Test Time: What is Lipiview?

The Lipiview measures the thickness of the oily layer of the tears. It works by looking at the coloured fringes that appear when oil floats on water. From this it can calculate the lipid layer thickness. The normal measurement is 100 and anything below this indicates a thin lipid layer. If this layer is too thin then the tears can evaporate too quickly causing dry eye. Occasionally the levels are extremely high this indicates the presence of ocular rosacea, a condition that causes the glands to over-produce a lipid layer that is not formed of the correct constituents and is inflammatory. This causes inflammation and dry eye. We will tell you if you have this condition.

What do all the tests we do mean? 
At the Dry Eye Centre we do a battery of tests to diagnose your dry eye, including: LipiView, Meibography, InflammaDry, Schirmers test, Meibomium gland evaluator, Slitlamp bio-microscopy. Interested in an initial assessment to identify what treatment would be right for your Dry Eye? Book an appointment with us today.

What's in a Tear?

Most of us probably think our tears are made mainly of salty water but there is a lot more in tears then you think. Tears are made of three layers, all of which are vital to tear stability.

The layer closest the eye is call the mucin layer. This is a sticky mucus layer that helps hold the tears against the eyes. This layer is produced by cells called goblet cells on the white of the eye and insides of the lids. These cells can be damaged by exposure or by chemical injury. Sometimes the mucus formed is not normal and clumps together to causes mucus filaments. This can interfere with the vision and also cause dry eye.

The next layer is the aqueous layer. This is mainly water. It is produced by the lacrimal glands. The lacrimal glands are susceptible to damage from an auto-immune disorder called Sjogrens. However they may also produce too little aqueous if the nervous signal to the glands is damaged. This can happen in LASER surgery and also through taking some medications. If the aqueous layer is not sufficient the eye becomes dry we call this aqueous dry eye.

The final layer that floats on the top of the watery layer is the lipid layer. This is an oily layer which protects the watery layer from evaporating. It is produced by the Meibomian glands which line the upper and lower lids. Often the Meibomian glands get blocked and this leads to a lack of lipid layer on the tears. The tears then evaporate too quickly and the eye becomes dry. We call this evaporative dry eye.

Tears also contain lots of components of the immune system such as antibodies. When we see you at the Dry Eye Centre we take many measurements to establish which type of dry eye you have, and we develop a treatment program tailored to your needs.

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Dry Eye: More than meets the eye

What is Dry Eye? 
Experts used to think that the symptoms of dry eye were due to a lack of tears being produced in the eye. Unfortunately research has shown that for many people the symptoms we now call 'Dry Eye' are not caused by a lack of tears at all and that 'Dry Eye' may actually be a misleading name. Perhaps a better name would be Sore or Inflamed Eye.

The Tear Film and Ocular Surface Society has defined Dry Eye 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. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface”

An effective treatment of the condition must not only involve treating the symptoms, such as lack of tear production or Meibomian function, but must also address the cause of the inflammation itself.

There are a number of ways to treat Dry Eye symptoms and causes but there is no one size fits all approach to treatment. Some patients respond best to a range of different techniques over time. At the Dry Eye Centre, we are one of the few expert centres in the UK that offer IPL treatment. We are also one of few practices that is licensed to prescribe medicines to reduce inflammation. We often combine these with our other treatments to get the maximum effect to try to cure this difficult disease.

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