I actually thought I was losing my sight when my Dry Eye Syndrome started. I hadn’t put two and two together when it came to the symptoms I was suffering from, and having always had 20-20 vision, not being able to read the tube signs a few feet ahead of me was very concerning.
It wasn’t until I made a panicked appointment with the optician that I realised what was going on. My eye test results kept changing, and it transpired that when I blinked a lot before taking a test, my vision was much improved. Suddenly it made sense; I was suffering from dry eyes and had so little moisture in my eyes that I was struggling to see through the blur.
It seemed an odd diagnosis. If anything I’d have said my eyes were watery, not dry. Very often, and particularly in windy or cold environments, my eyes would pour with tears and sting so much I had to stop and rinse them with water. It turns out my watery eyes were actually something called 'reflex tearing' – my body's emergency reaction to extreme eye dryness.
What causes dry eyes?
There are three components to dry eyes. "In the first, you don't produce enough tears," Mr Daya, Medical Director of London's Centre for Sight explains, "so your eyes are dry. The second type is that you produce enough tears but they evaporate quickly because the oils made by your eyelids which usually mix with your tears and keep them there, are not present. The third component is Inflammatory Dry Eye, which is where you have some inflammation of the eye. Each person suffering from Dry Eye can have one or a mixture of these issues at any time."
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Having conducted a series of tests, Mr Daya was able to conclude that my problem wasn't creating tears, but keeping them there. The meibomian glands, which make the lipid layer responsible for keeping your eyes moist with tears, were not functioning correctly, meaning my tears were evaporating every 3 seconds. Normally tears evaporate at some point between 12 and 15 seconds. And the reason was, that my glands were blocked. While peering into my eyes with a giant microscope, he put pressure on the glands with a cotton bud, forcing them to unblock. Through oily vision I was able to see instantly what it was my eyes had been missing. My missing tear film meant my eyes were permanently unlubricated, red, sore and difficult to see clearly through.
How do you treat dry eyes?
I had been using eye drops but to little success – something I now understood. The creation of tears wasn’t my problem, keeping them in the eye was. So although I could receive instant relief (even if often the process was painful as my eyes were so sore) within minutes the problem would be back. The key was to unblock these glands and make them start secreting oils again.
This is where the laser comes in. In fact, the benefit to dry eyes that IPL (Intense Pulsed Light treatment) can result in was discovered by chance. IPL is usually used on the face to treat skin conditions such as rosacea. As a coincidence, it was commented that many patients had seen an improvement in their dry eye symptoms. A treatment was created where facial IPL treatment was adapted for the eyes, and a protocol developed which involves 4 IPL sessions to the upper cheek and forehead to stimulate the Meibomian glands and causes them to start working again.
What does IPL feel like?
Your face is covered with a gel and the experience for the first time is alarming – I’ll be honest. Even with your eye protectors on, and your eyelids firmly closed, the laser is very bright and you feel something akin to an electric shock when it fires. The first session I recoiled with each one, but as time went on I became able to anticipate it and relax more. It smells a bit concerning too (fried flesh was my initial concern, actually it’s just the frazzling of the small hairs on your skin) but it’s over very fast.
After the IPL, the doctor clears your glands again (it’s a very satisfying feeling when the glands are cleared of their blockages) and you’re on your way after about 15 minutes.
Eye drops may help you for a few minutes but soon the dryness returns
How many sessions of IPL do you need?
The protocol requires 4 treatments, and in my experience this really is necessary. I feel I did get some relief from symptoms after the first couple of treatments but it was either moderate or short lived. I had resigned myself to the fact that this wasn’t going to be a wonder treatment for me, but went along to numbers three and four just to be complete. Since that fourth treatment I have been almost symptom free. I’ve gone skiing (cold and dry and windy – the exact conditions that I could not cope with last year) with no issues. The freezing weather this winter was not a problem either - before treatment, leaving a heated office and coming face-to-face with the external icy conditions was guaranteed to set my eyes streaming and give me fire-like pain. This year – nothing. It’s really quite miraculous.
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What else should you do to keep your eyes healthy?
On top of IPL, Mr Daya recommends a warm compress on your eyes every night for 10 minutes to help melt any oil build up in your meibomian glands, and prevent the gland from becoming blocked. I have to admit (and I’m sorry, Mr Daya) that I struggle to find even 10 minutes a day to sit still with warm cotton wool balls on my eyes in the mum work-life juggle. But knowing how terrible dry eyes can be, I'm resolving to try and find that time to make sure my cure remains.
Another thing he suggests is using baby shampoo to cleanse the eye lids – a simple way of gently removing oil clog build up and encouraging the glands to work. And the third suggestion is the use of a high strength omega three oil like Omega Eye which are easy to take and don’t taste fishy (bonus). I found taking mine on an empty stomach made my stomach bloated however, so had to be careful to only take with food.
"I believe a lot of this is to do with nutrition," Mr Daya explains. "In the olden days, cows used to go out and eat grass, these days they eat corn. Grass has a huge amount of omegas, corn doesn't. It has more omega 6s which are inflammatory. In our bodies we need a ratio of 1:1, that's one omega 3 to one omega 6. The average human being in the Western world has a ratio of 20 omega 6s to 1 omega 3. We know when we give patients high dose omega 3, after about 6 weeks they start to transform."
How long do the results last?
So far, so good for me. After my fourth treatment my TBUT (the time it takes for my tears to evaporate from my eye) had increased from 6 seconds to 10 seconds in one eye (just above the threshold for Dry Eyes) and a huge 16 seconds in the other. Treatment is so new, Mr Daya doesn't know for sure - he's only had to treat one patient more than once though.