THE VALUE OF GÕOD EYESIGHT
DRY EYE
Dry Eye Syndrome is a common condition caused by inadequate lubrication of the eye’s surface (cornea and conjunctiva), either due to insufficient tear production or poor tear quality. It results in discomfort such as itching, a gritty sensation, eye fatigue, blurred vision, and in severe cases, corneal damage. As a chronic, multifactorial disease influenced by environmental, hormonal, toxic, and autoimmune factors, it requires a thorough examination to tailor the most individualized and effective treatment. While there is no definitive cure, many options are available to improve the patient’s quality of life and alleviate symptoms.
“At visiõnclínic, we provide comprehensive care for dry eyes, employing the latest diagnostic technology and expert professionals to offer the best treatment for each case.”
Dr. Josep Torras Sanvicens
Ophthalmologist specializing in cornea and dry eye
FIRST VISIT AND EYE EXAMINATION
To diagnose dry eye, we conduct a complete eye examination to identify the factors contributing most to your symptoms and determine the best treatment plan. It is crucial that a cornea specialist performs the diagnosis and recommends the appropriate treatment. Schedule a consultation without obligation.
WHY CHOOSE VISIÕNCLÍNIC+ FOR DRY EYE TREATMENT?
PROVEN EXPERTISE
Dr. Josep Torras, a leading authority in corneal, conjunctival, and tear film pathologies, is part of the Instituto Clínic de Oftalmología (ICOF) at Clínic Barcelona. He and his team treat over 1,500 patients with dry eye annually, including approximately 200 new cases. Some of which involve Sjögren’s syndrome, an autoimmune disorder with systemic manifestations.
MULTIDISCIPLINARY TEAM
At visiõnclínic, we collaborate with a team of ophthalmologists and optometrists to provide comprehensive visual health care. As part of the Hospital Clínic Group, we maintain close contact with professionals in other relevant medical fields. This multidisciplinary approach ensures high-quality, personalized care, particularly for patients with dry eye associated with Sjögren’s syndrome, through collaboration with specialists from the Autoimmune Diseases Service at Clínic Barcelona.
CUTTING-EDGE TECHNOLOGY
Our clinic utilizes the latest diagnostic and treatment technologies for dry eye pathologies. We employ objective clinical methods for the qualitative and quantitative measurement of tears and detailed studies of the Meibomian glands, enhancing treatment precision and follow-up effectiveness. For surgical needs, our facility features advanced corneal surgery options, including refractive surgery and femtosecond laser technology.
LEADERS IN RESEARCH
Research is a cornerstone of the visiõnclínic team. Our professionals participate in numerous multicenter clinical trials across Spain and Europe, contributing to the development of new medications. Currently, we are studying treatments such as topical cyclosporine and others that address neurosensory dysfunction in dry eye. Our findings are regularly published in leading scientific journals.
EVIDENCE-BASED TREATMENTS
All the treatments we offer at visiõnclínic and, in this case, the different options to end the symptoms of dry eye, are based on published scientific evidence on the subject. The health of our patients comes first and, for this reason and to guarantee their safety, we base our care on published scientific evidence.
WHAT IS DRY EYE SYNDROME?
Dry Eye Syndrome, also known as keratoconjunctivitis sicca, is a multifactorial disease of the ocular surface, characterized by a disrupted tear film, causing discomfort and visual disturbances. It leads to inflammation of the ocular surface and neurosensory issues.
The underlying cause is often the poor function of the Meibomian glands in the eyelids, which secrete lipids to hydrate and lubricate the eyes, preventing the evaporation of the tear film that covers and protects the eye.
Dry Eye is a very common condition, though often underdiagnosed. Its prevalence ranges from 10% to 20% of the population, affecting an estimated 5 million people in Spain and 100 million worldwide. It is significantly more common in women and tends to increase with age.
TYPES OF DRY EYE
AQUADEFICIENT DRY EYE
Aquadeficient dry eye is characterized by reduced production of aqueous tears from the lacrimal gland. Symptoms typically include burning, itching, irritation, a foreign body sensation, and blurred vision. It may occur independently or as a side effect of medications such as antihistamines, beta-blockers, antidepressants, anxiolytics, etc.
In some cases, it is associated with Sjögren’s Syndrome, a systemic autoimmune disease marked by the destruction of exocrine glands throughout the body. This condition commonly affects the eyes, mouth, digestive system, respiratory system, skin, and genitourinary system. Diagnosis involves identifying dry eye in conjunction with dry mouth, specific antibodies, reduced salivary secretion, and salivary gland inflammation. It can also be linked to other autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, and Hashimoto’s thyroiditis.
EVAPORATIVE DRY EYE
Evaporative dry eye is a type of dry eye that occurs when there is a reduction in the lipid layer of the tear film or increased evaporation from the exposed ocular surface. The lipid layer is crucial for preventing excessive tear evaporation and maintaining lubrication.
Causes may include:
– Meibomian Gland Dysfunction (MGD), associated with conditions like rosacea, psoriasis, or seborrheic dermatitis.
– Blinking or Lid Disorders, such as facial paralysis, proptosis (forward displacement of the eyeball), hyperthyroidism, or reduced blink frequency.
– Vitamin A Deficiency, exposure to preservatives in topical medications, contact lens-related changes, or allergic conjunctivitis.
Evaporative dry eye is more prevalent than aquadeficient dry eye, though both types often overlap, with one being more dominant.
DIAGNOSIS OF DRY EYE
Diagnosing dry eye syndrome can be challenging due to its generic symptoms, which may be mistaken for other conditions like allergies or simply aging. A comprehensive assessment of symptoms, tear composition, and Meibomian gland function is essential for accurate diagnosis.
Key diagnostic tests include:
– Blinking Frequency and Tear Production/Quality Analysis
– Meibography: Imaging of the Meibomian glands to evaluate their condition.
– Eyelid Margin Study.
– Staining Tests: Using fluorescein or lissamine green to assess the cornea’s condition and sensitivity.
– Surface Biopsy.
– Blood Tests: To rule out associated immune diseases.
DRY EYE TREATMENTS
Treatment for dry eye syndrome depends on its severity and type, and should always be supervised by an ophthalmologist to ensure efficacy and manage potential side effects. Eye dry treatment typically follows a stepwise approach.
TREATMENT OF AQUADEFICIENT DRY EYE
FIRST LEVEL: LIFESTYLE AND SPECIFIC MEASURES
Avoid exposure to tobacco smoke, high heating or air conditioning, protect eyes from wind and avoid driving with open windows, blink frequently when reading or using a computer, lubricate eyes during air travel, manage systemic medications (antidepressants, anxiolytics, antihistamines, beta-blockers, diuretics, contraceptives, anti-estrogens, etc.), and maintain a balanced diet and stay hydrated.
SECOND LEVEL: USE OF ARTIFICIAL TEARS
Administer tear substitutes, such as eye drops with components like hyaluronic acid to increase tear volume and retention, especially if the conjunctiva and cornea are stressed and altered by dryness. Preferably use preservative-free formulations.
Topical anti-inflammatories (steroids, cyclosporine, etc.) are also recommended to address the typical eye dry‘s inflammation in the conjunctiva and cornea.
THIRD LEVEL: BLOOD PLASMA-DERIVED EYE DROPS
One option is to use autologous serum eye drops or growth factors derived from platelets obtained from the patient’s own blood (Platelet-Rich Plasma or PRP). Thanks to the growth factors and anti-inflammatory properties contained in these eye drops, they are beneficial for repairing the cornea and conjunctiva damaged by dry eye.
FOURTH LEVEL: ADVANCED THERAPIES
This includes temporary punctal occlusion, amniotic membrane transplantation, and the use of therapeutic soft or scleral contact lenses (PROSE).
TREATMENT OF EVAPORATIVE DRY EYE
The treatment of evaporative dry eye involves ocular hygiene with heat, massage, and daily cleaning, the use of artificial tears with lipid components, and the administration of oral Doxycycline or topical Azithromycin. New therapies for the evaporative dry eye treatment such as intense pulsed light (IPL) therapy and thermal pulsation systems (Lipiflow) are still under study, awaiting more published research and randomized clinical trials.
CANAL VISIÕNCLÍNIC
Our professionals explain the latest advances in diagnosis and treatment of dry eye.
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