Discomfort and burning, redness, photophobia and a foreign body sensation in the eye are the main symptoms of the so-called dry eye syndrome (also known as DES, Dry Eye Syndrome).
This is a widespread eye condition. It has been estimated that over 300 million people worldwide suffer from dry eye syndrome. In Italy, 26% of the population suffers from it. In particular, women over the age of 40 (50%) and in menopause (90%).
What Causes Dry Eye Syndrome
Dry eye syndrome is caused by insufficient production of the lacrimal gland (hypolacrymia) or by the presence of tears of abnormal consistency that evaporate too quickly (dyslacrimation).
Mainly responsible for this alteration (about 80% of cases) is the dysfunction of the Meibomian glands or MGD. The Meibomian gland is responsible for producing the lipid layer of the tears.
When these no longer work properly, they do not produce sufficient oily component in the tear film, and the tears evaporate more quickly. An insufficient or lack of lipid layer can cause tear evaporation up to 16 times faster.
An eye that is not sufficiently lubricated by tears or moistened by a qualitatively altered tear film necessarily faces medium or severe problems that can make the most common daily activities such as working on a computer, reading a smartphone screen, driving at night difficult due to high photosensitivity.
What Triggers Meibomian Gland Dysfunction
The factors that can trigger the dysfunction of the meibomian glands and the consequent hypolacrimation or dyslacrimation are multiple and of different natures:
- presence of repeated allergic conjunctivitis
- typical hormonal imbalances like menopause
- excessive use of eye cosmetics
- prolonged use of contact lenses
- chronic blepharitis
- age (problems arise especially after the age of 50)
- prolonged use of screens (smart phones and PCs)
- prolonged intake of systemic drugs (e.g. antihistamines)
- exposure to air pollution
Treatment Methods and Strategies
Prevention
Prevention is certainly an essential factor to avoid recurring problems caused by dry eye syndrome. Avoid prolonged use of computers and smartphones, always place yourself at a distance of at least 30 centimeters from the video terminals, constantly use protective sunglasses (especially in the case of strong light or wind), and frequently ventilate the rooms where you live and work to guarantee a correct degree of humidity are all useful precautions to avoid dehydration and consequent damages, even severe one, to the cornea.
It is also good to pay attention to your diet by drinking plenty of water and prefer fruit and vegetables, foods rich in vitamins, capable of maintaining the right hydration of the body.
Traditional Treatments
In addition to the prescription of ophthalmic gels and lubricating eye drops to be administered several times a day to restore the aqueous state of the tear film, the most common treatments for treating dry eye syndrome are aimed at restoring the function of the meibomian glands.
Treatments like application of hot compresses on the eyelids, manual cleaning of the glands or eyelid massage, are palliative solutions that do not cure but simply offer temporary relief to the patient. Therefore, their use must be constant and permanent.
The Revolutionary IRPL treatment with Intense Pulsed Light Adjustment
Today, an innovation in the treatment of dry eye syndrome is made up by therapy with Intense Regulated Pulsed Light (IRPL). This revolutionary treatment acts directly on the meibomian glands stimulating their correct function and the production of the fat component essential for the preservation of the tear film.
Durable and in many cases definitive, the treatment is rapid, completely painless and free of contraindications.
Good evening to all. We are here in Dr. Bellone’s office. I flew for four hours but I think the time has come to take care of my eyes and do this intervention which I hope will solve all the problems I have had these last few months living in Fuerteventura (especially with regards to dry eye problems which is another reason that brought me to Dr. Bellone).
We are here to perform a revolutionary treatment for chronic dry eye and we have a patient who came to visit us from abroad. Since he resides in an area of Europe that is in front of Africa, in the middle of the ocean, in a very windy and therefore very dry area, he is a perfect prototype patient to test if indeed this revolutionary treatment will have the desired effects on him.
This is a new treatment that acts on the causal part and is no longer symptomatic of dry eye. This business is worth a few billion dollars so it invests on a good portion of the population.
What are the symptoms of the typical patient suffering from dry eye syndrome?
The last few months have definitely worsened due to the strong light despite the glasses. In addition to leading to the dryness of the eye, it has also caused conjunctivitis several times a month, with itching and an unpleasant sensation.
Therefore, the main symptom is the conjunctivitis because the patient goes to the doctor precisely because he thinks he has a simple conjunctivitis. He feels as if he had sand in the eye but in reality he has dry eye because the tears are inadequate. This is due to environmental factors, intrinsic hormonal factors, age factors or any other factor that causes this disorder which affects millions of people around the world.
A drop of tear of person is composed of an aqueous component, a mucous component and a fat component. The aqueous component is located in the middle of the tear film, that is, leaning against the cornea. There is this mucous component with the tails of the molecules attaching to the corneal epithelium. Finally, on the surface, there is the fat component, which ensures that the tear does not evaporate.
Take two glasses of water. In one, you put a layer of oil on it and the other leave it be. When you come back after three days, the glass of water without oil on it has evaporated while the one with oil has not evaporated. Thus, for a tear to have a good function, it must have a layer of fat on it to protect it. This is the concept behind this revolutionary treatment that acts on the meibomian glands which is scattered in the eyelid. There are about fifty, half in the lower part and half in the upper part. Their function is to produce this fatty substance.
It has been said that if there is not a good fat component of the tear, it tends to evaporate too quickly and the patient has the symptoms mentioned above. This is accompanied by a therapy that is able to restore the fatty substance and with the pulsed light treatment that acts by squeezing, a shock for the meibomian glands, reactivating them and restoring a physiological condition.
The treatment takes place over a few seconds with five flashes per eye that are placed in the lower part of the eyelids. We will position the patient lying down. A gel will be applied on the lower part which will give a sense of freshness, so as to be able to insulate the skin from heat. Though this ray of light is harmless, it is very powerful so it generates heat and the gel will serve as cushion (the last flash on the temple could be slightly more annoying because a nerve passes on that point).
The flash lasts a few milliseconds. The eyes will be closed with special glasses. It is a treatment that has no contraindications or risks, lasts a few seconds and the only caution is that you will not be able to sunbathe for at least 24-36 hours or, in the case of exposure, you will need a protective cream 50.
This is the first treatment. In the brochure that we provide there will be a treatment on day 0, then there is one after 15 days, one after 45 and the seventy-fifth one is optional. The treatments that will give substantial benefits will at least be the first two.
