Diagnosis of Dry Eyes
The proper diagnosis of dry eyes requires a thorough dry eye examination and dry eye consultation. The Eye Center doctors and the staff will take time to carefully review your medical history, eye history and eye conditions including any medications that you are taking. Please be sure to tell us about all of the medications you take or have taken recently, including not only the ones prescribed, but also those that you may have purchased on your own at the pharmacy.
Next, we will evaluate your tear production by using a specialized microscopic technique to observe the height of the tear film as well as using a clinical test called a Schirmer Test that allows us to actually measure the rate at which you produce natural tears. We may also use specially formulated dyes such as Fluorescein, Lissamine and Rose Bengal to help investigate the functioning of the various layers of the tear film as well as the underlying surface of the eye. This is not uncomfortable and will not interfere with your vision.
From this information, we will be able to make a proper diagnosis as to the particular cause of your dry eye syndrome and prescribe the necessary tear substitutes, eye drops and/or other options to help restore your tear film back to normal and make you more comfortable.
Treatment of Dry Eyes
Depending on the severity and the cause of your dry eyes, we may recommend a number of different treatment options.
If you have mild or even moderate dry eyes, the first course of treatment may be to use unpreserved artificial tears. The selection of the exact type of artificial tear drop is important. Depending on the nature of your tear film deficiency, we may have you use a specific type of artificial tear that has different characteristics in terms of salt content and viscosity. For patients with severe dry eyes we offer serum tears at our office for purchase. The process for serum tears includes drawing a tube of your blood, centrifuging it to separate the red blood cells from the plasma and finally mixing the plasma with artificial tears. Many patients with severe dry eyes find relief and improvement in their symptoms.
Warm, moist compresses to the upper and lower eyelids may help stimulate tear production. You can use a warm, moist wash cloths or we have reusable moist heat eye compresses available for purchase at our office.
In addition there may be some environmental factors that you need to alter to make you more comfortable such as how and where you are exposed to heat ducts or fans blowing as well as attempting to keep the areas that you spend a great deal of time in at a proper humidity level. Use of a humidifier is recommended.
Sometimes, if the oily layer of the tear film is deficient, we may suggest that you increase your consumption of oily fish, fish oil supplements or even take flax seed oil. Most likely you will be asked to drink plenty of water.
In instances where these approaches do not help relieve your dry eye symptoms, the doctors may suggest the insertion of tiny punctal plugs that will slow down or even stop the drainage of tears from the eye. These plugs are easily and comfortably placed in the Lacrimal Puncta in your eyelids. Initially you may have a temporary dissolving plug put in place to see if your dry eye symptoms are actually responsive to this treatment. If the results are good, it may be necessary to place a more permanent type of plug in the Lacrimal Puncta to affect a long-term solution.
For patients with moderate to severe dry eyes who may have already tried using artificial tear eye drops and punctal plugs without relief, the prescription of Restasis or Xiidra eye drops with or without the other treatments can often help alleviate your symptoms.
Even with the above treatment options, there are some patients that may not respond as well as we would like due to some underlying low-grade inflammatory or infectious process. In these cases it may be necessary to also prescribe an oral antibiotic such as doxycycline or an anti-inflammatory eye drop such as a steroid eye drop.
As you can see, the diagnosis and treatment of dry eyes is complex and requires patience and persistence on the part of the eye doctor and the patient. With careful diagnosis and a systematic therapeutic approach, sufferers of dry eye syndrome can most often experience considerable improvement.
The Eye Center is conveniently located for patients suffering from dry eyes or dry eye syndrome or needing an eye examination for dry eye from Denver, Aurora, Arvada, Wheat Ridge, Westminster, Commerce City, Englewood, Littleton, Sheridan, Cherry Hills Village, Northglenn, Broomfield and Greenwood Village. If you, a family member or friend, would like to learn more about dry eye treatment or schedule a dry eye consultation, please call The Eye Center in Denver, Colorado at 303-777-5455