Dry eye disease, also known as dry eye syndrome or keratoconjunctivitis sicca, is a common condition characterized by insufficient lubrication and moisture on the surface of the eye. It occurs when the eyes do not produce enough tears or when the tears evaporate too quickly, leading to dryness, discomfort, and potential damage to the ocular surface.

What are the symptoms?

A complete examination by one of our corneal specialists is the best way to know for certain if you have this condition. Schedule an exam if you have the following symptoms:

• Pain, burning or scratchy sensation
• Thin, string-like mucus
• Sensitivity to light
• Redness
• A sensation of having a foreign object in your eye
• Difficulty wearing contact lenses
• Difficulty with nighttime driving
• Watery eyes – the body's response to irritation
• Blurred vision or eye fatigue

How is dry eye diagnosed?

At Bascom Palmer's Dry Eye Clinical Service, a specialized service dedicated to the diagnosis, management, and treatment of dry eye syndrome, we understand the impact that dry eye can have on your daily life. Our team of experts is here to provide you with personalized care and relief. We focus on understanding the underlying causes of your dry eye symptoms and developing tailored treatment plans to address your specific needs. Our service is equipped with state-of-the-art diagnostic technologies that allow us to assess the quality and quantity of your tears, evaluate the health of your ocular surface, and identify any contributing factors to your dry eye condition.

To enhance the management of our dry eye patients, we have implemented an advanced and unique patient-centered care model that involves the following steps:

1. Advanced Screening Process: Upon a patient's initial contact with our service, a comprehensive screening process begins. This process aims to identify the severity of the patient's dry eye condition. It typically involves specialized and validated questionnaires that the patients will complete online prior to their screening visit.
   
   
2. Specialized Dry Eye Testing Visits: For patients identified as needing further evaluation, our service offers specialized testing visits. These visits include a comprehensive array of advanced diagnostic tests to assess the ocular surface health.
   
   
3. Virtual Dry Eye Care: To reduce the time it takes for patients with mild and moderate dry eye disease to get an appointment and minimize their waiting time in the clinic, our service offers virtual dry eye care visits.
   
   
4. Complex Ocular Surface Disease Clinical Service: Our complex ocular surface disease clinical service is a specialized service dedicated to the evaluation, diagnosis, and management of challenging and multifaceted ocular surface diseases. These diseases often involve more severe and complicated cases that may not be easily resolved with standard treatments.

The Dry Eye Clinical Service employs artificial intelligence (AI) algorithms to assist in the diagnosis and management of dry eye patients. AI can help analyze the data collected from diagnostic tests, medical histories, and patient-reported symptoms to identify patterns and make more accurate assessments. AI can also aid in the development of personalized treatment plans based on individual patient profiles.

Tests

Dry eye diagnostic tests are used to evaluate the presence, severity, and underlying causes of dry eye syndrome. These tests help us gain a better understanding of the condition and tailor appropriate treatment plans. Some common dry eye diagnostic tests include:

• Schirmer's test: This test measures tear production by placing small strips of filter paper under the lower eyelids to absorb tears over a specified time. The amount of moisture absorbed indicates the quantity of tears produced.

• Tear breakup time (TBUT): TBUT measures the stability of the tear film by assessing how long it takes for the tear film to break up after a blink. Fluorescein dye is used to visualize the tear film, and the time it takes for dry spots or irregularities to appear on the cornea is measured.

• Corneal staining: Fluorescein or lissamine green dyes are used to assess the integrity of the cornea. The dyes highlight areas of the cornea where the epithelial cells have been damaged or compromised due to dryness or other factors.

• Osmolarity testing: This test measures the salt concentration in tears, which can indicate the level of tear film instability and dryness. High tear osmolarity is associated with dry eye syndrome.

• Meibomian gland evaluation: Meibomian gland dysfunction is a common cause of dry eye. Various techniques, such as meibography or expression of the meibomian glands, can be used to assess the structure and function of these glands.

• Tear markers analysis: Some diagnostic tests can evaluate the presence of inflammatory markers in tears, such as matrix metalloproteinases (MMPs) or interleukins. Elevated levels of these markers may indicate underlying inflammation associated with dry eye.

• Tear film lipid layer assessment: These tests evaluate the quality and stability of the oily layer of the tear film, which is crucial for preventing tear evaporation. Techniques such as interferometry or meibography can be used to assess the lipid layer.

• Patient symptom questionnaires: Questionnaires and surveys help gather information about the patient's symptoms, their impact on daily activities, and overall quality of life. They provide valuable subjective data to complement objective test results.

Treatments

Our team of experienced and compassionate healthcare professionals will take the time to listen to your concerns, perform a thorough evaluation, and discuss your treatment options. We offer a range of advanced therapies, including prescription eye drops, in-office procedures, and lifestyle modifications to alleviate your dry eye symptoms and improve your overall eye health. There are various treatment options available for dry eye syndrome, and the choice of treatment depends on the underlying cause, severity of symptoms, and individual patient factors. Some common treatments for dry eye are:

• Artificial Tears: Lubricating eye drops, or artificial tears, are often the first line of treatment for mild to moderate dry eye. They provide temporary relief by supplementing natural tear production and helping to moisturize the ocular surface.

• Prescription Medications: In cases of moderate to severe dry eye, prescription medications may be recommended. These can include anti-inflammatory eye drops, such as corticosteroids, cyclosporine or lifitegrast, which help reduce ocular surface inflammation and improve tear film stability.

• Tear Conservation: Tear conservation techniques aim to minimize tear loss and improve tear retention on the ocular surface. This can involve blocking the tear ducts with punctal plugs, which are small devices inserted into the tear drainage ducts to prevent tears from draining away too quickly.

• Eyelid Hygiene: Proper eyelid hygiene is important, especially for those with meibomian gland dysfunction, a common underlying cause of dry eye. Techniques such as warm compresses, lid scrubs, and gentle massage of the eyelids can help improve the function of the meibomian glands and reduce blockages.

• Autologous Serum Eye Drops: Autologous serum eye drops are a type of eye drop made from a patient's own blood serum. The serum is obtained by separating the liquid portion of the blood (serum) and diluting it with a preservative to create eye drops. These drops can provide beneficial factors, such as growth factors and nutrients, to help promote healing and improve the ocular surface.

• Plasma Rich in Growth Factors (PRGF) Eye Drops: PRGF therapy involves the extraction of a patient's blood, which is then processed to concentrate and activate the platelets. The PRGF is then applied topically to potentially stimulate tissue regeneration and healing of the ocular surface.

• Lifestyle Modifications: Making certain lifestyle changes can help manage dry eye symptoms. These include taking regular breaks from digital device use, maintaining adequate hydration, quitting smoking (which can exacerbate dry eye), and avoiding environmental triggers like dry or dusty conditions.

• Environmental Modifications: Modifying the environment can help alleviate dry eye symptoms. Using a humidifier to add moisture to the air, avoiding direct exposure to fans or air conditioning, and protecting the eyes from wind or drafts with wrap-around glasses can be beneficial.

• Lid margin therapies: These therapies aim to improve the function of the meibomian glands and optimize the quality of the tear film, leading to enhanced ocular comfort and reduced dry eye symptoms.

• Scleral lenses: Scleral lenses are custom-designed contact lenses that rest on the sclera, the white part of the eye. They create a fluid-filled vault over the cornea, providing a protective and therapeutic environment for the ocular surface. These lenses have proven to be a valuable tool in managing various ocular surface conditions, including but not limited to keratoconus or dry eye syndrome.

Resources

In addition to providing exceptional clinical care, we are committed to educating our patients about dry eye syndrome. We believe that informed patients are better able to manage their condition and make informed decisions about their treatment. We will provide you with resources, tips, and guidance to help you understand your condition and optimize your eye care. Whether you have been struggling with dry eye for a long time or have recently noticed symptoms, our dry eye clinical service is here to support you on your journey to better ocular comfort and improved quality of life.

Why Choose Bascom Palmer Eye Institute?

Consistently Excellent Vision Care. U.S. News & World Report ranks Bascom Palmer #1 in the nation for ophthalmology care. Our physicians are not only some of the brightest researchers and renowned eye experts, they’re compassionate caregivers who treat you as an individual.

University-based Medicine. Backed by the University of Miami Health System, we give patients a detailed diagnosis, up-to-the-minute treatment options and highly specialized care. Our doctors and scientists raise the bar on eye care through research, teaching and through sharing knowledge with ophthalmologists worldwide.

Today’s Top Treatments. Your future eye health depends on the treatment you receive today. That’s why we give you access to the most sophisticated treatment methods and technologies available.

Patient-centered Care. Your eye care team is with you every step of the way, from diagnosis to treatment to follow-up care. We work closely with you to resolve your condition or to manage it in the best possible way.