Dry Eye Center

The American Academy of Ophthalmology estimates that over 4.8  million men and women in the United States over age 50 have dry eye disease. When over-the-counter eye drops are ineffective in helping control the constant irritations of this condition, it’s time to learn about more effective methods for relief. The most effective way to treat dry eye is to first learn why it is occurring.

A Difference You Can See

Dr. Pendleton uses advanced techniques to identify the specific cause of dry eye and recommend the most effective treatment.

Types and Causes of Dry Eye Disease

You need a healthy tear film in order to coat, nourish and protect your cornea. The tear film is made up of three critical components: mucous, liquid, and oil.  When there is a shortage of any of these components, your eyes will feel irritated and vision may be affected.  In fact, fluctuations in vision with blinking may be the only symptom of dry eye disease in certain patients. There are different reasons why the tear film may not function properly, and often, multiple mechanisms are at play.

  • Evaporative Dry Eye: oil producing meibomian glands located within the eyelids become blocked and atrophy so that there is not enough oil on the surface of the tear-film.  Meibomian Gland Dysfunction (MGD) is another term for Evaporative Dry Eye, and it is estimated 86% of all dry eye cases have some component of MGD
  • Aqueous Dry Eye: microscopic cells on the ocular surface do not produce enough liquid tears / mucous
  • Incomplete blinking: a critical function of the eyelids is to “paint” an even layer of tears over the surface of the eye with each blink. Some patients routinely make incomplete blinks, particularly when concentrating, and a portion of the cornea becomes dry.  Our LipiView technology will show you how your blink
  • Exposure: abnormalities in eyelid position that occur with aging, such as ectropion, where the eyelid no longer rides snuggly along the eye surface, can prevent the tear film from reaching the entire eye surface. Additionally, some patients do not fully close their eyelids at night, when they sleep

Meibomian Gland Dysfunction (MGD) is another term for Evaporative Dry Eye.

Symptoms of Dry Eye Disease

  • Redness
  • Feeling of grittiness or Foreign Body Sensation
  • Eye Pain
  • Light sensitivity
  • Itchy eyes
  • Crustiness
  • Swollen eyelids
  • Fluctuating vision
  • Blurred vision

Paradoxically, intermittent watering eyes can sometimes be triggered by underlying dry eye.  Microscopic cells on the surface are not producing “baseline” tears triggering the lacrimal glands to produce a flood of tears, much like crying.

Dry Eye Treatments

The right treatment depends on your type and severity of dry eye disease and often requires a combined approach.

  • Preservative free artificial tears
  • Prescription medications such as RESTASIS® Ophthalmic Emulsion, XIIDRA©, or mild topical steroids
  • Punctal plugs so that your natural tears spend more time on the ocular surface
  • LipiFlow® Thermal Pulsation System for meibomian gland dysfunction
  • PROKERA® Amniotic Membrane Device
  • Subconjunctival steroids
  • Eyelid surgery for eyelid malpositions

LipiFlow Thermal Pulsation System

Dr. Robert Pendleton is able to fully assess the quality of your tear film, the status of your meibomian glands and the completeness of your blinking using the LipiView II® Ocular Surface Interferometer.

If he determines you have Evaporative Dry Eye/Meibomian Gland Dysfunction, he may then be able to provide relief using the LipiFlow Thermal Pulsation treatment.  Using both heat and gentle pressure, Lipiflow is a “deep cleaning” treatment that unblocks the meibomian glands so that they may resume production of healthy tear-film oil.


PROKERA Amniotic Membrane Device

If chronic. severe dry eye is causing you discomfort due to corneal damage or inflammation, Dr. Pendleton may recommend a PROKERA amniotic membrane device. The device, which is inserted onto the surface of your eye for several days, is made up of two plastic rings with a thin piece of amniotic membrane tissue in between. The science behind this technique is that growth factors within the amniotic tissue will diffuse into and heal your corneal surface quickly, resulting in less pain, scarring and inflammation. The amniotic tissue used in PROKERA is provided by a tissue bank regulated by the FDA and has passed numerous quality control tests making it safe and effective. The PROKERA device is not permanent; it is removed after a few days when your corneal surface has healed.

Punctal Plugs

If tears are escaping your eyes too quickly, Dr. Pendleton may recommend that the tear drains be plugged using punctal plugs. Temporary, dissolvable or permanent plugs may be inserted into the drain of the lower eyelid to improve eye lubrication.

Medications: RESTASIS and Xiidra©

To treat Aqueous Dry Eye, or chronic dry eye, RESTASIS or Xiidra© prescription eye drops may aid in helping your eye produce more aqueous tears and mucous. Used twice a day, these options can be very effective in some patients.

To learn more about dry eye in Oceanside, California, contact us today.