Dry eye

Dry eye is a recurrent reason for consultation in our lives – especially for those with a dry eye over 40. Fortunately, we have an approach to relieve dry eye symptoms.

Dry eye management includes:

• a study of your dry eye profile
• a quantification of the severity of the symptoms you feel
• a complete ophthalmic examination
• Lipiview ®, which makes it possible to measure the meibomian attack as well as the analysis of the dynamics of the blinking.

This approach, in most cases, leads to therapeutic management that provides a satisfactory resolution of your dry eye symptoms.

Symptoms of dry eye include:

• Burning and tingling sensations
• Eye fatigue
• Crying eyes
• A scratching eye
• Redness in the eye
• Itching eyes
• Sensitivity to light
• Vision disorders

Impacts of dry eye include:

• Difficulty performing visual tasks such as
  • reading,
  • watching TV
  • working on screens
  • driving
• Contact lenses intolerance
• Symptoms worsening over the day
• Constant use of eye drops
• Photosensitivity (avoidance of exposure to sunlight)

The “International Dry Eye Workshop” (DEWS, 2007) redefines dry eye as a

“multifactorial tear and ocular surface disease that causes instability of the tear film that can lead to lesions on the ocular surface. It is accompanied by an increase in osmolarity (solute concentration) of the tear film and inflammation of the ocular surface. Neurosensory abnormalities also have a role.”

Eye dryness functionally manifests by a foreign body sensation, burning, tingling, irritation, blurred vision, eye strain, photophobia with often paradoxical reflex tearing.

As a result, dry eye can become painful and a real handicap. Dry eye remains the leading cause of contact lens intolerance, and 50% of contact lens patients report having dry eyes, whereas this prevalence is only 20% in non-contact lens wearers.

The prevalence of dry eye is 9% in patients aged 40 years and older and 15% after 65 years. The percentage of patients treated increases with the ageing of the population. The prevalence of this pathology increases with age. Today, it is more and more frequent.

This dry eye dysfunction can be caused by:

• Ageing
• Hormonal disorders (like menopause)
• Prolonged contact lens wear
• Intensive use of screens (TV, computer, phones)
• Pollution or other environmental factors (dry climate, air conditioning)

TearScience ® – An assessment of dry eye in 3 steps:

1. You describe their symptoms in a quick questionnaire (sensations, disorders).
2. We perform a 3-minute, non-contact, pain-free examination with LipiView ®, the ocular area interferometer, which enables them to observe the tear film and blink dynamics.
3. We then perform a (painless) examination of the patient’s eyelids to evaluate secretions.

After following these steps, we can, therefore, confirm the cause of your dry eye to be:

• Either a lipid deficiency, due to dysfunction of the Meibomian glands (86% of cases)
• An aqueous deficiency, due to dysfunction of the lacrimal glands.

Finally, once we confirm a diagnosis and assess the severity of the impairment, we then propose treatment.

• Dry eye treatment consists of
  • Alocal treatment based on lubricating eye drops which we can combine according to their preferred action
  • Local anti-inflammatory treatment.
  • Depending on the case, we may offer you
    • Corticosteroid eye drops,
    • Nonsteroidal anti-inflammatory drugs,
    • Antibiotics with anti-inflammatory action,
    • Calcineurin inhibitors or a newborn glycyrrhizin, a new molecule available since January 2016 in the form of eye drops,
    • Kéradrop®
  • 1 drop morning and evening for 3 months and whose anti-inflammatory action would be equivalent to dexamethasone without side effects.
• Eyelid hygiene
• Blinking exercises
• We can supplement treatments with two technologies that have proven effectiveness:
  • Lipiflow ®
  • Pulsed Light E-Eye