Over 44 million Americans suffer with Dry Eye Disease, and the leading cause of dry eye is evaporative in the form of Meibomian Gland Dysfunction (MGD). Approximately 86% of dry eye is caused by a dysfunction of the glands that leads to degradation of the glands and eventually gland drop out.
We’ve developed a plan to combat dry eye disease before it’s too late, reversing the trend toward gland drop out and improving the production of high quality natural tears without reliance on inferior, artificial tears.
The prevention and/or treatment is a simple hygiene regimen that includes an eye vitamin.
MGD, blepharitis, and styes are functional problems solved in a similar fashion to how cavities are prevented in the dental profession.
Like toothpaste, floss, toothbrushes, and mouthwash are used for dental hygiene, a simple eyelid disinfectant, warming apparatus, and eyelid cleanser keep the area where the meibum is produced free of contaminants. The building blocks for healthy meibum is the omega 3 DHA and EPA found in cold water fish. Therefore, the fourth component in our Healthy Tears Bundle is a dry eye supplement called EZ Tears. It is clinically proven to provide the fatty acids that are the building blocks your glands need to produce quality tears.
Ocular nutrition is a foundation for healthy eyes the way healthy tears is a foundation of clear vision; the first clear media that light passes through on its way into your eyes is the tear film.
Healthy Tears Bundles are prepared with an instant $20 discount at the office; in case it is needed the instructions for use are as follows:
INSTRUCTIONS (up to once a day for pre-MGD vs. twice a day for all other levels of MGD):
Step 1) Spray your hands and the outside of your closed eyelids with Lid Prep (free refills at f/u visits).
Step 2) Follow package instructions & apply warm compress for >5 minutes, with a cotton liner if necessary.
Step 3) Apply 2 pumps of the Tea Tree Oil cleanser to your hand or cotton round and clean your lashes and face. If you were prescribed an eye drop this is a perfect time to add that refreshing lubricant to each eye.
Step 4) Take 1 EZ Tears omega-3 vitamin up to twice a day with food; the building blocks of healthy meibum.
There are 4 classifications of MGD severity and what’s important to note is that treatment with the HTB (Healthy Tears Bundle) is applicable in all 4 classifications plus other eyelid abnormalities like blepharitis and chronic styes. The frequency prescribed varies from as needed to multiple times a day; regardless the dosage of omega 3 fatty acids is always the same = >1,000 mg of EPA/DHA twice a day for our adult patients.
1) Normal: Functioning Meibomian Glands (pre-MGD). A nightly spray of hypochlorous solution on our closed eyelids is safe and effective for all ages 3 and up so please share your Lid Prep spray with the rest of the your family for routine disinfection of the skin and lashes around the eyes; the bottle from 4Sight iCare comes with free refills with every office visit until the date of expiration on the bottom. Use of the bundle can be performed as often as once a day if you’d like; prevention is going to be best if you develop a routine, so we do recommend use at least once a week. But when it isn’t prescribed to you daily or even twice a day that’s the best!
2) Mild MGD: Is a quality of tears problem much more than a quantity problem. When our glands produce a thick, discolored ooze or silly string-like toothpaste rather than clear meibum the tears are out of balance and the ocular surface suffers. Intervention at this stage can prevent meibomian gland “drop out” and return the tears to natural homeostasis; Mild MGD is 100% reversible. Simply follow the steps on the reverse of this form to regain healthy tears and improve your quality of life. A special kind of eye drop may be prescribed that provides an artificial imitation of your natural tears. The less you need eye drops, the better your prognosis; if you require drops more than 2 times per day, see little or no improvement after one month’s use of the Healthy Tears Bundle, or it is prescribed we may need to add Tear Care Treatment (TCT).
3) Moderate MGD: When tear production is halted for a prolonged time and/or nutrients are withheld from the meibomian glands they atrophy; this is known as gland “drop out” and those suffering from moderate MGD have lost between 1 and 5 meibomian glands per eyelid. The glands that have died cannot come back to life, but those that remain can produce more quality meibum to make up for their loss. To jump start the process we must initiate Tear Care Treatment (TCT). Preservative Free Artificial Tears (PFAT’s) will be necessary on an ongoing basis since the meibum production can’t ever again reach normal capacity; at this stage you can expect to need PFAT’s 1 to 10 times a day. Moderate MGD can also cause a keratinization along the linear junction between the skin outside and the soft tissue inside the eyelids - this is removed at at the TCT.
4) Severe MGD: Once 6 or more meibomian glands have been lost per eyelid it is exceedingly difficult to produce enough meibum from the remaining glands to compensate. TCT and advanced home therapy can reduce dependence on PFAT’s to just 10 to 20 times per day. Without repeated intervention and aggressive treatment of the dry eye disease, all glands could be lost leaving some to fully replace their natural tears with artificial drops dozens of times a day. If end-stage severe MGD is reached, no amount of in office treatment can return one’s natural tears to homeostasis and artificial tears may be the only respite.