Dry Eye

Dry Eye Syndrome Denver

Most people will tell you that they have no problem shedding tears when they are upset but a small percentage of the population are unable to create tears. These people suffer from a condition known as Dry Eye. Dry eye is a condition that causes your eyes to feel as though there is an irritant present. The cause for this irritation is that the eyes are not producing the required fluid that needs to be covering the eyes. Normal healthy eyes are being continuously cover by a thin tear film. This film allows people to be able to see more clearly. Treatment of dry eyes aims to restore a more normal tear film to minimize your dryness, blurred vision and irritations.

Persistent irritations to one or both of your eyes might be a cause of dry eye(s). A decreased tolerance to contact lenses is a common symptom as well. Symptoms do vary from patient to patient when it comes to dry eyes. Most patients say they suffer from the feeling that there is something in their eye that is unobtainable to get out. If you have any of the following symptoms listed, you may be suffering from dry eye.

  • Scratchy and burning feeling in the eyes
  • Heightened sensitivity to smoke or wind in the eyes
  • Light sensitivity
  • Decreased vision
  • Tired eyes from reading or trying to focus on an object
  • Becoming immune to contact lenses

Dry eye can be caused by multiple different variables. The quality of the tear film is directly related to the quality of tears that your eyes are producing. The tear film is made up of three separate layers: Oils containing lipids act as the outer layer, water is the thickest layer and is in the middle, and the last layer is the inner layer of Mucus which allows the tears to spread evenly over the eye. The lack of tear production can also lead to Dry Eyes in the later stages of life. Decreases in tear production may be a result of a LASIK procedure. Having trouble blinking may cause your eyes to dry. Environmental factors such as wind, pollution, sun, and dry air inside homes or offices definitely affect the eyes, but especially in a patient with dry eyes. Patients usually do not produce enough natural tears to offset these and other environmental irritants.

If you feel as though you may be suffering from Dry Eye you may seek to have your eyes tested. Your eye doctor will ask you a series of questions about your lifestyle, work and home environments, work requirements, and even nutrition habits so that they can begin to make a general assessment. Often he or she will measure your tear volume or tear production using one of several tests. These tests may include the “Schimers Tear Test” which a strip is placed under your eyelids to see how much tears are absorbed. Other tests include a series of dyes to determine the surface conditions of your eyes and to determine how long it takes for your eyes to evaporate the tears. These tests determine the degree of dryness and the location of the dryness on the eyes.

Traditional treatment for dry eye may include lubricating eye drops, thicker eye ointments, punctal plugs, or even suggesting lifestyle changes. Traditional treatments often treat the symptoms and some patients do get relief from these simple treatments. However, the traditional treatment does not address abnormal tear quality or composition, health of the ocular surface and lacrimal gland, or underlying disease process. Everyday studies are being done to help improve the lives of people with dry eyes.


It's time for a revolutionary approach for Dry Eye treatment.

If you've been suffering with this painful condition- or think you may have it – we can determine the cause of your symptoms and apply therapy appropriate to your specific needs that may make your daily discomfort a thing of the past. We also offer the new LipiFlow® thermal® pulsation treatment, if you suffer from evaporative Dry Eye you can now get this treatment in our office. With just one treatment, you may experience sustained relief.

LipiFlow® is designed to provide relief, so you can get on with your life.

Evaporative Dry Eye can be a thing of the past – with LipiFlow®

If you're ready to get started, call us to schedule an assessment appointment. Reduce your dependence on drops of maybe even eliminate them. Goodbye, daily therapies. Hello LipiFlow®


How do we determine if you are suffering from Dry Eye?

At Hines Sight we will conduct a series of evaluations and determine the likely cause of your Dry Eye symptoms.

First, you will complete a Dry Eye lifestyle questionnaire – this brief assessment allows us to understand how your eyes feel on a daily basis

If the questionnaire indicates symptoms beyond mild, we will proceed with LipiView® – This technology allows Dr. Hines to evaluate the lipid (oil) layer on your eye.


Here's how it works:

LipiView® takes extremely detailed images of your eye's tear film.

The procedure is non-invasive, can be preformed in our office, and takes less than five minutes. If you've ever had a comprehensive eye exam, LipiView® will feel similar. The tear film can be clearly seen as an array of colors that are reflected when a light source is directed toward the front surface of the eye. Readings are instantly calculated and displayed on the LipiView® monitor.

Typically, our physician will perform a Meibomain gland evaluation.

LipiView® is an imaging device that is intended for use by a physician in adult patients to capture images of the tear film. The following conditions may affect the assessment of a patient's tear film using the LipiView®

  • Use of ophthalmic drops such as artificial tear lubricants, ointments and medications. Patients should not use oil-based ophthalmic drops (e.g., Soothe®, Restasis®) for at least 12 hours prior to LipiView® assessment. Patients should not use ointments for at least 24 hours prior to LipView® use.
  • Soft or rigid contact lens wear – patients should remove contact lenses at least 4 hours prior to device use.
  • Use of oil-based facial cosmetics around the eye.
  • Eye rubbing.
  • Recent swimming in a chlorinated pool. Patients should not swim for at least 12 hours prior to LipiView® use.
  • Any ocular surface condition that affects the stability of the tear film. These conditions include disease, dystrophy, trauma, scarring, surgery, or abnormality.

Following these evaluations, we will then determine whether or not you have Evaporative Dry Eye or Meibomian Glad Dysfunction and if you are a candidate for LipiFlow®.

If you've been unable to receive long-lasting relief from the over-the-counter or prescription remedies you've tried, it may be because they haven't been targeting the primary cause of your condition - the blockage of your Meibornian glands located in your eyelids. Perhaps you've tried things like eye drops and warm compresses, which many find inconvenient and only offer short-term relief.

The LipiFlow® Thermal Pulsation System, by TearScience®, is a significant technological shift managing Evaporative Dry Eye. With a single procedure, applying a combination of directed heat and pulsatile pressure, many find a single treatment effective in relieving the blockage of their Meilbomian glands. The LipiFlow® System is intended for the application of localized heat and pressure therapy in adult patients with Evaporative Dry Eye. Opening the blocked glands may allow your body to resume its natural production of tear film oil.

NO OTHER DRY EYE THERAPIES DO WHAT THE PULSATION SYSTEM CAN!

LipiFlow ® treatment is clinically proven with sustained results. In a clinical study about 79% of patients reported an improvement in overall dry symptoms after a single LipiFlow® treatment. Depending on the severity of your specific condition and your response to treatment, you may need to repeat the LipiFlow® treatment periodically as your symptoms return over time.

With LipiFlow® - and regular checks and ongoing care to monitor your progress - let us help you experience Dry Eye relief like never before.

Goodbye Evaporative Dry Eye. Get started today!

If you're ready to kick Evaporative Dry Eye, all it takes is a phone call to get started. Make an evaluation appointment with Hines Sight and determine if you're a candidate for LipiFlow®.

What actually happens during a LipiFlow® treatment?

The LipiFlow® Activator (a disposable eyepiece) is inserted under your lower and upper eyelid and is shaped to prevent contact with your cornea. Once in place, you simply recline in the treatment chair and experience the 12-minute procedure. In a clinical study, 32% of patients reported no discomfort and 48% of patients noted awareness of pressure without pain during the LipiFlow® treatment. The average total Meilbomian gland score for patients who received a single LipiFlow® treatment more than doubled from 6.3 + 3.5 glands at the baseline to 16.7 + 8.7 glands at 4 weeks. As previously mentioned, 79% of patients treated with LipiFlow® in the clinical study reported an improvement in overall Dry Eye symptoms.

Why is LipiFlow® superior to other Dry Eye Therapies?

If you're a moderate to severe Evaporative Dry Eye sufferer, life can seem like a constant battle to alleviate symptoms. Those drops and warm compresses become a regular ritual. You've tried blinking exercises and lid scrubs. And you avoid wearing contact lenses and extended sessions in from of the computer.

If this sounds familiar, you may need LipiFlow®. The breakthrough treatment for evaporative Dry Eye is LipiFlow®:

  • The first and only treatment that addresses the cause of Evaporative Dry Eye at the source, allowing your eyelid glands to produce the oils required for a healthy tear film. Other treatments – warm compresses and drops – just give you temporary symptomatic relief.
  • The only treatment that can give you sustained relief through improved gland function. Other treatments require daily, and some times even hourly attention to keep your Evaporated Dry Eye under control.
  • A powerful step in managing Dry Eye disease, providing symptom relief and helping stop the cycle of Dry Eye deterioration and worsening symptoms.

Where can I find detailed safety information about LipiFlow®?

CLICK HERE FOR PATIENT SAFETY INFORMATION

Get immediate, lasting Dry Eye relief – Start Now!

Are you ready to experience the relief of LipiFlow®? Get started by completing our questionnaire.

PATIENT SAFETY INFORMATION

The LipiFlow® System is used by your doctor for the application of localized heat and pressure therapy in adult patients wit chronic cystic conditions of the eyelids, including Meibomain Gland Dysfunction (MGD), also known as Evaporative Dry Eye or lipid deficiency dry eye.

The LipiFlow® System is a prescription device. Federal law restricts the device to sale by or on the order of a licensed doctor. You are not a candidate for LipiFlow® if you have experienced any of the following conditions within the last 3 months: eye surgery; eye injury; Herpes of the eye or eyelid; or history of chronic eye infection, eye inflammation, eyelid irregularity or eye surface irregularity.

Tell your doctor if you have a history of eye allergies, eyelid inflammation, systemic disease that causes dry eye, or are taking medications known to cause dryness. The device may not fit all eyes, such as small eyelids anatomy. In addition, the treatment procedure may loosen previously inserted punctual plugs, which may worsen dye eye symptoms.

Possible adverse events that may occur as a result of the treatment procedure include, but are not limited to the onset of or increase in: eyelid or eye pain requiring discontinuation of the treatment procedure; redness and/or swelling of the eyelid or eye surface; irritation of the eye surface; inflammation of the glands in the eyelid, stye in the eyelid, slight worsening of eyelid gland blockage, and eye symptoms of dryness, redness, burning sensation, eye fatigue, hazy or blurred vision, and sensitivity to light. Potential serious adverse events that are not anticipated because the device is designed to prevent occurrence include: thermal injury of the eye or eyelid, physical pressure-induced injury to the eyelid, and eye surface infection.

The LipiView® Ocular Surface interferometer is an eye imaging device used by your doctor in adult patients to take digital pictures or images of the tears on the surface of the eye, known as the tear film, called specular (interferometric) observations. Using the LipiView® Interferometer is a prescription device. Federal law restricts the device to sell by or on the order of a licensed doctor.

Prior to taking images of your tear film, advise your doctor if you have used eye drops recently; worn contact lenses; used oil-based cosmetics around your eye; rubbed your eye; recently swam in a chlorinated pool; or are aware of any condition that affects your eye surface and the stability of your tears. These conditions may affect the imaging assessment of your tear film.



Carolyn N

How did suffering from Evaporative Dry Eye impact your life?

It was horribly uncomfortable – a feeling like my eyes were scratched. I had some light sensitivity; I couldn't wear my contacts much. It was uncomfortable when I was outside, especially if it was windy. Sometimes I couldn't drive, I couldn't read. I was continually putting drops in. I just had so many problems with my eyes, it was brutal. I have a high tolerance to pain, but it was a constant nuisance at best. I was just miserable.

What other kinds of treatments had you tried?

I had punctal plugs, which helped some. I used warm compresses, I used just about every kind of drop.

What was the LipiFlow treatment like? Was there any pain or discomfort?

No. I just sat back in a chair and they put these things on my eyes and I sat there and talked to the nurse for a little while and that was it. I could certainly feel the heat but it was nothing painful.

After the LipiFlow treatment, when did you start feeling relief?

I would say within a few days; it was a gradual thing. But it didn't take more then a few days until I could tell a big difference.

What has been the difference since the LipiFlow treatment?

Massive. It has made a huge difference. I use drops once in a blue moon. I can wear my contacts. I usually don't wear them everyday, but I certainly can wear them and have them in all day long; that was something that I wasn't able to do. I'm able to walk outside on a windy day, sit in front of the computer, do my sewing. It's very exciting. This has made a huge, huge difference.

How did the treatment compare to your expectations?

It's been better then I expected. This has been almost the best.


Elaine H

How did suffering from Evaporative Dry Eye impact your life?

I had trouble keeping my eyes open because of the burning and the pain. I wore goggles most of the time; they kept air from coming into my eyes. I used Braille talking books since I couldn't read in the evening. I had trouble driving. I tried to keep doing what I could but I was just miserable. It was debilitating.

What other kinds of treatments had you tried?

At the end of day I would close my eyes and put hot compresses on. I tried pretty much everything. One eye doctor said I had dry eye and just try some over-the-counter stuff. Then I got a prescription for Doxycycline; I took that for about six months and it didn't help. Then I had punctal plugs, which seemed to help for about a week.

What were your expectations of the LipiFlow treatment?

They weren't that high because nothing helped me before. But I was willing to try it because I was pretty desperate. I had already done the old-fashioned method where the doctor just pushes really hard on your eyelids to open up the oil glands. It's quite painful.

What was the LipiFlow procedure like?

There was some discomfort; there wasn't any pain. Compared to the other treatment it was like going from 15th-century medical treatment to 20thcentury.

How soon after the treatment did you start feeling the effects?

Right away. Within a day I would cry. I hadn't been able to actually cry for years. I was able to stop wearing the goggles unless it was windy. It was like day and night. Before this little gizmo, the only time I had relief from pain was when my eyes were shut and the compresses were on them. I've had a new job for the last six months and it requires more time on a computer. I couldn't have done that before.

Elaine H.
Physician's Notes

Pre-treatment

  • first seen in 2007, patient reported severe suffering for the past 4-5 years; problems were very complex and included constant severe pain, severe dryness, tearing, constant redness, headaches, fatigue, itching, blurred vision and difficulty reading
  • patient reports using treatments including Restasis; punctal plugs; lacriserts; doxycycline; trazadone; warm compresses; many eye drops including TheraTears, Soothe and Simalasin; belladonna; salagen; flaxseed oil; fish oils; choline supplements; herbal medicines; acupuncture and humidifiers
  • patient forced to wear swim goggles 95% or more of the time, and blink constantly which caused headaches
  • evaluation revealed only 2 minimally functional secreting meibomian glands on each lower lid, out of 24 on each; a diagnosis of severe meibomian gland dysfunction was made

Immediately post-treatment

  • patient reports no pain, and in fact a pleasant and soothing effect during the treatment
  • exam results show 7 glands open on each lid

One month post-treatment

  • exam results show 8 glands now open on the right eye, 7 on the left
  • patient reports at least 80% improvement in all symptoms; no longer has to wear goggles in the house and can go outside without them; no longer blinks constantly and headaches have resolved; states she can not believe the results, given her 5 years of pain and suffering

One year post-treatment

  • exam results show 9 glands open on each eye
  • tear film stability, redness, lid swelling and all other symptoms remain remarkably improved or resolved
  • patient reports she can read books, only wears goggles under severe conditions and remains much improved

Nancy S

How did suffering from Evaporative Dry Eye impact your life?

I really can't see without glasses or contacts. I do public relations, I'm a spokesperson, I'm on TV. I was always worried that the day I was on TV would be the day my dry eye would act up. In general, it was a very dry and irritating

– this gritty, annoying feeling like you've been out in a windstorm and there is something in your eye that you can't get out.

What other kinds of treatments had you tried?

My doctor was very cautious about drops, because you can get dependent on them – but you want to use them all the time. I was constantly having to do hot compresses. Even throughout the day at my office, I would put a washcloth in the microwave. It was three times a day with drops plus several times a day with the compresses. Oh, and there were lid scrubs too, every day.

What were your expectations of the LipiFlow treatment?

I was a little apprehensive. I'm very sensitive about people touching my eyes; I wasn't sure about the idea of having a heated disc even temporarily in my eye.

What was the LipiFlow procedure like?

It wasn't nearly as bad as I thought. Especially when you're used to having

something in your eye all the time. It didn't hurt at all, just a little uncomfortable. But no pain whatsoever; it was really very easy.

How soon after the treatment did you start feeling the effects?

Immediately. That was about two years ago, and I do not have problems today.

The only thing that I'm doing is hot compresses in the shower because I'm in the habit. I haven't done the drops since I had the treatment.

What follow-up have you had recently?

I probably haven't seen my eye doctor in about a year. It's probably time for my check-up.

Nancy S.
Physician's Notes

Pre-treatment

  • first seen in 1988, patient reported severe difficulties due to dryness; there was corneal scarring as the result of wearing contact lenses with the dryness; diagnosis of meibomian gland dysfunction
  • in 1991, lid swelling, redness and other symptoms developed from the meibomian gland problems; warm compresses and gland scrubs were instituted
  • in 1994, home treatment was unable to control the problem; redness, lid swelling, severe itching, dryness, etc. returned even more acutely, exacerbated by air travel
  • problems from MGD continued; symptoms were general controlled, with 1 or 2 yearly episodes of increasing dryness, redness and difficulty with lenses
  • in 2007, despite home therapy, evaluation revealed only 2 functional secreting meibomian glands on the right lower lid and 1 on the left, out of 24 on each; tear film stability time was 9 for the right eye and 10 for the left,

Immediately post-treatment

  • patient finds treatment of thermodynamic heat and pulsative pressure comfortablez
  • exam results find treatment to have been effective; approximately 10 glands
on each lid have opened

One week post-treatment

  • exam results show 9 glands now open on the right eye, 13 on the left
  • patient reports significant improvement in eye comfort and redness

15 months post-treatment

  • exam results show 9 glands open on each eye
  • tear film stability, redness, lid swelling and all other symptoms remain remarkably improved or resolved
  • patient reports that treatment has resolved her problems and that her eyes felt better than any time she can remember; the chart of the past 21 years confirms her statement

Ricky H

How did suffering from Evaporative Dry Eye impact your life?

By the end of the day wearing contact lenses, my eyes were uncomfortable. Pretty much every evening I used some kind of eye drop to try to ease the burning and the discomfort. I think that I was probably in the middle range; I wasn't miserable, but I was living with this discomfort for many years. Then one of my eyes started watering pretty regularly. That was the one symptom that was most disruptive.

What other kinds of treatments had you tried?

The drops were just meant to help alleviate the discomfort, not really treat the dry eye. My doctor suggested it would be smart to use warm compresses and then do a scrub on the inner parts of the eyelids, to help keep the discomfort down a little bit. He also suggested some blinking exercises, which I did for a while and then stopped doing.

How did you get diagnosed?

I go annually to the eye doctor and at some point way back when he probably said, "How are your eyes feeling?" and I said, "They're tired." He told me I had dry eye, like so many people. That was the reason my eyes were tired and hurt at the end of the day.

How have your eyes been since the LipiFlow treatment?

My eyes have definitely improved. I can leave my contact lenses in longer, and it's more comfortable. I'm not as desperate to get them out at the end of the day. I still use the warm compresses; I have done that religiously since the day my doctor told me to do it. A year after the treatment, I realized that I hadn't needed to put eye drops in at the end of the day and my eye hasn't been dripping. And it sort of hit me that I actually had improved. I was very struck by this – I hadn't been focusing on my eyes and had gone back to my life.

Ricky H.
Physician's Notes

Pre-treatment

  • first seen in 1985, patient doing well but reported that eyes were very sensitive
  • in 1986, noted 75% obstruction of meibomian glands
  • the problems with Meibomian Gland Dysfunction continued – reflected in increasing dryness, redness and difficulties with lenses
  • in 1994, advised that warm compresses and blinking were mandatory, not only for wearing contact lenses but also to avoid redness, burning and recurrent episodes of conjunctivitis
  • punctal plugs were somewhat but not totally helpful
  • in 2008, despite home therapy, evaluation revealed only 4 functional secreting meibomian glands on each lower lid; tear film stability time was 10 seconds for each eye,

One week post-treatment

  • exam results show 11 glands now open on the right eye, 7 on the left
  • patient reports improvement on day 1, not the rest of the week; she summarized it as "surprising improvement"

One month post-treatment

  • exam results show 10 glands open on the right eye, 13 on the left
  • tear film stability for each eye is 20 seconds,
  • patient reported small improvement; physician counsels that symptoms may not improve for some time because of long-term tissue changes

15 months post-treatment

  • exam results show 10 glands open on each eye
  • tear film stability remains at A+ level
  • patient reports that treatment had been "like a delayed reaction" – noted there was no more tearing, and other symptoms including aching had resolved


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