Dry Eye Clinic
Advanced Dry Eye Treatment in Surrey and Greater Vancouver
At our dry eye clinic we offer a variety of modern in clinic treatment options for patients suffering from dry eye and/or ocular surface disease including
- IPL (Intense Pulsed Light)
- Radiofrequency Treatment
- Meibomian Gland Expression
- Scleral Lenses for Dry Eye
- Amniotic Membrane
- PRP Eye Drops
- Clinical Strength Artificial Tears
- At Home Dry Eye Care Products
Our dry eye clinic is lead by Dr. Shiv Sharma who has many years of experience in the treatment and management of dry eye disease including reviewing research, providing consulting to industry partners, and speaking and educating other clinicians on the latest available treatment options.
What Is Dry Eye Disease?
Dry eye disease or ocular surface disease is a multi-factorial disease which causes irritation, burning, grittiness, pain, and discomfort in the eyes in addition to blurry vision.
There are a variety of different root causes for dry eye disease including:
- Autoimmune conditions like arthritis and, Sjogren’s disease.
- Hormonal changes due to menopause
- Computer , TV, or smartphone use with inadequate blinking
- Nutritional deficiencies including lack of Omega-3 fats (common in vegan and vegetarian patients)
- Inadequate lid hygiene with associated blepharitis or demodex
- Contact lens use
- Post-operatively after cataract surgery, LASIK, PRK, and other ocular surgeries.
- Medications including antidepressants, birth control pills, beta-blockers, antihistamines, and more
How Is Dry Eye Disease Treated?
Radiofrequency Treatment For Dry Eye
Radiofrequency treatment for dry eye is a procedure that uses radio waves to stimulate the production of tears and improve the health of the tear film. It is a non-invasive and painless treatment that takes about 20 minutes to perform.
Radiofrequency treatment is also used in medical aesthetics for skin tightening and wrinkle reduction, patients undergoing the treatment for dry eye can expect wrinkle reduction in and skin tightening around the eyes which will tighten orbital fat and help reduce wrinkles including crowsfeet.
During the procedure, a small device is placed on the skin around the eye. The device uses radiofrequency energy to stimulate the meibomian glands, which are responsible for producing the oily layer of the tear film. The glands are warmed to approximately 40 degrees celsius during the procedure which melts the blocked meibum inside them. The meibum is then expressed by an Optometrist using a cotton swab or a specialized paddle. Radiofrequency treatment is safe for all skin types and can help to reduce dry eye symptoms such as discomfort, redness, and vision problems.
Radiofrequency treatment is non invasive and doesn’t require any downtime. It may be recommended as a treatment option for people with dry eye who have not had success with other treatments, such as artificial tears or ointments. It may also be used in combination with other dry eye treatments to provide additional relief.
What Type Of Radiofrequency Device Do We Use For Dry Eye Disease?
We use the Forma-I by Inmode for our radiofrequency treatment for dry eye disease. Forma-I Is Health Canada approved for the treatment of dry eye disease caused by Meibomian Gland Dysfunction.
Can Meibomian Glands Be Restored?
Chronic meibomian gland dysfunction may cause dropout of glands as shown in the “before” photo below. Fortunately, after 5 sessions of radiofrequency with gland expression and dietary supplementation with high dose Omega 3s we were able to restore gland structure as seen in the “after” photo.
IPL (Intense Pulsed Light) For Dry Eye
IPL stands for “intense pulsed light.” It is a type of treatment that uses a specialized device to emit bursts of high-intensity light energy to the surface of the skin. IPL has been used in dermatology for many years as a non-invasive way to reduce fine lines, wrinkles, and skin appearance
In the context of dry eye disease, IPL can be used to help improve the health and function of the tear film by reducing inflammation and opening up the Meibomian Glands prior to expression of blockages performed in our clinic.
IPL treatment for dry eye is a non-invasive procedure that takes approximately 20 minutes to perform. 3-5 sessions of IPL followed by expression of meibum are typically most effective for treatment of dry eye disease.
An effective IPL treatment cannot be performed on all skin types and cannot be performed if your skin has recently been tanned, for more information please schedule an appointment with us.
What Type Of IPL Do We Use For Dry Eye?
We use the Inmode Lumecca system for our IPL treatments. Inmode is an award winning medical device company that has been a leader in medical aesthetics for several years.
IPL Can Reduce Inflammation In Dry Eye Patients
The intense pulsed light energy treats the small blood vessels in the skin that transport inflammatory cells and proteins to the ocular surface. See the before and after photos below
Before and After IPL Treatment (Eyelids)
Before and After IPL Treatment (Cornea)
Meibomian Gland Expression
Meibomian glands are located in the eyelids and they secrete an oily substance called meibum, which helps to lubricate and protect the eyes by preventing tears from evaporating too quickly. However, if the meibomian glands become clogged or blocked (inspissated), the meibum can’t be secreted properly, which can lead to a number of problems including dry eyes, irritation, and inflammation.
Expressing the meibomian glands involves applying pressure to the eyelids in order to release any trapped meibum. At Optiview Eye Clinic we express blocked meibum during every dry eye treatment. The procedure is comfortable and is typically done after instillation of one drop of topical anesthetic.
Expressing the meibomian glands is important because it helps to remove blocked/inspissated meibum and allows the meibum to flow freely on to the eye surface which promotes a healthy tear film and ocular surface. It can also help to alleviate symptoms associated with dry eyes, such as redness, irritation, and discomfort.
Dry Eye Assessment
Dry Eye Assessment is a key part of not only determining the cause of dry eye symptoms but also in establishing an appropriate treatment program and tracking results. Our Dry Eye Assessment is typically scheduled outside your regular eye exam and includes the following:
- Dry eye questionnaire and case History and nutritional overview
- NIBUT (non-invasive tear break up time)
- Tear height measurement
- Lipid layer analysis
- Meibomian gland imaging (infrared)
- Eyelid margin imaging
- Eye redness analysis
- FBUT (fluorescein tear break up time)
- Ocular surface imaging
- Complete report with assessment and plan
The video below shows software based fluorescein tear break up analysis in a patient with Sjogren’s disease.