What are the symptoms of Dry Eyes due to Blepharitis and Meibomian Gland Dysfunction?
Chronic tearing, and watery eyes, ocular irritation (gritty/sandy feeling in eyes). Blurry vision, especially when reading, working on the computer, watching TV, or in the evening. You may also have crusty eyelids in the morning. (Your eyes do not have to feel “dry” to have dry eye.)
If my eyes are dry, why do they water so much?
There are two types of tears – an oily tear (produced in the meibomian glands) and a watery tear (produced in the lacrimal glands). As we age, the oily portion of the tear (meibum) gets thicker and can block the tear ducts in the eyelids. When the oily part of the tears are not present, the eye makes too much of the watery tear – and your eyes water. We need the oily part of the tears to reduce evaporation of the watery tears and to keep the eye comfortable and for good vision.
How can I treat this condition?
Dry eyes due to Blepharitis and Meibomian Gland Dysfunction are chronic conditions and often require long-term therapy.
DERM (Dry Eye Relief Mask)
Instructions. Heat DERM mask in the microwave for 20-24 seconds. (Heating times vary per microwave) The mask should be hot, but not enough to scald the skin. You can also moisten the white liner, which will enhance the “moist” heat. The heat should last for 7-10 minutes. We also recommend squeezing exercises. After using the heating mask, open your eyes for 1 second, close for 1 second and squeeze for 1 second for a total of 30 seconds. You may have a brief period of blurry vision after these techniques – this is normal, and it means the treatment is working.
Artificial Tears (Oasis, Systane Ultra, Systane Balance, Optive, Optive Refresh Advanced)
Instructions. Use between 2-5 times a day. Use when your eyes feel dry or irritated and before reading and close work. Wait 1-2 minutes before reading, as these drops may momentarily blur your vision.
Prednisolone/ Lotemax / Durezol
This is a steroid drop, which will help reduce the inflammation (swelling) of your eyelids and make your eyes feel better. Use one drop 3 times a day for two weeks, then 2 times a day for 2 weeks.
Restasis
Instructions. Use one drop in the morning and one drop at night in each eye. Each vial should last at least one day. It is OK to recap and re-use the drops until the vial is empty. This drop may sting and burn on instillation. Keep in refrigerator to reduce the stinging. This medicine needs 8-12 weeks for maximum effect.
Omega 3 Fatty Acids (Fish Oil Pills)
Omega 3 Fatty Acids are beneficial for the entire body. Fish oil has been shown to lower cholesterol, decrease arthritis, improve the health of the skin, maintain brain function, and reduce the risk for macular degeneration. Fish oil is excellent at improving the quality of the tear film and reducing dry eyes. Start with 1 fish oil pill (800-1200 mg) with lunch and one with dinner. (Fish oil is better absorbed in the body when eaten with some fat in your meal.) You can increase the dose to 2 pills with lunch and 2 with dinner after 2-3 weeks.
We recommend PRN Dry Eye Omega.
Ointment at night
- (Erythromycin or Bacitracin – mild antibiotics and lubricants)
- (Tobradex – mild combination steroid and antibiotic ointment)
- (Refresh PM, Systane ointment – over-the counter non-medicated lubricant)
Instructions. Pull down your lower lid and place the ointment into the “pocket” created between the eyelid and the eye. Use the ointment immediately before going to sleep – this will blur your vision. You can rinse your eyes with lukewarm water in the morning if your eyes are still blurry.
Lid Scrubs (OCuSoft foam, Tea Tree oil, Hypochlor)
Instructions. After using the warm compress, squeeze some foam on your clean fingers and gently rub your lower eyelids and then the closed upper eyelids. Leave the foam on the lids for 1 minute, then rinse off with tap water.
Doxycycline
This is an antibiotic used to reduce inflammation of the eyelids.
It is OK to take with food or on an empty stomach, but avoid taking with milk products, or antacids, such as Rolaids, Tums or Pepto Bismol. Avoid prolonged sun exposure on this medicine as there is an increased risk for sunburn. Do not take if you may be pregnant.
Lacrisert
This is a small tablet, which slowly dissolves and releases tears all day. You can use the applicator or a clean finger to place the tablet in the lower “pocket” between your eyelid and your eyeball. You can use the lacrisert tablets in the morning and it will provide lubrication all day. Some people like to use lacrisert before bedtime to prevent overnight ocular dryness.
Warm Compresses in the Morning and Evening
Instructions. Take a clean washcloth and heat it with warm to hot water. (Do not burn yourself.) Ring out the water and fold the washcloth in half. Lay the compress over your closed eyes for 2-3 minutes, reheat the washcloth, and repeat for 2-3 minutes. Do this at least twice a day (morning and night.)
