There are several treatments and procedures your optometrist or opthamologis can perform in their office to help your dry eye disease. Some treatments will help with Aqueous Deficient Dry Eye, where you don't create enough tears. Others will help for Meibomian Gland Dysfunction and Evaporative Dry Eye and help to keep your oil glands clear and flowing. On this page we'll go into detail into both types of treatments as well as tell you how they may help your dry eye.
The primary treatment your doctor can perform if you don't make an adequate supply of tears is adding punctal plugs to your lower eyelids. When you make tears, they drain through a little hole in the bottom of your eyelid called the punctum. A punctal plug can be placed in this hole to help keep tears on the surface of your eye longer, which can be beneficial if the amount of tears you produce is below normal.
Your doctor may start you off with temporary punctal plugs that will dissolve after a short time. If they are successful, your doctor may install permanent punctal plugs in your eyelid so that you conserve tears.
The process of adding the plugs takes only a few minutes in your eye doctor's office and should be painless, although there may be some discomfort as the doctor tries to get the plugs into position. Once the plugs are in place they should cause no pain, however they can cause pain if they are positioned incorrectly or become loose.
If you have Evaporative Dry Eye / MGD, the main treatments available are aimed at opening up your oil glands. The following treatments can all help to open your oil glands:
These treatments have a lot in common, but are also different, both in the experience as well as the cost involved. Typically insurance will not pay for any of these treatments.
TearCare is the newest of these treatments. With TearCare, your eye doctor will place a strip with a heating element on the upper and lower half of each of your closed eyes. You will sit back and relax while the strips heat up to a warm but not hot temperature. The strips will heat up, melting any stuck oils in your meibomain glands. Your doctor may have you sit there with your eyes closed, or may have you blink to help remove the oils from your glands. The procedure usually takes about 12 minutes from the time the strips start to heat up to the time they are done.
Your doctor may also manually express your meibomian glands once the procedure is done. This involves the doctor taking a pair of medical tweasers and gently squeezing on your eyelids to help remove any oil that may still be stuck in your glands. This part may be a little uncomfortable for a few moments, but shouldn't be painful.
The TearCare procedure can vary in cost depending on the doctor's office, however my doctor's office typically charges $600 per treatment. I find that one treatment can give me 6 - 9 months of relief, however my doctor has mentioned that less severe patients typically get a longer period of relief.
Click here to learn more about TearCare or to find a doctor near you who offers the procedure.
Lipiflow is similar to TearCare in that it heats the oils in the glands of the eye, but it does so differently than TearCare. With LipiFlow, a disc with a heating element is inserted into your eye by your eye doctor and it rests against the upper and lower glands on the inside of the eye. It is like a big contact lens. The disc heats up and melts the oils in your eye and also has a gentle pulsing action to help move the oils along. This procedure is painless and usually takes around 15 minutes.
The cost of LipiFlow can vary, but I've seen prices ranging between $750 and $1200 for a single treatment.
Miboflo also works to heat the oils in your eyes, however it is a bit different than TearCare and Lipiflow. The Miboflo machine has a heated paddle that is applied to the outside of your closed eye. Your doctor will apply some gel to the paddle, then move the paddle around the outside of your eye to heat the oil in your glands. The procedure usually takes between 10 - 15 minutes and your doctor may also follow this up with a manual expression of the oil in your glands, just like with TearCare.
While the cost of this procedure may vary, I've had this procedure done at a cost of $250 and it usually offers relief for a period of 2 - 3 months. Click here to learn more or to find a doctor who performs this procedure.
Another available treatment is Intense Pulsed Light (IPL) treatment. This treatment uses pulsed light to open the meibomian glands. I have not personally had this treatment so I cannot speak too much to its effectiveness, however you can find out more here.