Dry Eye

SEC Role in Dry Eye

Siddhartha Eye Care (SEC) aim is to provide high quality of comprehensive dry eye evaluation. We are first here in Nepal, to introduce and implement the complete evaluation by IDRA dry eye diagnostics.

Dry Eye

Dry eye does not mean that your eyes are dry. Dry eye is a broad term describing abnormalities in tear film. Tear film has three layers: outer layer is lipid layer, middle layer is aqueous layer and inner layer is mucin layer. Disturbance in any of these layers can affect lubrication and lead to dry eye.

Common Dry Eye Causes

• Aging
• Dry environment or work place (wind, air conditioning)
• Sun exposure
• Smoking or second-hand smoke exposure
• Cold or allergy medicines
• Related with other ocular problem: Bulging eyes (proptosis), eyelid related problem

Symptoms of Dry Eye

• Dryness
• Irritation
• Feeling that there is grit or debris in the eye
• Burning sensation
• Blurred vision
• Eyes may feel tired
• Discharge-especially in the morning upon waking

Who gets Dry Eye Symptoms?

• Computer users report dry eye symptoms so frequently, it’s been called CVS-Computer Vision Syndrome
• LASIK eye surgery patients often suffer post LASIK dry eyes
• Women especially during menopause get dry eye symptoms as a result of hormonal fluctuations.
• Older people also suffer as their tear production is 40% less
• Patients on medications like antihistamines, antidepressants and birth control pills
• Smokers and allergy sufferers
• People living in dry, dusty or windy climates

Modern Diagnostics

Dry eye has multiple causes. Dry eye can be due to blepharitis, meibomitis, post phaco surgeries, post lasik surgeries, autoimmune disorders and could be due to various drugs. A proper management depends on proper evaluation of the dry eyes. At Siddhartha Eye Care we do followings evaluations for dry eyes.

• • Detailed history including Ocular Surface Disease Index
  • Proper evaluation under slit lamp
  • Interferometry: To evaluate the quantity and quality of the lipid component on the tear film. IDRA diagnostics highlights the lipid layer and the software analyses automatically Lipid Layer Thickness (LLT).
  • Blinking quality: Inefficient blinking may be related to low blinking rate or incomplete blinking and can often be a reason for dry eye symptoms or ocular surface staining. IDRA automatically detects and analyses blinking, determining its quality.
  • Tear Meniscus: The tear meniscus thickness that is observed on the eyelid margins provides useful information on the tear volume. The tear meniscus can be examined considering its height, regularity and shape.
  • NIBUT: The stability of the mucin layer and the whole tear film is assessed through the study of the non-invasive break up time (NIBUT), by using the Placido cone projected onto the cornea.
  • Meibography: It is the infrared evaluation of the glands through trans-illumination of the eyelid. It images the morphology of the glands in order to diagnose any Meibomian gland drop out which would lead to tear dysfunction.
  • Blepharitis: This test helps to detect blepharitis and presence of Demodex. It can be performed on the outer surface of the eye and eyelids.
  • Ocular Redness and Classification: We capture the images of the conjunctiva with its blood vessels and compare it with the classification sheets of bulbar and limbal redness degrees.
  • Pupillometry: It is the measurement of the pupil reaction to light with and without glare. Measurement mode: Scotopic, Mesopic and Photopic
  • White to White Measurement: Evaluation of corneal diameter from limbus to limbus (white to white distance, WTW).