This device measures particle concentration of tears. It is an objective non-invasive tear test. It can be high is the water or oil component is deficient. Hyperosmolarity drives inflammation. Getting to neutrality is the goal for “homeostasis”.
Detects presence of MMP-9, matrix metalloproteinase 9, an inflammatory marker of dry eye disease.
Specialized dyes (Fluorescein, Rose Bengal, and Lissamine) highlight damaged cells on the cornea, conjunctiva, and lid margin to aid.
The eyelid margin can harbor staphylococcus, allergic toxins, biofilm, and even mites creating inflammation and subsequent immune reaction in the cornea.
Your eye lids are the windshield wipers for the cornea and ocular surface. If your lids don’t come together at a regular rate, your tears can evaporate or a gap can be left causing exposure leading to blurry vision and discomfort, especially during sleep.
Advanced imaging, meibomography, is needed to directly image the 30-40 glands in your upper and 30-40 glands in the lower lids. Meibomian Gland Dysfunction (MGD) accounts for 86% of dry eye. Often these glands are obstructed but they can also simply produce poor quality oil due to nutrition, medication use, incomplete blinking, or systemic disease. Gland loss, like oral gum loss, can occur if care and maintenance aren’t instituted. We can measure your gland loss and initiate treatment to prevent future loss.
All dry eye is inflammatory but some dry eye is associated with more inflammation due to systemic disease, environment, or lifestyle.
The Oculus 5 tells the story of your ocular surface and chronic dry eyes. The comprehensive imaging assists us with developing a team strategy to understand treatments that may benefit your chronic condition.
If local inflammation control is not sufficient, lab testing might be indicated if you have dry mouth, fatigue, and joint pain.
The aqueous tear film reflects function of your lacrimal gland and forms the ‘tear lake’. The tear lake is measurable. The aqueous is the largest component of the three layers of your ocular surface layer.
The oily layer prevents evaporation of your tears in between blinks. Oil deficiency accounts for 86% of dry eye and usually means clogged meibomian glands. Partial blinking or decreased frequency of blinking as in electronic device us or Parkinson’s disease are common risk factors.
Ocular allergy can occur without systemic disease. Redness, itching, runny eyes are symptoms. We can test for 60 common allergens in Arizona that cause allergic conjunctivitis, your Allergist can test for systemic allergens.
Autoimmune, Sjogren’s, Rosacea, Parkinson’s, stress, lack of sleep can drive systemic disease. A careful medical history, ocular surgery and medication history is needed.
Medications such as diuretics used for blood pressure (hydrochlorothiazide, lasix), allergy medications (Zyrtec, Allegra, Claritin), acne medication (isotretoin), SSRI’s or selective serotonin reuptake inhibitors (Prozac), anti-depressants (Lexapro,Effexor), anti-seizure medication (Keppra), and antihistamines (Benedryl, fexofenandine), hormone therapy can cause dry eye
The Speed II score is a metric of your chronic eye condition and how you are progressing day to day. The calculated sum is a non-invasive test that helps us determine the ocular surface homeostasis or equilibrium. We use multiple metrics to drive treatment.
Nutrition and an anti-inflammatory diet are key to helping reestablish ocular surface equilibrium and improved meibum quality.
Detects presence of MMP-9, matrix metalloproteinase 9, an inflammatory marker of dry eye disease.
The great equalizer. The great stabilizer. Great for patients with rosacea, lid margin redness and MGD/dry eye.
Our technique will address the upper and lower lids with protection of your eye surface with laser grade eye shields. IPL is anti-inflammatory, anti-microbial (kills bacteria) and pro-metabolic (photobiomodulation: stimulates healing and regeneration). Treatment is based on your Fitzpatrick skin typing and is performed in 4 treatment sessions 3 weeks apart.
A home handheld device that exfoliates the lid margin, dimishes toxins, and improve oil production. You will be taught how to use this.
An in-office procedure that exfoliates the lid margin, diminishes toxins, and improves oil production. This is a complimentary treatment done in conjunction with lipiflow or IPL. It can also be done separately.
The gold standard in meibum deep cleaning and expression therapy. It is the only automated therapy that supplies internal regulated heat and external compression and evacuation of the meibomian glands.
All dry eye is inflammatory but some dry eye is associated with more inflammation due to systemic disease, environment, or lifestyle.
Several classes of drops are novel: they represent new technology for patients under our care for ocular surface disease. There are anti-inflammatory, ocular surface production stimulating, stem cell, and evaporative loss are utilized depending on testing.
A cryopreserved amniotic membrane (cAM) promotes corneal healing, heals persistent corneal defects, regenerates nerves, reduces nerve pain in LASIK patients, and decreases severe dry eye symptoms. This is an in office procedure well tolerated for 2-5 days. We will obtain a prior authorization if it is clinically indicated.
The aqueous tear film reflects function of your lacrimal gland and forms the ‘tear lake’. The tear lake is measurable. The aqueous is the largest component of the three layers of your ocular surface layer.
Punctal plugs are generally a later treatment or a temporizing treatment. We are less likely to plug the tear drainage system if there is inflammation floating within the tears to attack sensitive eye structures.
They resemble sunglasses but have an inner gasket that prevents air flow and hidden side pockets within the temple that provide insertion of moisture pockets to create humidity. This is useful for post LASIK eye pain, Sjogren’s patients, Bell’s Palsy, and allergy sufferers.
We recommend a thermal mask to deliver moist heat (104° F) for a minimum of 10 minutes every day as “lid maintenance”. Home remedies, like a moist bag of rice or a hot potato, don’t provide a safe and even temperature for the delicate eye lid skin. We need to adopt this regimen daily to keep stagnation out of the glands.
Is washing our face with soap and water sufficient to keep our eyelashes clean?
We ALL need a strong enough daily cleanser to remove the bacteria and toxins (biofilm) which build up (like tarter on the teeth) on the eyelid margin. Biofilm blocks egress of oil and promotes inflammation.
For patients with incomplete eyelid closure, sleep goggles create moisture inside the goggle to prevent the corneal surface from drying. Eye seal goggles also keep out light to allow deeper sleep. Clear goggles are also available.
Stress drives inflammation. Because dry eye is a chronic inflammatory disease, it is important to adopt stress reduction tools including exercise, and nutrition, and hydration.
Multiple studies link dry eye to poor sleep. Prior to Edison’s invention of the light bulb, our forefathers slept 11 hours each day, average sleep in the US is 7 hours or less each day. Put the device away for sleep, another room is ideal.
Exercise not only increases our endorphins but exercise may also improve our blinking since we aren’t generally staring at a computer screen…
Whether you have dry eye or macular degeneration, we should all give more credence to “patient heal thyself.” Food is medicine. We should avoid processed sugar, processed flour, processed meat and alcohol (a dehydrator). What we eat and drink impacts our health—we should eat more greens, avoid “seed oils” and drink lots of water while adopting a new food pyramid.
Would you blow dry your eyes? Review the environment impacting your eyes—computer use, work vents, home vents where you sleep, humidity, car vents, overhead fans, sleep apnea machines and make micro changes.
Electronic device use has transformed our blinking frequency and rate from complete to incomplete to partial blinking. Partial blinking cause ocular surface exposure to evaporation loss, stagnation of oil and biofilm build up.
Do you drink enough water each day? Try the hydration calculator. At a minimum, drink ½ your body weight in pounds in ounces. So if you weigh 150 pounds, drink a minimum of 75 ounces.
The cosmetic industry is not “eye friendly”. Forty (40%) of cells die from exposure to cosmetics, even if nonirritating. Loss of lashes maybe a sign of systemic disease like mites growing in the lash root or a byproduct of the toxins in eye makeup.
Migraine headaches and trigeminal neuralgia can involve the Trigeminal or 5th cranial nerve which innervates both the dura (lining of the brain) and the ocular surface. Research is underway to determine if addressing the dry eye might decrease the severity and frequency of the Migraine and TGN.
Global Retina Institute accepts the following insurance:
Questions? Call our office.
