Patients' complaints of burning, dry and red eyes are often passed off as either nothing significant or a side bar of dry eyes. Many eye doctors simply recommend artificial tears and hope for the best. When these same individuals return with contact lens discomfort and related symptoms, they are more difficult to deal with.
While dry eyes are in many cases the etiology of the symptoms, the cure is more complex. The underlying reason for the dry eye condition must be determined in order to fully correct the problem. An often overlooked cause is Meibomian Gland Dysfunction (MGD). The Meibomian gland is responsible for secreting a very important component of the human tear, the oil component. Oil protects the tears from immediately evaporating. Without this important component, the tears would evaporate immediately, and the eye would be painfully dry. Therefore, in order to relieve an individual's symptoms and, in some cases increase contact lens comfort and wear, this lid condition must be remediated.
The first step is to clean off the lids. This is best done by aggressive lid hygiene using diluted baby shampoo and a Q tip to perform lids scrubs on a regular basis. This should be followed by warm compresses and lid massage to express collected and trapped mucous and debris in the glands. Following the lids scrubs Azasite, a prescription medication, should be instilled as this new antibiotic performs two functions. The first is bactericidal and the second is anti-inflammatory. It rehabilitates the lid margins. Additionally, omega III supplements should be taken as they will increase tear production. The patient must be told that this effect will take 2-3 months to begin and they must take the omega III regularly. Artificial tears should also be used on a regular basis as these will bridge the gap until the other therapies take hold. Finally, Restasis can be prescribed in certain cases to further increase the tear production. As with other medications, proper instructions must be given.
Avoiding contact lens wear during the initial phases of this therapy is recommended and can be modified on case by case basis. Of course, proper lens fit, hygiene and wearing schedules are a must.
Since MGD is a chronic condition, regular follow ups are recommended and regimen modification may occur.
This article is written by Dr. Jay Stockman, contributing consultant to Vision Update . Dr. Jay Stockman has co-managed a significant number of refractive surgery patients. Advise, and medical questions can be directed to New York Vision Associates