Tear layer approach effective for dry eye

May 1, 2012
Mitchell A. Jackson, MD

private practitioner in Lake Villa, IL

The tear layer approach is effective in the diagnosis and treatment of dry eye syndrome.

Dry eye is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface. Normal value is <290 mOsm/l, and abnormal is >300 mOsm/l on a relative scale.

Dry eye is particularly prevalent in patients with diabetes, with an incidence in more than 50%. More than 25 million Americans have diabetes; more than 5,200 people are diagnosed each day; and more than 1,900,000 are diagnosed each year,2 noted Marguerite B. McDonald, MD, FACS, Ophthalmic Consultants of Long Island, Westbury, NY.

The diabetes epidemic is not slowing down and the medical community must teach patients about the prevention, diagnosis, and treatment of the disease. The ophthalmic community must educate patients with diabetes about the necessity for regular eye care, including anterior segment and dilated fundus exams, she said.

Lipid layer

Treatment options include warm compresses, lid massage, lid scrubs, topical azithromycin, tobramycin/dexamethasone, and artificial tears that replace the oily layer. Oral doxycycline 50 mg/d is used for 4 weeks with topical treatment. Maskin MG intraductal probing technique can be helpful. Recently, Tear Science Thermal Pulsation System received 510(k) clearance in the treatment of patients with MGD.