Relief From Dry, Scratchy Eyes

Martha “Marcy” McClanahan loves books so much, she could read from morning till night, but her dry, scratchy eyes caused her to blink and squint a lot. Her regular eye doctor prescribed drops to improve her eyes’ natural ability to produce tears, but she didn’t find consistent relief.

Photo by Nerissa Johnson.

Reading her favorite novels is no longer a challenge for Marcy.

“I tried not to drive myself crazy scratching my eyes with my hands,” the Port St. Lucie resident remembers.
Her eye doctor eventually referred her to Dr. Salinger, who offers extensive testing and comprehensive treatment for dry eye disease.
“We offer the LipiView® test for evaluating the oil layer of the eyes; lactoferrin for evaluating the aqueous, or water layer; a test called IgE for evaluating the presence of allergy; tear osmolarity, which measures the salt concentration in the eyes; and a test called InflammaDry® for assessing the presence of inflammation,” he expounds.
Dr. Salinger installed plugs in Marcy’s tear ducts, but sometimes her eyes would water so much, they’d “run like a sieve.” Once Dr. Salinger concluded the plugs weren’t a good solution for Marcy, he suggested the same type of medical treatments that he did for Judy.
While Marcy showed some improvement, she still suffered from dry eye symptoms, so she and Dr. Salinger turned to the LipiFlow® Thermal Pulsation System from TearScience® to relieve blockages of her eyelids’ oil glands.

Enhancing Oil Production

The three-step treatment takes about an hour. It involves deep cleaning the eyelids before the LipiFlow procedure and expressing the oil glands in the eyelids afterward.
Opening and clearing those blocked glands enhances the natural production of the oils that are needed for a healthy layer of tears on the surface of the eye.
During LipiFlow, an eyepiece contacts the outer eyelid and contains a soft, flexible bladder that intermittently inflates to provide controlled pressure and massage to the eyelids. The application of heat to the inner surface of the lid is intended to provide heat close to the location of the glands.

Photo by Nerissa Johnson.

Drops help Marcy’s eyes stay lubricated.

The Lipiflow procedure, which Dr. Salinger calls “a revolutionary breakthrough” in treating chronic dry eye disease, takes 12 minutes for each eye and is performed in his office.
A leading cause of dry eye syndrome is meibomian gland dysfunction, which means those glands don’t secrete enough oil into the tears, which then evaporate too quickly. This condition has become “an epidemic in the younger population, nineteen- to thirty-five-year-olds” because they’re constantly staring at cell phone, tablet or computer screens and not blinking enough, Dr. Salinger observes.
“My middle daughter at nineteen developed a stye,” a red, painful lump near the edge of the eyelid that may look like a boil or a pimple. “Of my three daughters, she was the one most often on social media,” he says.
Dr. Salinger describes a stye as “the ultimate blocked oil gland that gets inflamed, irritated and sometimes infected. I pressed on her eyelid, and out came this cheesy, waxy substance caused by more time between blinks in addition to more incomplete blinks.”
When people read, watch TV, drive or work at their desks, they blink on average about every seven or eight seconds, he elaborates. When texting or using a computer tablet or e-reader, people blink every ten or 12 seconds, with an even higher percentage of incomplete, partial blinks.
At Dr. Salinger’s suggestion, Marcy is making a conscious effort to stop staring for long periods at the screen on her e-reader when she’s engrossed in her favorite light reading.
“I have to stop and blink real hard for a few minutes and just give my eyes a chance to rest,” she relates.
Dr. Salinger additionally recommends special eyewear to protect against ultraviolet sunshine and radiation that is reflected off sand, pavement, cars and other metallic surfaces.
“Eyewear shape should be contoured, wraparound, and close to the face to protect from the wind, airborne debris and particulate matter in the air,” similar to the glasses patients wear after cataract surgery, he states.
“Eyewear also protects from allergens, such as pollen, and other things that may incite or stimulate an inflammatory reaction on the eye,” Dr. Salinger says. He notes that protective eyewear includes not only sunglasses but also glasses with clear or amber tint that can be worn on hazy, cloudy or even rainy days.
Some types of protective eyewear can be worn over the top of prescription glasses, he notes, or crafted to prescription specifications.
For most patients, “the realistic expectation for symptomatic improvement of dry eye is seventy to eighty percent,” Dr. Salinger acknowledges. “In baseball terms, that’s a double or a triple. The only way to hit a home run is to turn back time. While we can see great improvement, it requires ongoing treatment for a chronic condition.
“The worse it is, the longer it has been there, the longer it is going to take to turn it around. Once we’ve improved the situation and stabilized the dry eye condition, it usually requires a lot less treatment to maintain that benefit.

“For the first time in my life, I don’t need any type of contacts or glasses. I don’t need a million pairs of reading glasses around.” – Marcy

“But if we fall off the wagon and stop treatment altogether,” Dr. Salinger adds, “it’s only a matter of time until things get worse again.”
That’s because dry eye and other ocular surface diseases are progressive conditions attributed to numerous factors, including age, hormone changes such as menopause, diet, medications and “the chronic insult to our bodies that we perpetuate every single day in our environment,” he elaborates.

“Comfortable Vision” Returns

Nearly a year after having the LipiFlow procedure, Marcy remains satisfied with her results. Drops help her eyes stay lubricated, and sometimes she forgets to use them “because my eyes feel absolutely wonderful and everything is moist, and there are no problems.”
Marcy calls LipiFlow “a very valuable way to help people have comfortable vision again.”
As for Dr. Salinger, “I couldn’t have asked for a finer, more brilliant mind to work with me and help me see that this is really something to be concerned about,” she raves.

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