What is Dry Eye Syndrome?
Dry Eye Syndrome is a common, chronic ophthalmological condition among patients. It is usually mild, or even asymptomatic at the beginning. DES is also related to prolonged wearing of contact lenses and to past procedures of laser refractive surgery or cataract surgery.
What are the signs of DES?
The signs of DES include visual disturbances, feeling of discomfort in the form of dryness, grittiness or foreign body sensation, burning, itching or redness of eyelid margins. Characteristic are also recurrent inflammations of the eye surface (often diagnosed as allergy), and of eyelid margins, in the form of styes and chalazions. DES occurs in two basic forms
- DES associated with excessive evaporation of tears (tear film),
- DES associated with impaired or insufficient tear production.
More than 70% of recorded cases refer to the form associated with excessive evaporation, whose primary cause is dysfunction of adipose glands (meibomian gland) located on the eyelid margins.
Treatment of Dry Eye Syndrome
The basis for selection of the right therapy is an in-depth diagnosis in order to establish causes of dry eye, as well as targeted and regular therapies. There are two options of DES treatment:
- therapies used at home – hygiene of eyelid margins (heating, massaging and washing of eyelid margins) and using prescribed lubricating and anti-inflammatory agents in the form of eye drops, gels and topical ointments, and sometimes also general treatment,
- therapeutic procedures performed at the office of Dry Eye Clinic – heating of eyelid margins with the use of Blephasteam goggles, removal of secretion with the use of tweezers, probing of meibomian gland orifice using Maskin method, application of punctal plugs (which stop outflow from the conjunctival sac), as well as diagnosis and treatment of demodex (demodicosis).
The aim of treatment is to preserve life comfort. Unfortunately, the recommended hygiene of eyelid margins may be initially problematic. That is why, subsequent control visits at the Dry Eye Clinic are necessary, to verify the effectiveness of the instructions and to update treatment. You are invited to take part in qualification tests for the latest procedures improving the eye surface function. Cleaning of the eyelid margins and eyelashes belongs to the basic elements of so called eyelid hygiene, which is necessary for effective treatment of meibomian gland dysfunction, eyelid margin inflammation and related dry eye syndrome. Everyday procedures performed at home are recommended, but their efficacy is not always sufficient. That is why, they are supported by the use of special devices, like the one already discussed Blephex, and LidPro from MIBO, being a supplement of the ThermoFlo device introduced by this company, which cleans the glands by adequate heating and massaging. LidPro is recommended before performance of Thermoflo procedures.
The eye margins are cleaned by a rotating miniature silicon disc, which exposes the meibomian glands orifices and facilitates their emptying. Therapy with the use of MiboThermoflo – device (produced by Mibo Medical Grup, Texas, USA) is a safe and effective method of treatment of dry eye syndrome, especially the form associated with excessive evaporation of tears (which results from dysfunction of meibomian glands). During the procedure, the device emits a constant temperature of 42°C, which stimulates meibomian glands to secretion; at the same time, massage is performed, followed by eyelid cleaning. This results in improved function of palpebral glands, tear film structure, and gradual regression of complaints. The procedure is non-invasive and painless. The device has a medical certificate issued by FDA. The treatment efficacy will depend on the compliance with a specific therapeutic protocol, also at home. It is recommended that 4 procedures be performed within 2 months. Then, additional sessions may be indicated, depending on the period when the complaints are stronger. BlephEx device is used for non-invasive, deep cleaning of eye margins in the case of eye margin inflammation. The procedure lasts about 8-10 minutes, and it is not painful, but for a better comfort of the patient, topical anaesthetic eye drops are used. After examining the patient, the doctor recommends an appropriate schedule of treatment, which may be modified depending on the symptoms. Another element in the treatment of meibomian gland insufficiency causing deficit of the adipose tissue in the tear film and rapid evaporation of tears is transdermal gland stimulation with the use of intense, polichromatic, pulsed light. This method, introduced in the United States several years ago, is currently available in Poland, and at our centres. We use E-Eye device from a French company E-swin, which has designed the first device of this type in the world, to be used by ophthalmologists. The procedure is painless and lasts only a few minutes. For a full effect, 4 procedures at several-week intervals are recommended, but many patients observe improvement already after the first use. Complex treatment involving the cleaning of eyelid margins and gland orifices with the use of LidPro and/or Blephexu, emptying the glands with the Thermoflo device, and their stimulation with E-Eye pulsed light gives the best chances to control the dry eye syndrome caused by meibomian gland dysfunction and eyelid inflammation.
Qualifications for the procedure are performed at the Dry Eye Clinic in Lublin (Professor Zbigniew Zagórski and Marta Piecyk-Sidor, MD, PhD) and in Kraków (Katarzyna Molęda-Gładysz, MD), at the Clinic in Nowy Sącz (Agnieszka Kudasiewicz-Kardaszewska, MD) and at the Clinic in Rzeszów. Procedures with the use of MiboTermoflo device – are performed at the Eye Surgery Centre of Professor Zagórski, Branch in Lublin, 17/9 Spokojna Street, phone +48 798 77 22 44 and at OCHO in Kraków, Nowy Sącz and Rzeszów. Procedures with the use of BlephEx device are performed at the Dry Eye Clinic OCHO Kraków and Private Office in Lublin
During a basic ophthalmological visit, the patient’s ophthalmological history is taken, and the following examinations are conducted: autorefraction, keratometry, intraocular pressure measurement, visual acuity examination, slit lamp examination and fundoscopic examination.
In most cases, yes. If the doctor decides that some additional examinations are necessary, they may be performed during the visit, or if the doctor does not perform that kind of examinations, the patient is referred to another specialist.
An ophthalmological visit with performance of basic examinations lasts about 20 minutes. In some Centres, the examinations being part of the visit are performed by auxiliary personnel in the examination room. These activities are also included in the time of the basic visit.
Yes, it is recommended that contact lenses be removed before the visit. The patient should bring the lenses to the visit, since the doctor may ask the patient to insert them.
The cost of a visit is as per the price list on our website.
The waiting time for a private visit is up to a week. This time may be longer if the patient wants to see a particular specialist. The waiting time for a National Health Fund visit is according to the waiting list. Please call or e-mail us to appoint a specific date.
Yes, but you should inform the doctor that you would like to select glasses or lenses at the beginning of the visit.
Yes, you should normally apply your eye drops.
An ophthalmological visit does not require special preparation. If this is your first visit at the centre, you should have the identity card, which is necessary to create a patient record. Also remember that in most cases it is not allowed to drive a car after an ophthalmological visit.
During the first visit, the doctor takes the patient’s ophthalmological history. If the patient has any ophthalmological documentation from other institutions, it is worth taking it to the visit.
You can return to work/school after the ophthalmological visit, but please remember that if you received eye drops at the visit, your vision may be disturbed and blurred for about 2-3 hours.
Ophthalmological check-ups is an individual matter. The doctor usually informs the patient during the visit when he/she should return. Patients over 50 should have a check-up at least once a year.
If you received pupil-dilating drops at the visit, you must NOT drive a car directly after the visit. You should wait for about 2-3 hours.