I. What is dry eye?
Dry eye is a disease with multiple causes of tear film and ocular surface damage, which can lead to ocular discomfort, visual impairment and tear film instability, and subtle damage to the ocular surface, accompanied by high osmolarity of tears and inflammatory response.
Second, who are more likely to get dry eye disease?
1, computer workers. Staring at the fluorescent screen for a long time, lack of normal blinking.
2, menopause, pregnancy, lactation and oral contraceptive women. Due to changes in hormone levels can produce dry eye symptoms.
3. Contact lens wearers. Contact lenses are floating on the tears, wearing contact lenses will accelerate the evaporation of tears.
4. Three quarters of people over the age of 65 have dry eye syndrome.
5, drivers, stay up late workers;
6, some disease factors. For example, rheumatoid arthritis, diabetes, thyroid abnormalities, asthma and lupus erythematosus; long-term systemic oral antidepressants, hypotensive drugs for patients.
7, living or working environment: with air conditioning, smoke, higher temperature or drier air.
8, a long time to use a certain eye drops, because eye drops generally contain preservatives, these preservatives on the eye surface epithelial cell damage can also cause damage to the tear film, but also easy to form dry eye.
In recent years, the trend of dry eye disease is younger. This is mainly due to the fact that in modern life, young people work and play more and more in contact with TV and computer, facing fluorescent screens for a long time, lacking the right time to blink or let the eyes rest, which affects the tear secretion of both eyes, resulting in dry eye has moved from old age to adolescence.
Third, how do I know if I have dry eye?
If you have one of the following symptoms, then you should be alert.
1.Sense of dryness
2.Vision fatigue
3.Foreign body sensation
4.Burning sensation
5.Sticking feeling
6.Itchiness
7.Tingling sensation
8, photophobia
9.Redness of eyes
10.Sense of eye swelling
When you visit us, we will ask you to fill out a self-assessment questionnaire. In addition to examining your eyes, the doctor will also do some special tests for you, mainly the following
1.Tear film break-up time (BUT): to observe the stability of the tear film;
2, Schirmmer test: also known as the tear secretion test, mainly to observe the amount of tear secretion;
3.Sodium fluorescein (corneal activity staining) or Lissamine green, Bengal red staining (conjunctival activity staining), to observe the ocular surface cell damage;
4.TEAR LAB tear osmolarity measurement;
The doctor will make the correct diagnosis based on the above patient’s symptoms and medical history and the results of the eye examination.
Which type of dry eye do you belong to?
Generally, there are two types of dry eye: lack of tear secretion and excessive tear evaporation. According to the results of our clinical outpatient dry eye patients’ etiology analysis, they can also be classified as
1, environmental and occupational factors caused by dry eye (mostly computer workers, young and middle-aged people are more common);
2, sex hormone imbalance (mostly middle-aged and elderly women);
3, lid gland dysfunction (mostly middle-aged men, rosacea and abnormal skin lipid metabolism);
4. Nerve conduction disorders (mostly in patients after various eye surgeries, such as keratoconus surgery, cataract surgery, glaucoma surgery and corneal transplantation; patients taking long-term antidepressants, antihistamines, diuretics, beta-blockers and other systemic drugs);
5.Dry syndrome with systemic autoimmune disease (such as rheumatoid arthritis);
6, various other causes of dry eye.
V. How to carry out the standard treatment of dry eye?
Because of the complex etiology of dry eye, the pathogenesis of dry eye is not yet fully understood, therefore, it is not yet possible to carry out cause-specific treatment.
The general treatment measures are as follows.
1.Elimination of causative factors and balanced diet: avoid long-term use of computers, stay up late at night, etc., and supplement omega-3 unsaturated fatty acids.
2. Physical therapy: hot compresses, eyelid massage, cleansing, wearing wet room lenses, etc. Mainly for patients with dry eyes with lid gland dysfunction.
3, artificial tears, moderate to severe dry eye if long-term use, should try to use artificial tears without preservatives;
4.Tear punctal embolization: tear punctal embolization can effectively preserve the patient’s own tears, simple, safe, reversible and effective;
5, anti-inflammatory treatment: moderate to severe dry eye can be short-term use of low concentrations of hormones or immunosuppressants, to reduce the immune inflammation caused by dry eye;
6.Severe dry eye can be treated with autologous serum;
7.Surgery: used for severe dry eye, when other methods are ineffective. Autologous free submandibular gland transplantation instead of lacrimal gland secretion fluid, but the surgery is complicated and costly, with some efficacy;
8.Other: Lid gland dysfunction type dry eye can be treated with oral or local application of tetracycline antibiotics. For some patients with systemic dryness syndrome, you can also apply Chinese medicine appropriately for systemic conditioning;
What is the treatment of dry eye by tear punctal embolization?
Because the tears enter the nasal cavity and throat through the tear dots and tear ducts, so blocking the tear outflow channels can make the tears remain in the eyes for a longer period of time. Tear duct embolization is a widely used clinical treatment for ocular surface diseases (especially dry eyes).
The principle is to prolong the residence time of tears on the ocular surface by blocking the tear ducts, in order to maintain the tear film coverage on the ocular surface, reduce inflammation or prolong the time of drugs on the ocular surface, and improve the therapeutic effect of drugs. A large number of clinical studies have confirmed the exact efficacy, safety and reversibility of tear plugs for dry eyes with lack of tear secretion.
Seven, those patients can be tear punctal plugging?
1.Moderate to severe dry eye: tear film rupture time <5 seconds, Schirmer I <5mm and positive corneal staining.
2, frequent use of artificial tears for more than six months, no significant improvement in symptoms or ocular signs.
3.Patients who have dry eye symptoms after wearing corneal contact.
4.Patients with dry eye after eye surgery, such as: after keratoconus surgery, cataract surgery, glaucoma surgery, corneal transplantation and other internal eye surgery.
5, certain ocular surface diseases can also be treated by tear punctal embolization, such as
(1) Viral keratitis (resting phase) with dry eye symptoms.
(2) Recurrent corneal epithelial erosions.
(3) Keratoconjunctivitis of the superior corneal limbus.
(4) Drug toxic keratoconjunctival disease.
(5) Neuroparalytic keratitis.
(6) Dry syndrome with rheumatoid arthritis.
VIII. What are the advantages and efficacy of FCI tear punctal embolization?
FCI tear punctal plug is the mainstream product of tear punctal plug introduced from French FCI company, which has the following advantages: no need to dilate the tear punctum, one size can fit all sizes of tear punctum, pre-assembled implant is easy to install, soft silicone and special design of head eliminates foreign body sensation, visible and reversible, safe and beautiful.
IX. The efficacy is demonstrated by.
1.Improvement of subjective symptoms related to dry eyes.
2.Longer tear film rupture time.
3. Tiger red or fluorescein staining shows a reduction in ocular surface damage.
4. Decrease in dependence on artificial tears.
5, Improvement in visual function (improved visual acuity and reduced aberration).
Therefore, its efficacy is more obvious for patients with moderate dry eyes, symptoms can be relieved, and some patients can stop using artificial tears; for patients with severe dry eyes, the number of times of artificial tears and other medications can be reduced to avoid the side effects brought by long-term medication. However, there are a few patients who are ineffective for unclear reasons, and patients may still need lifelong artificial tears maintenance treatment or supplemented with other treatments.
Ten, those people are not suitable for FCI tear punctal embolization?
1.Allergic to silicone.
2, abnormal tear dots location.
3.Patients with tear duct and ocular surface infection, such as patients with dacryocystitis.
4, the patient itself tear duct obstruction.
XI. When to remove the tear dots plug?
FCI tear dots plugs are made of soft silicone, so they do not degrade and therefore can be retained for life. However, if tear overflow occurs, or if there is inflammation, granuloma trip or foreign body sensation that cannot disappear, then it needs to be removed.