Dry Eye Management

Home Maintenance 

At the core of every dry eye therapy is home maintenance. While we are all taught at a young age that brushing and flossing our teeth is essential for good oral health, what most people are unaware of is that the same care and attention is required for good ocular health as well, especially if you suffer from dry eye disease and/or blepharitis. And, much like after an in-office dental hygiene deep cleaning, all next level dry eye treatment and therapies require continued at home maintenance to keep your eyes healthy and help prolong therapeutic results.

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Here are some core therapies and habits to adopt to keep your eye's surface healthy:

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#1 WARM COMPRESSES 

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​We recommend using a heated mask meant specifically for treatment of dry eyes/meibomian gland dysfunction to provide 10 minutes of continuous heat to the closed eyelids. While some people rely on on using washcloth with warm water as a compress, it is typically not as ideal because they cannot retain heat for the recommended duration. Additionally, compresses that contain wheat or rice, particularly when moistened, can harbour bacteria and microorganisms. Our recommended microwavable compresses are designed to retain heat for ten minutes and are made with antimicrobial beads and materials.

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Don't have access to a microwave? Consider gifting yourself a Umay USB chargeable mask for ease of use and portability. Not only can this mask provide continuous heat, but also has a setting for cold, which can help promote natural tear production and soothe irritated eyes, an especially refreshing start to the morning. 

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#2 LID HYGIENE WIPES AND CLEANSERS

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​Don't forget, your eyelids shield your eyes from dirt and other contaminants throughout the day and, much like you brush your teeth daily to prevent plaque buildup, you should be using  daily ophthalmic wipes or cleansers to remove oils, skin cells, bacteria, mites, and other debris that can accumulate along the eyelashes. It is the accumulation of these substances and biofilm that can lead to eye infections, irritation, itchiness, and blockages in the meibomian glands.

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​Your optometrist may recommend a gentle wipe or cleanser for your eyes, usually contain anti-microbial properties to reduce the amount of bacteria on your lids.​​​​​​​​ ​​Our eyelids are thin and sensitive, which is why you should only use a product approved for use around the eyes. Ask your eyecare professional which one is the right one for you!

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#3 PRESERVATIVE FREE ARTIFICIAL TEARS

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Over-the-counter eye drops can help keep your eyes moisturized and comfortable. Many common eye drops have preservatives added for longer use, however they might irritate your eyes so we typically recommend using preservative free artificial tears whenever possible. For those with more severe dry eyes, thicker lubricators like gel drops or ophthalmic ointments might provide longer acting relief, particularly when used at night before bed. 

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Warning: Be careful of over-the-counter red eye relief eyedrops. Many of these drops contain drugs called vasoconstrictors, which work by shrinking the red blood vessels in the white part of the eye to make your eyes appear more white and bright (look for ingredients like terahydrozoline or naphazoline). While your eyes may temporarily look and feel better, frequent use is unsafe and can lead to more serious problems. Your blood vessels are the vehicle to  oxygen and important nutrients throughout the structures of your eye. Constantly shrinking these blood vessels might compromise your ocular health. Additionally, once the vasconstrictor wears off and your blood vessels will revert back to their original size, with prolonged use those blood vessels can permanently enlarge, causing your red eye to look even worse than before (a process called rebound hyperemia)! Essentially your eyes can become addicted to these drops.

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Ask your optometrist which is the right - and safe! eye drop for you.

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#4 PROPER NUTRITION 

OMEGA-3s  Research has found that those who consume larger amounts of omega-3 fatty acids have a lower risk of dry eyes. Omega-3s have long been known for their anti-inflammatory properties, and a deficiency in omega-3s can be a cause of chronic ocular surface inflammation. In addition, omega-3s increase the quality of meibomian gland oil, which helps improve the lipid layer in the tear film and prevent evaporative dry eye symptoms. 

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You can get your omega-3s from fish (think wild salmon, tuna and sardines), walnuts, vegetable oils and flaxseed.

For those with insufficient consumption, supplements can be a great way to get your ideal amount of omega-3 fatty acids. Be warned though, not all omega-3 supplements are built the same. The therapeutic dose recommended for dry eyes is typically around 2000 mg per day. In particular, you want to choose omega-3 supplements with higher levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). EPA and DHA should make up 60% to 85% of the formulation. Lastly, you will want to use an omega-3 that overly tests for toxins and that comes in triglyceride forms over the ethyl ester kind due to their superior bioavailability.

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VITAMIN A  is another essential ingredient for combating dry eyes (and one of the signs of vitamin A deficiency is dry eyes!). Vitamin A increases cell turnover rate of corneal epithelial cells. Patients with dry eyes often have signs such as superficial punctate keratitis, caused by loss or damage of the corneal epithelial cells.

Beta carotene we ingest in our diet converts to vitamin A. They can be found in orange vegetables such as carrots and sweet potatoes, green leafy vegetables such as spinach and kale, as well as cantaloupe, fish and eggs.

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VITAMIN C  is an essential antioxidant that has been shown to help reduce the symptoms of dry eyes by helping combat oxidative damage and inflammation, and may also may be beneficial in helping eyes heal from corneal wounds. Natural sources of vitamin C include citrus fruits, tomatoes, strawberries, bell peppers, kale and broccoli. ​

VITAMIN D  Vitamin D improves ocular surface hemostasis, create better tear stability and a more improved tear osmolarity. Natural sources of vitamin D include spending time outdoors in the sun (but still protect those peepers with sunglasses, we produce vitamin D when ultraviolet rays shine on the skin) and eating foods such as fish, eggs, mushrooms, and fortified dairy products.

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HYDRATION  For your body to produce tears, it must be properly hydrated and in most cases, water is best! Proper hydration also ensures that the salt concentration within our tears remains balanced; when dehydrated, tears can become overly salty, causing increased irritation and discomfort.​

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#5 BEHAVIOURAL SHIFTS ​​​

Environmental changes can also help alleviate dry eye symptoms. When wind blows onto your eyes, it dries out the surface of the eye and causes tears to evaporate (think ceiling fans, vents in your car, etc...). Wear sunglasses when outdoors to not only protect your eyes from UV damage, but also keeping wind and dust out of your eyes. Consider adding a humidifier and air purifier to your home and office. 

 20-20-20 rule  It is very important to remember to take breaks from prolonged screen time, reading, and near work. On average, we blink about 17 times per minute. With activities that require concentration and the use of our eyes, our blink rate decreases to about 4 times per minute, resulting in less tears. Therefore we recommend everyone practice the 20-20-20: every 20 minutes of screen time/reading/work, take a 20 seconds to look 20 feet away to not only give your eye muscles a break, but to restimulate your blink rate. ​​​​​​

ZEST Blephaexfoliation Treatment 

ZEST (Zocular Eyelid System Technology) is an in-office eyelid treatment performed by your eyecare professional to treat blepharitis. The ZEST treatment involves the use of a specialized Zocular gel which contains natural extracts, to cleanse the eyelids and remove debris, bacteria, demodex mites, and other irritants, relieving associated inflammation and reducing dry eye symptoms. 

The treatment is designed to be a gentle yet effective blepharitis management strategy, providing  immediate relief from symptoms and promoting healthier eyelid hygiene.