Innovations to See a Better Future- Dry Eye Treatments

Dry eye is one of the most annoying eye disorders caused due to vague indescribable discomfort. The international dry eyes workshop has defined dry eye disease as a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. Dry eye is of two types, one is due to tear deficiency e.g. Sjogren's syndrome, and the other is due to increased tear evaporation, which again can be, either due to intrinsic causes like inflammation e.g. Meibomian gland disorder or, extrinsic causes like computer vision syndrome. Dryness due to any of these factors on longstanding leads to inflammation which in turn, increases dryness, and the cycle continues. On controlling the inflammation, the inflammatory chemicals are eliminated thereby stabilising the tear film and reducing the evaporative time whereas in tear deficient dryness the inflammation role is limited.

Solutions Available:
Various treatment modalities have been tried to relieve this condition. Artificial tears, Steroids, Anti-inflammatory, Omega-3-fatty acids, and the latest topical medications being secretagogues, immunosuppressant, and lipid-derived endogenous molecules. The topical medications either act by adding tears to the eyes or suppressing inflammation. But the relief is just as long as the use of the medications.

What’s latest?
M22 OPT is the latest Intense Pulsed Light (IPL) technology devised to address the root cause of the inflammation. The cycle of inflammation and dry eyes is attributed to the abnormal blood vessels, known as telangiectasia’s, that grow at the lid margin and supply constantly the chemical mediators that cause tear film instability and increase tear osmolarity causing dry eyes. IPL acts on these telangiectatic blood vessels and eliminates them, thus removing the root cause of inflammation. As the inflammation subsides the components of the tear film becomes healthier thus stabilising the tear film.

IPL uses near-infrared light to target the tissues.  It works on the principle of selective photothermolysis, in which thermally mediated radiation damage is confined to chosen targets at the cellular or tissue structural levels. Tissues surrounding these targeted structures, including overlying or immediately neighbouring cells are spared, potentially reducing nonspecific, widespread thermal injury.

We have screened the dry eye patients and have segregated them into tear deficient and evaporative dry eyes. As the evaporative dry eye is mainly due to inflammatory causes, we have treated these patients with M22 OPT. These patients had constant dry eyes with annoying symptoms like grittiness, foreign body sensation, puffiness around the eyes, blurring vision etc. We have examined the eyes and have tested for tear film stability before and after the treatment and have found a marked improvement in the tear film stability. There is an increase in the tear film evaporation time, tear film height, a significant reduction in puffiness around the eyes, corneal staining, frothy secretions and other symptoms.

The Future Ahead:
Around the globe, various new technologies and molecules are coming up for the treatment of dry eyes.The newer molecules like recombinant Human Lubricin protein has been found to improve the symptoms. Vectored Thermal pulsation procedure, transcutaneous periorbital electrical stimulation and IPL are the other upcoming technology.

Conclusion:
M22 OPT has successfully reduced the symptoms of the dry eye patients giving promising results. Finally we have a very good alternative to the regular use of medications and in fact, a full stop to continuous eye drops.

This article has been authored by Dr Sri Ganesh, Ophthalmologist.