Dry Eyes is extremely common and can be caused by a wide range of factors. Our eye doctor in Clarksville provides world-class treatment for dry eyes that's fully tailored to your specific situation. We diagnose and assess your eyes using the latest technology combined with good old-fashioned visual exams, questions, and all around great patient care that will get to the core cause of your condition. For example, is your blinking effective? Do you blink often enough? Are your tear ducts lined up properly?
Our eye doctor will also conduct an in-depth assessment of indicators for other diseases and health problems which might be contributing factors to your dry eyes.
We then develop a personalized treatment plan based on what we find, and ongoing based on what's working for you.
The Dry Eye Exam
On every patient questionnaire, we ask if you are suffering from any of the typical symptoms of dry eyes. Do your eyes feel gritty? Sore? Do you feel like something is in your eye or that you just don't seem to have any tears?
If you report symptoms of dry eye, or appear to exhibit those symptoms, then we recommend beginning the dry eye exam process, which is quick, easy, and painless.
Tear Lab ― What Exactly Goes into Healthy Tears?
The first thing we want to check is the stability of the tear-film. We use TearLab to test the osmolarity of your tears― that is, the relative concentrations of salts, water, and lipids (fatty oils). These lipids are produced by the meibomian glands. Most cases of dry eyes occur where there is a problem with these glands. They could be blocked, atrophied, or otherwise damaged. If your tears evaporate too quickly (which causes burning), it's usually caused by a lack of these lipids.
A strong imbalance between the osmolarity of one eye vs. the other is a strong indication that someone has dry eye disease.
Phenol Red Thread Test
Depending on the results of the TearLab, our Clarksville Dry Eye specialist will also want to see if the overall volume of tears could be the problem. In some cases, the meibomian glands are producing the lipids needed for lubrication, but there just isn't enough of the aqueous layer (this means tears) to spread it around effectively.
In order to test this, our optometrist will place a thin piece of red thread draped over the eyes for a few seconds in order to measure how wet the eye gets and comparing the differential between the eyes.
Another tool in the arsenal of our dry eyes experts is InflammaDry, a specialized diagnostic tool which measures whether or not a patient has elevated levels of MMP-9 in their tears from the inner lining of the lower eyelid. MMP-9 is a protein which indicates inflammation, which is fairly common for anyone suffering from dry eyes.
Our eye doctor will typically prescribe steroids in order to get the eye inflammation under control.
Sometimes, a visual inspection of the eyes isn't enough. Since a problem with the meibomian glands (which produce those essential lubricating lipids) is most often to blame for chronic dry eyes, it's important to get the best digital image of the meibomian glands possible. That's why our dry eye specialists use LipiScan, which takes a high-resolution digital image of the lower AND upper glands.
Such imaging tells us a lot about how healthy your oil glands are. Are they healthy? Blocked? Dilating? Atrophied? Gunky? Is the oil cloudy or clear? ― cloudy oil indicates the presence of a bacterial infection which thickens the oils until they simply are no longer effective. This we can usually clear up with antibiotics.
Fluorescein Dye Test
Our dry eye doctor will also test your tear breakup time. Sometimes, tears don't last long enough to work effectively. In order to test this, we use a fluorescein orange dye to test the breakup time (as well as any other corneal diseases, conditions, or foreign bodies). Using a small blotting paper, the optometrist will lightly touch your eye. As you blink, the dye spreads and gently coats the tear film covering the cornea. Using a blue light (the dye is orange), problems will be revealed to the eye doctor as green.
All the findings are evaluated by our dry eye specialist, and a custom treatment plan is developed. Depending on cause and severity this can include:
- Omega-3 supplements
- Changes in habits and lifestyle
- Artificial Tears
- Anti-inflammatory drops
- Medicated drops such as Restasis or Xydra
- Blephex for blepharitis
- LipiFlow for chronic Meibomian Gland Disorder (MGD)