☆ Can dry eye disease be cured?
Mild dry eye can be cured with the implementation of the following treatment measures (ocular environmental intervention, computer work environment intervention, topical application of artificial tears or topical medications to promote tear production, and discontinuation of medications that cause dry eye to worsen).
Moderate to severe dry eye cannot be cured and requires regular follow-up to change or adjust the treatment plan and to monitor structural damage to the eye to prevent more serious complications. Dong Nuo, Ocular Surface and Corneal Diseases, Xiamen Eye Center, Xiamen University
☆ Treatment options for dry eye disease
In addition to interventions for dry eye triggers, the frequency of artificial tears can be increased as the severity of dry eye increases, but frequent eye medication should take into account your own lifestyle and operational proficiency, and you can apply emulsions or gels. If you apply more than 4-6 times a day, preservative-free artificial tears should be preferred. If symptoms and ocular dryness do not resolve with the above measures, or if you are unable or unwilling to take medication as often as needed, or in combination with the aforementioned risk factors (e.g., prolonged contact lens wearers, post-myopia surgery, post-cataract surgery, dryness syndrome, rheumatoid arthritis), consider tear punctal embolization. Eyeglass shields, humidifiers, and wet rooms are optional non-invasive treatments, but these treatments are not readily accepted because of their cosmetic impact.
Anti-inflammatory treatment for dry eye disease is increasingly valued by physicians, the most commonly used of which is glucocorticoids, which can relieve ocular irritation and reduce damage to the corneal epithelium, but the application of hormonal eye drops should pay attention to the frequency and duration of application to avoid complications such as secondary glaucoma and cataract. 0.05% cyclosporine drops have been shown to increase tear secretion and relieve ocular irritation, but domestic The concentration of cyclosporine produced in China is high and irritating, and most patients with dry eye disease cannot tolerate it.
☆ Misconceptions about artificial tear therapy
The traditional treatment for dry eye disease is mainly the use of artificial tears. However, long-term use of artificial tears containing preservatives can cause damage to the ocular surface.
Artificial tears can only briefly relieve eye discomfort, and after 5 minutes of dabbing, 80% of the artificial tears flow into the nasal cavity and throat through the tear dots.
In addition, using artificial tears more than 6 times a day will dilute natural tears, damage the tear film, cause eye irritation, disrupt the reflex arc of tears, and even aggravate the dry eye symptoms mentioned above.
☆ Long-term efficacy of tear punctal embolization
Preserving the patient’s own natural tear secretion and keeping it on the surface of the eye for a longer period of time is currently an important treatment for dry eye, especially for moderate to severe dry eye, and tear punctal embolization is currently one of the most commonly used methods.
Lacrimal punctal embolization is performed by partially closing the tear drainage ducts in order to increase the natural tearing of the ocular surface and its lubricating effect. This treatment is effective in providing long-term relief of dry eye symptoms. For many people lacrimal embolization can effectively reduce, or even eliminate, the use of artificial tears.
The procedure involves the temporary or permanent placement of a sesame-sized plug in the tear duct, a process that takes only a few minutes. Since natural tears enter the nose and throat through the tear dots and tear ducts, blocking the tear outflow channels allows natural tears to remain on the surface of the eye for a longer period of time.
☆ Types of tear punctal plugs
There are two types of tear dots plugs: biodegradable and permanent, and two types of surgical procedures: lower tear dots implantation and upper and lower tear dots implantation at the same time.
Collagen tear dots plugs eventually dissolve, and it is possible to know whether these plugs can serve to preserve tears and how well they are tolerated by patients.
Silicone tear plugs are considered permanent, but they are also easy to remove.
The SmartPlug is the latest medical device used to close the tear dots or tear ducts and increase natural tear storage on the ocular surface. The design of the SmartPlug allows the product to be used on all patients with different tear spot sizes. It is made of a soft, thermodynamic, water-sensitive propionic acid polymer.
SmartPlug Tear Plug Insertion Procedure and Method
After surface anesthesia, the physician gently begins to insert the SmartPlug into the tear duct.
After implantation, the SmartPlug adapts to the lacrimal ducts and tear ducts through an automatic adjustment process that shortens the length and thickens the diameter.
The plug eventually becomes a soft gel-like plug with virtually no exposure.
This non-exposed design and special material minimizes tissue irritation.
The SmartPlug tear duct plug will not come out by rubbing the eye. (It can be flushed out by the physician using a salt solution for tear flushing).
● Implantation of the SmartPlug tear duct plug is a simple procedure that takes only a short time, and it provides long-lasting relief from dry eye.
What should I expect after tear punctal embolization?
Tear punctal embolization can reduce symptoms and can reduce the amount of artificial tears and improve the patient’s signs and symptoms. However, for patients with severe dry eye, it may take a longer time to improve.
In addition, maintaining good working and living habits is an effective means of preventing dry eye.
1. Blink more often.
Blinking is a protective neurological reflex action, and the tear layer allows tears to coat the corneal and conjunctival surfaces evenly to keep them moist and not dry. Once the number of blinks is reduced, the amount of tears is directly reduced and the tear film exposed to the air will evaporate quickly and lose its protective power over the eye.
When operating a computer, driving, or reading for long periods of time with your eyes, remind yourself not to concentrate too much and take some time to blink. Most people generally blink once every five seconds, about 20 times per minute.
2. Pay attention to eye hygiene.
You should pay attention to eye hygiene, wash your hands regularly, don’t rub your eyes with your hands, take a break from using your eyes for an hour or so, close your eyes and look into the distance. For patients with oily secretions, debris, and shedding on the eyelids, pay attention to eyelid hygiene.
3. Attention to those who use computers for long periods of time.
People who work with computers for a long time, especially young people, should pay attention to timely treatment of dry eye symptoms, reduce the time spent using computers, and avoid using computers continuously for a long time.
Work posture and distance is also very important, try to maintain a distance of 60 centimeters, adjust an appropriate posture, so that the line of sight can be maintained down about 30 degrees, such an angle can make the neck muscles relax, and make the eye surface exposed to the air to minimize the area.
4. Pay attention to diet
Those who are engaged in computer operation for a long time should eat more fresh vegetables and fruits, and increase the intake of vitamin A, B1, C and E.
To prevent dry cornea, dry eyes, vision loss, and even night blindness, you should eat more foods rich in vitamin A, such as soy products, fish, milk, walnuts, green vegetables, cabbage, hollow vegetables, tomatoes and fresh fruits.
Vitamin C can effectively inhibit cell oxidation. The main role of vitamin E is to: lower cholesterol, remove waste from the body and prevent cataracts. Vitamin B1 can nourish the nerves, and green leafy vegetables contain a large amount of vitamin B1.
You can properly drink green tea and chrysanthemum tea every day, because the lipopolysaccharide in tea can improve the hematopoietic function of the muscle, and tea also has the function of preventing radiation damage.
Some foods and drinks can dehydrate your eyes and body, chocolate, cola. Coffee and tea both contain caffeine, and caffeine can consume the body’s water, in order to keep the body has enough water, we need to drink more water (if possible at least six glasses of water a day).
5. Wear frame glasses
It is true that contact lenses can greatly improve one’s appearance, but it brings not less pain, and dry eyes are one of them. Wearing contact lenses for a long time will reduce tear production, so people who wear contact lenses will always feel dry eyes.
To prevent dry eyes, we advocate wearing glasses on windy days, goggles when swimming, and sunglasses when going out.
6. Use air conditioning as little as possible and stay less in rooms with low humidity.
In addition to regulating the temperature, air conditioners also dehumidify the air, reducing the amount of moisture in the air. In this dry environment, the evaporation rate of the tear film increases, which tends to make the eyes dry and astringent. The dry climate of winter is the most common season for dry eyes.
In hot weather, it is important to open the windows regularly to ventilate the air conditioner, or place an air humidifier in the room. Keep the humidity in the room between 30% – 50%.
Avoid direct eye contact with hair dryers, hot dryers, electric fans
7. Order artificial tears as needed. Be careful not to use artificial tears too often, preferably no more than 6 times a day. If more than 6 times a day, the normal tear film will be washed away, thus aggravating the symptoms.
7. Check the medications you are using.
Some medications that can make your eyes feel increasingly dry, such as antihistamines, nasal decongestants, sedatives and antidepressants, you need to let your doctor know what you are taking, because some of these drugs can aggravate dry eye symptoms.
Use of eye gels. Eye ointments have a long retention time in the eye, but they are greasy and do not feel “hygienic” to the patient, have significant blurred vision, and are poorly accepted. Ophthalmic gel is a more desirable preparation at present. Ophthalmic gel has a longer retention time in the eye, is hygienic, and has a cooling sensation when used in drops, is easy to use, and has good acceptability.
8. Treatment of lid gland dysfunction do eyelid cleaning and hot compresses. It is best to do this once in the morning because the lid glands secrete the most at night and retain the most secretions, so a hot compress can help the retained secretions to drain.
Doing a blepharoplasty: A medical professional will massage the blepharoplasty gland in the direction of discharge to push out those secretions that cannot be discharged by applying heat. If you feel it is effective, you can do it once a week for a month.
9. Chinese medicine treatment.
Generally, Chinese herbal medicine (Qiju Dihuang Wan), which is used internally or topically to clear heat and nourish yin, and to produce fluid and moisten dryness, can relieve dry eyes.
☆ Our dry eye clinic
Xiamen Eye Center affiliated to Xiamen University has now opened the first dry eye specialist clinic in Fujian Province after long-term preparatory work, and has established a standardized, series of tests and diagnostic procedures for dry eye disease. microscopy (including tear morphology and BUT time measurement), corneal topography, blot cytology examination, etc. At the same time, the province is the first to introduce anterior segment OCT made by Zeiss of Germany and KowaDR-1 digital dry eye tester made in Japan, which can achieve non-contact dynamic observation of natural tears and implement individualized treatment measures for different dry eye patients.
Under the leadership of the internationally renowned ocular surface expert Professor Zuguo Liu and the discipline leader Director Guoping Wu, we have integrated the current domestic and foreign advanced dry eye treatment methods and developed effective measures for dry eye treatment in our hospital, including pharmacological and non-pharmacological treatment measures, which have achieved remarkable clinical efficacy and look forward to bringing you visual brightness and comfort.
Tel: Outpatient 0592-2109791; Ward: 0592-2109838; 0592-2109839