At the initial, comprehensive dry eye consultation, the dry eye specialist and his/her team ideally should:
1) Review your medical/medication history (including biologic, lifestyle, and environmental factors),
2) Capture high definition and infrared images, perform point-of-care testing, fully evaluate the ocular surface with a slit lamp microscope, and instill of vital dye staining,
3) Properly identify/rule-out conditions (such as Ocular Rosacea, MGD, Demodex Blepharitis, Nocturnal Lagophthalmos, Neurotrophic Keratitis, Filamentary Keratitis, Punctate Keratitis, Allergies, Aqueous Deficiency, and others),
4) Educate and empower the patient of findings/diagnosis as well as recommend lifestyle modifications.
There are multiple treatment modalities including:
1) Office-Based options such as OptiLight, LLLT/LED therapy, Lipiflow, TearCare, iLux, Blephex, Meibomian Gland Probing, Prokera, Punctal Plugs, Scleral Lenses, Irrigation (ie Rinsada), ZEST,
2) Pharmaceuticals options (Immuno-modulators, Oral Doxycycline, Steroids, MIEBO, Xdemvy, Tyrvaya nasal spray, etc), some may have undesirable side effects,
3) Advanced therapy drop options including RegenerEyes, Autologous Serum tears, Plalelet-Rich Plasma (PRP),
4) At-home devices (ie iTear100 and Nulids), and
5) At-home products (ie lid hygiene, OM3, compress, PFATs, nighttime therapy, and more).
Important to note that in mind that there commonly isn’t just ONE option that is considered a silver bullet but when the right combination therapy is chosen, many patients can often find lasting relief and/or pivot from the ‘rehabilitation’ phase to the ‘maintenance’ phase. In this situation is where we see the greatest improvement signs/symptoms as well as quality of vision and quality of life.
To learn more, here’s an Advanced List of Dry Eye Treatment Options (updated October 2023): https://www.bheyeguy.com/blog/