Relief for dry eyes
DRY eye disease is a common pathology affecting over 20% of the population with symptoms increasing with age.
Conditions of a modern lifestyle including working in front of computer screens, driving, artificial lights, air pollution and wearing contact lenses make dry eye syndrome a more frequent nuisance.
Generally, it is a result of tear film issue, either caused by insufficient tears or excessive evaporation.
It is recognised that a large majority of cases are caused by the evaporation form, mainly due to an insufficiency of the external lipid layer of the tear film secreted by the glands in the eyelids called the Meibomian glands.
Dry eye disease is an unpleasant sensory and emotional experience.
Burdened with discomfort and fear, patients often feel miserable, not knowing how to precisely describe what they are feeling.
Most will end up feeling exasperated because no one understands what they are going through.
Mild conditions can lead to frequent visits to eye care practitioners, while moderate to severe cases are often associated with significant pain, limitation in performing daily activities, reduced vitality, poor general health and in some cases, depression.
The treatment is particularly frustrating to patient and practitioner, as it often interferes with the management and perceived satisfaction of the patient.
There are significant symptoms, which are either not treated effectively or ignored. Usually when there is not much time or when it is perceived as insignificant or untreatable.
Although lubricating eye drops may provide some relief, it is often not enough in more severe conditions. Depending on cause, treatment will include other eye drops like cyclosporine, steroid eye drops, lipid-based drops.
Manual expression, Meibomian gland probing and a procedure called Blephex may also need to be done.
The latest addition to the armamentarium of treatment modalities is Intense Pulsed Light (IPL) therapy. It involves applying perfectly calibrated, homogeneously sequenced, sculpted light pulses.
The energy, spectrum and time period are precisely set to stimulate the Meibomian glands to cause them to return to normal function.
Each treatment session takes only a few minutes, during which the patient is seated comfortably. The ophthalmologist will adjust a protective eyewear to protect the eyes from the light.
A hydrogel will be applied onto the skin beneath the eyes for protection. A series of five flashes is applied under the lower eyelid and repeated for other eye.
IPL doesn’t directly affect the Meibomian glands directly. It stimulates the nerves supplying the glands via a series of chemical reactions taking place after the procedure, stimulating the secretion and contraction of the glands and improving microcirculation.
The treatment effect is cumulative. It generally lasts a week after the first session, between two and three weeks after the second and six months to two years after the third to fourth sessions.
This is a promising mode of treatment to help alleviate or negate the misery of dry eyes.
This article is contributed by Cataract, Refractive and Anterior Segment surgeon Dr Norazlina Bachik Ng.
■ For details, visit www.kpjcfs.com or contact KPJ Pusat Pakar Mata Centre for Sight at 03-4022 6222 (KL), 03-7880 8222 (PJ) and 03-6093 1051 (Rawang).
KKLIU No.2720/2018