study seems to have found a definitive link between them.

Researchers at the University of Miami reviewed 3.4 million visits to Veterans Affairs eye clinics between 2006 and 2011, when about 607,000 people were diagnosed with dry eye.

Factors Associated With Dry Eye Syndrome

A number of factors can increase your risk of dry eyes. These include:

Computer use. When working at a computer or using a smartphone or other portable digital device, we tend to blink our eyes less fully and less frequently, which leads to greater tear evaporation and increased risk of dry eye symptoms.
Contact lens wear. Though it can be difficult to determine the exact extent that contact lens wear contributes to dry eye problems, dry eye discomfort is a primary reason why people discontinue contact lens wear.
Aging. Dry eye syndrome can occur at any age, but it becomes increasingly more common later in life, especially after age 50.
Menopause. Post-menopausal women are at greater risk of dry eyes than men of the same age.
Indoor environment. Air conditioning, ceiling fans and forced air heating systems all can decrease indoor humidity and/or hasten tear evaporation, causing dry eye symptoms.
Outdoor environment. Arid climates and dry or windy conditions increase dry eye risks.
Frequent flying. The air in the cabins of airplanes is extremely dry and can lead to dry eye problems, especially among frequent flyers.
Smoking. In addition to dry eyes, smoking has been linked to serious eye problems, includingmacular degeneration, cataracts and uveitis. (For details, see our infographic about why smoking is bad for your eyes.)
Health conditions. Certain systemic diseases — such as diabetes, thyroid-associated diseases, lupus, rheumatoid arthritis and Sjogren's syndrome — contribute to dry eye problems.
Medications. Many prescription and nonprescription medicines — including antihistamines, antidepressants, certain blood pressure medications and birth control pills — increase the risk of dry eye symptoms.
Eyelid problems. Incomplete closure of the eyelids when blinking or sleeping — a condition called lagophthalmos, which can be caused by aging or occur after cosmetic blepharoplasty or other causes — can cause severe dry eyes that can lead to a corneal ulcer if left untreated.

Also, LASIK and other corneal refractive surgery can sometimes cause dry eyes. In most cases, however, dry eye discomfort after LASIK is temporary and resolves within a few weeks of the procedure.

If you have dry eyes prior to LASIK, your eye doctor may recommend a dry eye treatment regimen before your procedure to insure the best possible LASIK results.

DRY EYE NEWS

Smartphone Use Linked To Dry Eye In Schoolchildren

There might be another cost associated with children using smartphones besides a large monthly bill from the phone company: It could be causing kids to develop dry eye disease at an early age.

Researchers in Korea evaluated risk factors for dry eye disease among schoolchildren who used video devices, including smartphones. They examined 288 children and classified them as either having dry eyes or having a normal, moist eye surface (control group). Each child completed a questionnaire concerning the types of video devices they commonly used (computer, smartphone and television) and the amount of time they spent using each device.

Dry Eye Tests

The only way to know for sure if you've got chronic dry eye syndrome is to have your eye doctor perform one or more dry eye tests during an eye exam.

Symptoms alone are poor predictors of the presence and severity of dry eye disease. Symptoms can vary significantly from person to person, and may even be affected by personality type. Some people with only minimal or mild dry eyes may feel their eyes are very bothersome, while others may have significant dry eye problems and not consider their symptoms significant enough to see an eye doctor (or they may not experience dry eye symptoms at all).

Only a careful examination of your eyes by an optometrist or ophthalmologist can reveal the presence and severity of dry eye syndrome and help your eye doctor determine the best type of dry eye treatment to keep your eyes healthy, comfortable and seeing well.

Dry Eye Treatment And Prevention

Thankfully, there are effective treatment options if you suffer from chronic dry eye. In many cases, routine use of artificial tears and minor behavioral modifications (taking frequent breaks during computer use, for example) can significantly reduce dry eye symptoms.

In other cases, your eye doctor might recommend prescription eye medications and in-office procedures to help your body create and secrete more tears and to decrease eye irritation and inflammation.

For an in-depth discussion of dry eye treatments and prevention, see our Dry Eye Treatment page.AAV

DRY EYE RESEARCH View of air pollution in Chicago.

Researchers have discovered a lot of interesting things about dry eyes. Here are just a few:

Dry eye syndrome is more prevalent in cities with high levels of air pollution, says one study. Cities cited include Chicago, New York, Los Angeles and Miami. And study subjects in and around Chicago and New York City were three to four times more likely to be diagnosed with dry eye syndrome than those in less urban areas with relatively little air pollution. Plus, the risk of dry eye syndrome was 13 percent higher in high altitude areas.
More than 75 percent of women who routinely use a computer at work may suffer from dry eye disease, according to researchers in Japan. Among male workers studied, it was 60.2 percent. Risk factors for dry eye included being over 30 and using a computer more than eight hours per day.
Reading speed can slow down for dry eye sufferers, another study found. And reading rates decrease as the severity of the dry eye disease increases.

Plus d'infos »

vendredi 14 septembre 2018

Eye doctor

Ernest About Eye , Eye doctor

Choosing an eye care provider is an important health care decision. After all, you will be trusting youreye doctor to safeguard your precious sense of sight and help you maintain a lifetime of good vision.

The first step in your decision is to understand that there are two types of eye doctors: optometrists and ophthalmologists. And there is a third "O" among eye care providers: the optician.

What Is An Optometrist?

An optometrist is an eye doctor who has earned the Doctor of Optometry (OD) degree. Optometrists examine eyes for both vision and health problems, and correct refractive errors by prescribingeyeglasses and contact lenses. Some optometrists also provide low vision care and vision therapy.

Optometrists in the United States also are licensed to prescribe medications to treat certain eye problems and diseases. The scope of medical care that can be provided by optometrists is determined by state law. (For details about the scope of practice of optometrists where you live, visit the website of your state's board of optometry.)

FIND A DOCTOR: Use our new locator to find an eye doctor near you. >

Both optometrists and ophthalmologists examine eyes and prescribe eyeglasses and contact lenses.

Optometrists also may participate in your pre- and post-operative care if you have eye surgery performed by an ophthalmologist. With a few exceptions, optometrists in the U.S. are not trained or licensed to perform eye surgery.

An optometrist generally must complete a four-year college degree program in the sciences, plus four years of post-graduate professional training in optometry school. In this regard, the educational requirements of an optometrist are similar to those of a dentist.

Like ophthalmologists, optometrists are required to fulfill continuing education requirements on an ongoing basis to maintain their licensure and stay current with the latest standards of eye care.

What Is An Ophthalmologist?

An ophthalmologist is a medical doctor (MD) or a doctor of osteopathic medicine (DO) who specializes in eye and vision care. Ophthalmologists are trained to perform eye exams, diagnose and treat disease, prescribe medications and perform eye surgery. They also write prescriptions for eyeglasses and contact lenses.

Ophthalmologists generally complete four years of college, four years of medical school, one year of internship, and a minimum of three years of hospital-based residency in ophthalmology.

So (to extend the analogy with dentistry), whereas the education of an optometrist is similar to that of a general dentist, the education and training of an ophthalmologist are more similar to that of an oral surgeon.

What Is An Optician?

An optician is not an eye doctor, but opticians are an important part of your eye care team. Opticians use prescriptions written by an optometrist or an ophthalmologist to fit and sell eyeglasses and other eyewear.

In some states, opticians must complete an opticianry training program and be licensed. Other states don't require opticians to obtain formal training or licensure. Some states allow opticians to fit contact lenses, usually after completing a certification program.

Which Eye Doctor Should I See: An Optometrist Or An Ophthalmologist?

If your eyes are healthy and don't require specialized medical or surgical treatment, the type of eye doctor you choose for a routine eye exam is a matter of personal preference.

Optometrists and ophthalmologists both perform routine eye exams and both types of eye doctors are trained to detect, diagnose and manage eye diseases that require medical and non-medical treatment.

If you already have a medical eye problem — such as glaucoma, macular degeneration or cataracts — it is important to seek care from an eye doctor who is highly trained and skilled in monitoring and treating your condition. In many cases, this may mean that medical or surgical eye care by a specially trained ophthalmologist is in order. In such cases, your optometrist (or general ophthalmologist) may refer you to a colleague who is a specialist in treating your condition.

Most optometrists offer medical treatment for common eye problems (such as dry eyes and eye infections) and certain chronic eye diseases (such as glaucoma). But certain eye disorders require treatment by an ophthalmologist, particularly if surgery or other specialty care is needed.

Ophthalmologists are medical eye doctors who are licensed to perform eye surgery.

In many cases, care for a specific eye problem may be provided by an optometrist and an ophthalmologist working as a team. This arrangement is called co-management.

In co-management, your primary care eye doctor (usually an optometrist) refers you to a specialist (usually an ophthalmologist) for a definitive diagnosis and treatment plan. The ophthalmologist may choose to manage the problem medically, perform eye surgery, or both. After the condition is controlled or surgically treated, the specialist then sends you back to your primary care eye doctor, who continues to monitor and treat your condition or perform post-operative care based on the specialist's recommendations.

Co-management is a particularly good solution if you are very pleased with the quality of eye care you are receiving from your primary care eye doctor, but you want to have any specific medical eye conditions treated by an experienced specialist.

Vision Insurance And Your Choice Of Eye Doctor

If you have vision insurance or a health insurance policy that covers eye care, one factor in choosing an eye doctor is determining if he or she is an authorized provider under your insurance plan, and what your out-of-pocket expense will be for the exam.

Typically you can get this information by calling the doctor's office and giving them your insurance information. Many insurance companies also post on their websites a directory of eye doctors who accept their vision plans.

Most optometrists and ophthalmologists who provide general eye care for the entire family accept Medicarefor older patients. But be aware that while Medicare covers your visits to an eye doctor for medically necessary eye care, it does not cover routine eye exams.

If you have Medicare coverage and are just getting a routine eye exam to have your eyes checked and your glasses prescription updated, payment for the exam will be your responsibility unless you also have a private vision insurance policy that covers routine exams. But if you are eligible for Medicare and you have a pre-existing eye problem such as cataracts or macular degeneration, part of your comprehensive eye exam may be covered. Ask your eye doctor for details.

Also, when calling an eye doctor's office, ask how they handle insurance claims. Will you have to pay for the exam and then submit the claim to your insurance company yourself, or will the eye doctor's office bill your insurance company for the exam so no payment is required of you?

If you don't have an insurance policy that covers eye care, find out the eye doctor's fee for a routine exam and for any special testing that may be required. While you don't want to choose an eye doctor based on cost alone, it is a factor to consider.

Other Factors When Choosing An Eye Doctor

When inquiring about the services an eye doctor provides, ask what happens if a problem is detected that requires treatment beyond the doctor's scope of care. Which medical and surgical specialists do they refer to, and where are they located?

A doctor's professional affiliations and memberships can help to indicate expertise in certain areas of practice; for example, ophthalmologists may belong to the American Society of Retinal Specialists or the American Society of Cataract and Refractive Surgeons . Some organizations have rigorous standards for membership or Fellowship, such as the American Academy of Optometry .

Finally, a major factor you should consider when choosing an eye doctor is the recommendation of that doctor by friends, family members or coworkers. Word-of-mouth referrals often are the best way to find a friendly, competent and caring eye doctor and avoid unpleasant surprises when you go to have your eyes examined.

Plus d'infos »

jeudi 13 septembre 2018

Dry Eye Treatment: Getting Relief From Dry Eyes

Ernest Eye doctor , Intraocular Lenses

Dry eye syndrome is a chronic and typically progressive condition. Depending on its cause and severity, it may not be completely curable. But in most cases, dry eyes can be managed successfully, usually resulting in noticeably greater eye comfort, fewer dry eye symptoms, and sometimes sharper vision as well.
cataracts cataracts cataracts cataracts

Because dry eye disease can have a number of causes, a variety of treatment approaches are used.

The following is a list of dry eye treatments that are commonly used by eye doctors to reduce thesigns and symptoms of dry eyes. Your eye doctor may recommend only one of these dry eye treatments or a combination of treatments, depending on the cause(s) and severity of your condition.

Also, some eye doctors will have you complete a questionnaire about your symptoms prior to initiating dry eye treatment. Your answers to this survey are then used as a baseline, and the questionnaire may be administered again after several weeks of treatment to evaluate the effectiveness of the chosen treatment approach.

Successful treatment of dry eyes requires that you are willing to follow your eye doctor's recommendations and that you use the products he or she recommends consistently and as frequently as directed. (If you don't have one yet, please click here to find an eye doctor near you.)

1. Artificial Tears

For mild cases of dry eyes caused by computer use, reading, schoolwork and other situational causes, the best dry eye treatment may simply be frequent use of artificial tears or other lubricating eye drops.

Eye doctor

Artificial tears usually are the first step in dry eye treatment.

There are many brands of artificial tears that are available without a prescription. The challenge with using artificial tears is not lack of product availability — it's the confusing number of brands and formulations available to choose from.

Artificial tears and other over-the-counter (OTC) lubricating eye drops are available in a wide variety of ingredients and viscosity ("thickness").

Artificial tears with low viscosity are "light" and watery. They often provide quick relief with little or no blurring of your vision when you apply them. But often their soothing effect is very short-lived, and sometimes you must use these drops very frequently to get adequate dry eye relief.

On the other hand, artificial tears that have a high viscosity are more gel-like and can provide longer-lasting lubrication. But typically these drops cause significant blurring of your vision for several minutes immediately after you apply them. For this reason, these drops often are not a good choice for use during your work day or when you need immediate clear vision for tasks such as driving. Instead, high-viscosity artificial tears are recommended only for bedtime use.

Also, the ingredients in certain brands of artificial tears may determine which type of dry eye condition they are better suited for. For example, one brand might work better for aqueous-deficiency dry eyes, while another brand may be more effective for an evaporative dry eye condition.

If your eye doctor recommends that you use one or more brands or formulations of artificial tears, be sure to follow the directions he or she gives you concerning when and how often you use the drops. Also, do not substitute different brands from those your eye doctor recommends. Using a different brand or multiple brands of artificial tears will make it difficult to assess the success of the dry eye treatment your doctor recommended.

2. Restasis

Instead of OTC artificial tears (or in addition to them), your eye doctor might recommend daily use of a prescription eye drop called Restasis (Allergan) for your dry eye treatment.

Restasis does more than simply lubricate the surface of your eye. It includes an agent that reduces inflammation associated with dry eye syndrome and helps your body produce more natural tears to keep your eyes moist, comfortable and healthy.

It's important to know, however, that the therapeutic effect of Restasis is not immediate. You must use the drops daily for a minimum of 90 days to experience the full benefits of this dry eye treatment.

A significant percentage of people who try Restasis will experience burning eyes early during the first few weeks of treatment.

DRY EYE NEWS

If you work in an operating room, you're at a higher-than-normal risk for dry eyes.

Study Reveals That Operating Rooms Are A Breeding Ground For Dry Eye

September 2016 — Dry eye affects about 10 to 20 percent of the population, and most of those who have the disease are over age 50.

But if you work in a "clean room" environment, such as an operating room, you're at even greater risk — as high as 56 percent according to new research that evaluated dry eye prevalence in surgical residents with a mean age of only 27.8 years.

Clinicians have long known that activities that decrease blink rate can increase the prevalence of dry eye syndrome. For example, long hours spent at a computer is a well-established risk factor for dry eye.

3. Xiidra

In July 2016, Shire announced it received FDA approval to market its new Xiidra (ZYE-druh) prescription eye drops for the treatment of dry eye in the United States.

Xiidra, like Restasis, is aimed at reducing inflammation that is associated with the signs and symptoms of dry eyes.

The safety and efficacy of Xiidra was studied in four placebo-controlled, 12-week clinical trials that included 1,181 people with dry eyes. Participants were evaluated for dry eye signs and symptoms just prior to starting use of the drops, then after two weeks, six weeks and 12 weeks of Xiidra use.

In two of the four studies, participants noticed a significant reduction in dry eye symptoms after using Xiidra for two weeks. In all four studies, participants noticed a larger reduction in dryness symptoms after six weeks and 12 weeks of Xiidra use.

Also, at 12 weeks, a statistically significant reduction in signs of dry eyes was found among Xiidra users compared with participants given a placebo in two of the four studies.

The most common side effects of Xiidra reported in the studies were eye irritation, altered taste sensation and reduced visual acuity, which occurred in 5 to 25 percent of participants.

The recommended dosage for Xiidra, like Restasis, is two applications in each eye per day, approximately 12 hours apart.

4. Steroid Eye Drops

Over the past several years, doctors have discovered the importance of inflammation as a cause of dry eyes. Inflammation frequently causes the redness and burning associated with dry eye disease; but in many cases, it may be present without any visible signs or symptoms at all.

Artificial tears usually do not adequately address these inflammatory changes, and your doctor may recommend steroid eye drops to better manage the underlying inflammation associated with dry eyes.

Often there's no "quick fix" for dry eyes. Follow your eye doctor's instructions and be patient for results from dry eye treatment.

Steroid eye drops are generally used short-term to quickly manage symptoms. They are often used in conjunction with artificial tears and Restasis, as a complement to these more long-term treatment strategies.

While a small amount of the steroid may get absorbed systemically, in the right candidate, the effects of steroid eye drops are generally not noticed beyond the eye. Still, it's important to discuss your medical history with your eye doctor before starting steroid eye drops.

Many different types of steroid drops are available and differ in their potency. Most doctors prefer to start with mild steroids that are quickly degraded inside the eye. In some cases, however, more potent drops are required to address more severe symptoms.

Steroid eye drops can increase the risk of developing high eye pressure or even cataracts if used for extended periods of time. But these risks are low when the drops are used only on a short-term basis for dry eye treatment.

SEE ALSO: How to Use Eye Drops Without Spilling Them All Over Your Face! >

5. Lacrisert

Lacrisert (Bausch + Lomb) is a sterile, slow-release lubricant that is placed under the lower eye where the conjunctiva of the inside of the eyelid meets the conjunctiva of the eyeball (this location is called the inferior cul-de-sac of the eye).

Lacrisert is a solid insert composed of a preservative-free lubricating agent (hydroxypropyl cellulose) that slowly liquefies over time, providing an all-day moistening effect.

For most people with dry eyes, a single Lacrisert is applied once a day. The device has been proven to relieve dryness, burning, watery eyes, foreign body sensation, itching, light sensitivity and blurred vision, according to the company.

Lacrisert typically is recommended for patients with moderate to severe dry eye symptoms, especially if dry eye treatment with artificial tears alone proves unsuccessful.

If improperly placed in the inferior cul-de-sac of the eye, it's possible Lacrisert could cause a corneal abrasion. Also, Lacrisert may cause transient blurred vision, eye discomfort or irritation, matting or stickiness of eyelashes, red eyes and sensitivity to light.

6. Punctal Plugs

Punctal plugs are sometimes used in dry eye treatment to help tears remain on the surface of the eye longer.

This drawing shows the lacrimal glands and tear ducts. A lacrimal plug (or punctal plug) has been inserted into the lower tear duct to keep the eye's moisture from draining away too quickly. Image: Oasis Medical, Inc. [Enlarge]

A punctal plug is a small, sterile device that is inserted into one of the small openings (puncta) of tear drainage ducts that are located in the inner corner of the upper and lower eyelids.

After these openings have been plugged, tears can no longer drain away from the eye through these ducts. In this way the tear film stays intact longer on the surface of the eye, relieving dry eye symptoms.

So where do the tears go? Usually they will simply evaporate from the eye surface without symptoms. But if insertion of punctal plugs causes the eyes to "water," one or more of the plugs can be removed.

7. Meibomian Gland Expression

A very significant percentage of dry eye cases are caused by inadequate oil (meibum) being secreted from meibomian glands located along the margin of the eyelids.

The openings of these glands are near the base of the eyelashes, and if these openings get clogged, the oil that is critical to keeping the tear film from evaporating too quickly cannot do its job. This is called meibomian gland dysfunction (MGD), which leads to a condition called evaporative dry eye.

To treat MGD and evaporative dry eye, your eye doctor may perform an in-office procedure called meibomian gland expression. In this procedure, warm compresses may or may not first be applied to your eyelids; then a forceps-type device is used to squeeze the clogged contents (hardened meibum and possibly other substances) from the meibomian glands.

To fully express the contents of the meibomian glands and get them functioning properly, significant pressure must be applied to the eyelids, which can be uncomfortable. But the results usually are worth putting up with the short-term discomfort of the procedure.

8. Warm Compresses

An alternative (and potentially more comfortable) way to help open clogged meibomian glands to treat dry eyes is to simply apply warm compresses to the closed eyelids to soften the hardened meibum.

Unfortunately, for warm compresses to work well, some researchers say you have to use a compress that can maintain a temperature of 108 degrees Fahrenheit for more than 10 minutes, and the compresses have to be applied for this length of time at least twice a day.

Most people are unable or unwilling to perform this type of dry eye treatment correctly, and shorter and less frequent use of variable-temperature warm compresses typically is ineffective.

9. LipiFlow

The LipiFlow Thermal Pulsation System (TearScience) is an automated, in-office dry eye treatment that combines the best features of warm compress therapy and meibomian gland expression.

Click on the image to watch a video about how LipiFlow works.

The patented device fits onto the eye and also over the eyelids and applies precisely controlled heat to the lids to soften hardened meibum. At the same time, the LipiFlow system applies pulsed pressure to the eyelids to open and express clogged meibomian glands, thereby restoring the correct balance of oils in the tear film to relieve dry eye syndrome.

Lipiflow treatment takes approximately 12 minutes per eye. In a clinical study of the effectiveness of the procedure, most patients (76 percent) reported improvement of their dry eye symptoms within two weeks, and patients also showed improvement in the quality and quantity of meibomian gland secretions and the duration of time their tear film remained on the eye before evaporating. In some cases, however, it can take a few months for improvements to become apparent.

Typically, the beneficial effects of the LipiFlow procedure last one to three years or longer.

Potential side effects from LipiFlow dry eye treatment include corneal abrasion, eye pain, swollen eyelids, eyelid irritation or inflammation, chalazion, transient blurred vision, itching, and red eyes.

LipiFlow dry eye treatment typically is not covered by health insurance. Fees for the procedure can vary from one practitioner to another and tend to range from $700 to $900 per eye.

10. Intense Pulsed Light

For well over a decade, the FDA has approved the use of intense pulsed light (IPL) to treat rosacea on the skin. Rosacea on the skin and eyelid often occur together. Ocular rosacea presents with dilated small blood vessels coursing along the eyelash margin in patients suffering from blepharitis and may contribute to dry eye symptoms.

In IPL treatment, a hand-held device flashes bright light onto the skin. The light is filtered to allow only wavelengths that can be absorbed by the dilated blood vessels. The effect of this treatment may be the resolution of the dilated vessels and associated inflammation.

Many patients experience relief from their dry eye symptoms and become less dependent on artificial tears and other eye drops to control dry eye symptoms after IPL therapy. For this reason, IPL treatment may be well-suited for dry eye patients who don't want to be troubled by the inconvenience of frequent eye drop use.

Patients usually require four to six intense pulsed light treatments, with about one month between each treatment. Typically, the treatments are well-tolerated and are not associated with any down-time. However, prior to the treatment it's important to discuss with your doctor how much time you spend in the sun.

IPL treatment generally is not covered by health insurance or vision insurance and it may not be appropriate for patients with certain skin pigmentations.

11. Nutritional Supplements

Doctors sometimes recommend nutritional supplements as part of a holistic dry eye treatment plan. Studies have found that supplements containing omega-3 fatty acids can decrease dry eye symptoms.

Good sources of omega-3s include cold-water fish such as salmon, sardines, herring and cod. For a vegetarian source of omega-3s, some eye doctors recommend flaxseed oil to relieve dry eye.

Drinking more water can help, too. Mild dehydration often makes dry eye problems worse. This is especially true during hot, dry and windy weather. Simply drinking more water sometimes reduces the symptoms of dry eye syndrome.

12. Home Remedies for Dry Eyes

If you have mild dry eye symptoms, there are several things you can try to get relief before going to the eye doctor:

Blink more frequently. When using a computer, smartphone or other digital device, we tend to blink our eyes less frequently than normal, which can cause or worsen dry eye symptoms. Make a conscious effort to be aware of this, and blink more often when using these devices. Also, perform full blinks, gently squeezing your eyelids together to wash your eyes fully with a fresh layer of tears.

Wraparound-style sunglasses and eyewear with side shields can protect your eyes from moisture-robbing wind and irritating debris. Shown here are Churada sunglasses with removable foam eyecups and Nereus eyewear with removable silicone eyecups. Both can accept prescription lenses and are manufactured by 7eye by Panoptx.

Take frequent breaks during computer use. A good rule of thumb here is to look away from your screen at least every 20 minutes and look at something that is at least 20 feet from your eyes for at least 20 seconds. Some eye care practitioners call this the "20-20-20 rule," and abiding by it can help relieve both dry eyes andcomputer eye strain.

Remove eye makeup thoroughly. Eyeliner and other eye makeup can clog the openings of the meibomian glands at the base of the eyelashes, leading to meibomian gland dysfunction and evaporative dry eye. At the end of the day, be diligent about remove all traces of makeup from your lids and lashes.

Clean your eyelids. When washing your face before bedtime, gently wash your eyelids to remove bacteria that can cause blepharitis and meibomian gland problems that lead to dry eye symptoms. Apply a warm, moist washcloth to your closed lids for a minute or two. Then gently scrub your lids and lashes with a mild cleanser, such as diluted baby shampoo or premoistened eyelid wipes sold in drugstores.

Wear quality sunglasses. When outdoors during the day, always wear sunglasses that block 100 percent of the sun's UV rays. It's best if they feature a wrap-style frame to protect your eyes from wind, dust and other irritants that can cause or worsen dry eye symptoms.

TOP DRY EYE HOT SPOTS

The National Women's Health Resource Center has named the top 100 dry eye hot spots in the United States based on information compiled from the National Oceanic and Atmospheric Administration's Climatic Data Center and the Environmental Protection Agency.

Factors used in the selection process included temperatures, humidity, wind, altitude, pollutants and ocular allergens.

The top 20 U.S. cities named as dry eye hot spots are:

Las Vegas, Nev.
Lubbock, Texas*
El Paso, Texas*
Midland/Odessa, Texas
Dallas/Fort Worth, Texas
Atlanta, Ga.
Salt Lake City, Utah
Phoenix, Ariz.
Amarillo, Texas
Honolulu, Hawaii

Oklahoma City, Okla.
Albuquerque, N.M.
Tucson, Ariz.
Norfolk, Va.
Newark, N.J.
Boston, Mass.
Denver, Colo.
Pittsburgh, Pa.
Bakersfield, Calif.*
Wichita, Kan.*

*Cities were tied for these spots.

Other Dry Eye Treatment Considerations

In addition to the dry eye treatments listed above, your eye doctor may recommend one or more of the following supplemental measures if any of the conditions below apply to you:

Medication adjustment. Many medicines — including antihistamines, antidepressants, birth control pills, certain blood pressure medications and more — can cause or worsen dry eye symptoms. Even over-the-counter (nonprescription) medications for allergies and other conditions can cause dry eyes.

Be sure to discuss all medications you are taking with your eye doctor if you are experiencing dry eye problems. In some cases, adjusting the type and number of medications you are taking may help reduce dry eye symptoms without causing adverse health effects.

However, never discontinue a prescription medication without first discussing the matter with your physician. If your eye doctor feels an adjustment to one of your medications may help relieve dry eye symptoms, he or she can discuss it with your physician (or have you discuss it with your doctor) to see if such a change is possible.

Treating eyelid conditions. If you have blepharitis, meibomian gland dysfunction or other eyelid conditions, these often are associated with dry eye disease and should be addressed as part of your overall dry eye treatment regimen. For example, if you have blepharitis, your eye doctor may recommend use of an antibiotic and/or steroid ointment or eye drop in addition to daily eyelid cleansing with a non-irritating shampoo.

Discontinuing or reducing contact lens wear. If you wear contact lenses, it can be difficult to tell if an underlying dry eye condition is causing contact lens discomfort or if your contact lenses are causing dry eye symptoms. If you wear contacts, it's often best to discontinue wearing them (or perhaps switch to daily disposable contact lenses for part-time wear only) while your dry eye treatment is in progress.

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