The Severity of Dry Eye Syndrome
Dry Eye Syndrome (DES) can be of different types and can range in severity among different patients. Your Ventura optometrist can diagnose whether your DES is chronic or severe.
Causes of Severe Dry Eyes
Severe Dry Eye syndrome may occur due to one of the following causes:
- A medical condition such as Sjogren’s syndrome.
- Surgical refractive treatments such as LASIK. Though dry eyes after LASIK is usually temporary, it may become chronic in some cases.
- Dry eye due to Meibomian Gland Dysfunction, which affects the lipid layer (oily secretion) of the eye. MGD is the leading cause of Dry Eyes attributed to over 85% of dry eye cases, however, it is not always the cause of severe chronic dry eyes.
Management of Severe Dry Eye
Patients with severe or chronic dry eye usually need to face additional problems including lid disease, staining of the central cornea, inflammation, filamentary keratitis, clumping of mucus, and increased tear debris. Such patients usually suffer from increased discomfort and deterioration of vision. For patients with such severe dry eye (Grade 3 level of severity), the International Dry Eye Workshop, in 2007, recommended the use of contact lenses. Since patients with severe dry eye are usually unable to tolerate contact lenses, scleral contact lenses are mostly a comfortable solution.
What are Scleral Lenses?
Scleral lenses are special types of contact lenses that have a large diameter. When fitted in the eyes, these lenses have their periphery and edges resting on the sclera or the white part of the eye. Due to this, these lenses provide a much more comfortable alternative to patients facing several complex conditions including keratoconus and severe dry eye. Learn more about Scleral Lenses.
Scleral Lenses for Severe Dry Eye
In patients suffering from severe dry eye, when other treatments are a failure and if they cannot tolerate regular contact lenses, scleral lenses are considered. These can be used in cases of moderate to severe DES. When a scleral lens is fitted in the affected eye, the lens arches over the entire surface of the cornea. Fluid fills the surface between the eye and the back of the lens, acting as a fluid reservoir. This liquid lubricates the eye and protects the cornea from mechanical shearing of the eyelids when the patient blinks. Scleral lenses, thus, provide lubrication and comfort to the patient. Studies reported that patients with scleral lenses reported less discomfort from their condition and better visual function. Moreover, if Ventura patients with dry eyes need other visual correction, scleral lenses may be one of the most comfortable solutions they can get. That is because other contact lenses including gas permeable lenses and soft lenses cannot be tolerated by them because of the troubled ocular surface. Also, treatments like LASIK may result in worsening the symptoms of dry eye. Scleral lenses, on the other hand, do not pose such side effects and can be worn comfortably. An additional benefit of Scleral contact lenses is that their large size means that they are less prone to move, which can be a source of major discomfort for patients with severe dry eyes.
The Need for Extra Care With Scleral Lenses
Patients with moderate to severe DES tend to produce relatively higher levels of mucus and tear debris. This extra tear debris may form a build-up beneath the surface of the lenses when the patient is wearing them. Although this layer of debris does not cause discomfort, it clouds up the scleral lens. This leads to changes in vision as the visual field looks cloudy. If this happens, the user needs to remove the lenses to have them rinsed and refitted.
Changes in Medication
If scleral lenses are fitted properly and the results are successful, your optometrist may decrease the dosage of topical medication you may be taking like antibiotics, steroids, and medications like Xiidra and Restasis. In cases, he may even choose to eliminate them. You may be asked to continue the use of artificial tears in the day with the lenses on, and topical lubricating gel at night when you remove them.
Scleral Lenses for Dry Eyes at Our Venura CA Eye Care Clinic
At our Ventura practice, we have patients from all over the area that come in for Scleral contact lens fittings. Because we have advanced dry eye treatment options such as Blephex many of our scleral lens patients also have had serious issues in the past with dry eyes symptoms like burning, itchy, watery, tender, and gritty eyes. We are blown away by the response of our patients when they start wearing Sclerals, they are astounded at the increased comfort and visual acuity that comes with Scerals.