Chronic Dry Eye

Did you know that over 16 million Americans suffer from Dry Eyes?

 

Dry eyes is often talked about on the TV commercials, and your eye doctor may have already given you this diagnosis.  We understand it is an age related condition, or we may feel that it is allergy related.  Do we know for sure?

 

What we do know is that the eye is dry because either we are not producing enough tears, or our tears are drying up too quickly, leaving the eye without moisture.

In my research, I have found that the major cause of dry eye is dysfunction of the meibomian gland (MGD).  One study found that over 86% of dry eyes is caused by MGD.

I can almost see you scratching your head, and wondering what I just said.

The Meibomian gland is located behind the eyelashes on both the top and lower eyelids.  They produce a fatty substance that is added to the tears, and slows the evaporation of the tears.  When something happens to the production of the fatty substance, then we have eye problems.

 

Meibomian Glands (source: Dryeyedirectory.com)

 

MGD occurs when the meibomian glands, located in the eyelids, do not sufficiently produce and release the oils needed to protect and maintain a healthy tear film.  This exposes the watery layer underneath, leading to more evaporation.  Thus, the problem for many dry eye patients is not inadequate tear production, as thought for so many years, but a lack of oil production that ensures the protective integrity of the tear film is maintained on a daily basis.

 

While more prevalent in older adults, MGD can occur at any age. In addition, improved detection methods have shown that MGD can occur in young adults and children, possibly because of the common use of digital display devices today. Excessive use of display technologies can lead to infrequent blinking, called “evaporative stress”.   Infrequent blinking creates a demand for more lubrication on the eye, stimulating more oil production from the meibomian glands.  Over time, this leads to thickening of the oil, blockage of the gland opening and shutdown of oil production in the gland.

 

So, what can we do to alleviate dry eye?  One thing we can do is to oil ourselves within.  Increasing your dietary intake of Omega 3 can also improve dry eyes, according to an international panel of experts.

Recent studies also show that increasing Vitamin D levels can also reduce symptoms of dry eyes.

 

According to one study, people with low Vitamin D levels (<50nmol/l) were associated with dry eye symptoms in older individuals . Study participants took an oral vitamin D supplement of 1000IU (units) each day for nine weeks. After increasing supplementation, a significant number of people noticed a reduction in symptoms. Similarly, a recent study used 2000 units (IU) daily and found a significant improvement in dry eye symptoms.

 

Inflammation in the body can also cause dry eyes. Risk factors include Thyroid Dysfunction, Sjogrens Syndrome, Androgen Deficiency, Hormone Replacement Therapy and medications such as Anti-histamines or Anti-depressants.

 

Practical help is available too.  All too often, women who sleep without removing their eye makeup find that the makeup debris flakes off the eyelids and eyelashes, makes its way into the meibomian glands, and stops the flow of oils needed to keep the surface of the eye healthy.

Ingredients such as preservatives in skincare and makeup products can also exacerbate dry eyes. Browse this list of common toxic ingredients in mascaras.

Removing your makeup nightly and massaging the eyelids has been shown to help with the restoration of the function of that gland.

Eyelid cleansing is also important to reduce the buildup of debris, known as Anterior Blepharitis. This is a mixture of bacteria, mites, and their toxic byproducts exist on the eyelids and lashes. Like plaque on teeth, it’s important to cleanse your eyelids everyday.

Want to refresh your eyes? Use eyelid sprays such as hypochlorous acid to help cleanse bacteria and their biofilms. Spray on closed eyes and leaving them shut for thirty seconds can help. Try doing this regularly after removing your makeup at night.

Additionally, there are eye masks that can be purchased that can help.  These masks can be put in the microwave, and then applied to the eyelids.  The mask will heat up the meibomian glands, the heat will soften the oil in the glands, and normal flow may resume.  You can research these products yourself.

Warm washcloths can add heat to your eyelids. However, they lose their heat quickly. For people with moderate to severe MGD, it is recommended to get at least fifteen minutes of sustained (yet tolerable) heat to help loosen clogged oils.

Some products like glass-bead heat packs are washable. Others contain silver to help reduce bacterial buildup in the heat packs. New devices are available that add gentle vibration and help loosen material more.

 

There is also some research that shows CBD oil (10-15 mgs) daily can help restore the function of the meibomian glands.  When searching for this product, please make sure you are getting a good clean product.

 

Newer treatments for dry eyes include Intense Pulsed Light. This is a natural light treatment that helps to boost the metabolism of the Meibomian Glands. It also reduces fine blood vessels (known as telangiectasias) and inflammation on the surface of the eyes. Intense pulsed light requires several treatments. However, it is a drug-free, drop-free treatment for dry eyes.

 

Lipiflow offers a way of gently massaging and clearing Meibomian Glands. Newer in-office treatments by dry eye doctors also allow gentle warmth and clearing of clogged glands.

 

I hope that you are encouraged that Chronic Dry Eye is not something that you have to live with.  There are many things that you can do to help your Meibomian glands recover.

Until next time,

 

Dr. Polly

 

 

25 Comments
  1. Thank you! This was very helpful to me.

  2. Dry eye syndrome is a problem involving tears. Your eyes need tears to stay clean and healthy. With dry eye syndrome, your tear glands don’t make enough tears or your tears evaporate too fast that causes dry eyes. A warm compress can be really beneficial for giving yourself relief from dry eyes.

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  4. Dr. Polly, how about a botched LASIK procedure that’s cause considerable sensitivity to light for weeks now dry eyes. Is it possible to put CBD oil in your eyes or you have to ingested

  5. I have severe dry eye and have had Lipiflow, do hot compresses, drink lots of water, use ointments and gels, etc. I still experience significant discomfort. I am interested in pursuing CBD oil. I live in California, where it is legal. I would like to find a health care professional who deals with this type of situation. I live in San Diego. I appreciate any assistance you can provide!I would love an email response, if possible.

  6. I have dry eye and MGD – as a result of LASIK (11 months ago). In your opinion, would my treatment options be any different or would you expect different results because the issues were caused by LASIK vs. Natural aging etc… I am asking because an acupuncturist said his opinion is that because the issue was a result of Lasik, he did not feel I would get positive results from acupuncture. Thank you.

    • I don’t know why dry eye would be the result of Lasik. In my understanding, the glands in the eyelid secrete the lipids that keep the eye moist. I think I would try some homeopathic drops for dry eye. We have a great brand. Call the office and we can give you the details, and get some in the mail to you. 281-312-2860

  7. The CBD Oil. Did you mean to take it orally or rub it on the eyelid?

  8. I have dry eye and MGB I’m thinking of try cbd oil

  9. I’ve been taking CBD (for chronic pain) for about 6 months and have noticed that in the last few weeks my eyes aren’t dry any more. I’ve had dry eyes all of my adult life (I’m 64) and this development is surprising and wonderful. I don’t know for sure if it’s as a result of the CBD, but that’s the only thing that’s changed in my diet or lifestyle. I will keep monitoring the situation.

  10. Hi there can you give a name of s good brand? There are so many out there. I saw you wrote 10-15 mg. Thank you!

  11. Hi Dr Polly! What about chronic dry eye sufferers from accutane use? I’ve tried ever drop, pill, etc I can try and have yet to have any relief. :/

  12. I took cbd oil and got blurred vision. After looking online for more information I discovered that CBD increases imflmation in the eyes.
    This was further proved with my eye Dr.
    THC reduces eye pressure and CBD is an isolate meaning all the THC and important other chemicals have been removed
    They make CBD from hemp and from rubbish like stem and leaf and further is unregulated.
    Personally I don’t agree genetically modified canabliods are the answer.

  13. I was taking about 30 mg of CBD oil sublingually per day, divided into three doses. I found it helped my dry eyes and that was completely a surprise since I was taking it for other reasons, so I doubt bias was involved. When I stopped taking it, the dry eye became unbearable again. Also–that article is available again because I just read it. https://www.ophthalmologytimes.com/modern-medicine-news/can-cannabis-succeed-where-other-compounds-have-failed

  14. CBD oil should help as it contains omega 3. But my optician recommended Sea Buckthorn oil as it contains Omega 7, which he said was effective for dry eye.

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