What is dry eye
Dry eye is a disease in which the condition of lachrymal fluid deteriorates due to various causes, resulting in symptoms such as dryness, a sensation of a foreign body, and pain.Nowadays, people are putting a lot of strain on their eyes in daily life, such as using smartphones, and a large number of people are suffering from dry eye.If the symptoms are severe, it may affect your daily life.At our outpatient clinic, we aim to investigate the causes of dry eye and propose treatment methods to make patients' daily lives more comfortable.
- Doctor in charge
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Director/Ophthalmologist
Takashi Kojima -
Vice director/
Ophthalmologist
Yoko Yoshida -
Ophthalmologist
Kazuko Yamazaki -
Column Takako
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Determining the type of dry eye
Inspection
- Schirmer test
- This is a test to check the ability to secrete tears.
- Idler
- This is a complex test device for dry eye.In particular, you can see the extent to which the meibomian lines are impaired and the stability of the tears.
meibomian glands normal
meibomian gland abnormality
- strip meniscometry
- When applied to the edge of the eye, tear volume can be measured in as little as 5 seconds.Dr. Kojima researched this test from Japan while he was enrolled at Keio University and disseminated it to the world.Currently, it is used in various countries and is also used to diagnose dry eye in small animals such as dogs because it can be measured in 5 seconds and is painless.
(8 minutes 51 seconds)
Treatment by type of dry eye
Reduced water secretion type
First choice is eye drops.
Developed in Japan, Diquas is an excellent dry eye drop that works by causing the ocular surface to secrete water.If this doesn't help, we recommend punctal plugs.A punctal plug is a treatment in which a silicone lid is placed over a small opening of about 0.5 mm through which tears flow into the nose.
The design of the current punctal plugs is so hypoallergenic that it is hard to tell if they are inside or not.Punctal plug treatment makes it easier for not only tears but also the used eye drops to stay on the surface of the eye, so it has the effect of reducing the frequency of eye drops and increasing the effect of eye drops.
- About Sjögren's Syndrome
- Sjögren's syndrome is a condition characterized by dry eyes and mouth (dry eyes and dry mouth).The lacrimal glands that make tears and the salivary glands that make saliva are destroyed by inflammation, and tears and saliva are not produced.The cause is that the immune system, which is supposed to protect the body, goes out of control and attacks and destroys the own lacrimal and salivary glands.Dry eye is often severe and often accompanied by loss of vision.Many people come to see us because it is difficult to keep their eyes open and they find it difficult to carry on with their daily lives.It is classified as a type of dry eye that lacks moisture.Treatment to reduce inflammation and treatment to increase hydration are performed at the same time.As a treatment to increase the water content, if it is mild, replenishment with eye drops or eye drops that secrete water such as Diquas are sufficient, but if it becomes severe, punctal plugs are used in combination so that your own tears and the water that is instilled in the eye can escape. do not.Punctal plugs often fall off, so punctal closure surgery may be performed in severe cases of Sjögren's syndrome.In addition to this treatment, autologous serum eye drops are also very useful in severe cases.
Reduced oil secretion type
I think that many people do not know that tears contain an oil component.
There are many oil-secreting oil glands called meibomian glands on the edges of the eyelids, which supply oil to the ocular surface every time you blink.This oil prevents tears from evaporating and drying them out.If the oil outlet of the meibomian gland remains blocked, the meibomian gland itself will disappear.
Treatment consists of applying heat to the eyelids to compress and push the oil out of the meibomian gland openings and stimulate secretion.
Care at home is also important, so we provide guidance on this as well.In addition, if the condition is refractory, IPL treatment using light energy is also an option.
Increased friction type
Even if there is no abnormality in the tear fluid itself, dry eye may occur due to increased friction between the eyelids and the ocular surface.
Typical diseases include conjunctival chalasis, superior limbal keratoconjunctivitis, pterygium, and lid wiper syndrome.The first choice of basic treatment is Diquas or Mucosta eye drops, which secrete mucin to reduce friction, but if eye drops do not improve the condition or the symptoms recur, surgical treatment may be performed.
Nervous type
The conventional idea of dry eye is that the condition of the tears deteriorates (drying), causing scratches on the surface of the eye, resulting in a feeling of dryness and pain in the eyes.However, some patients may have severe symptoms even though the eye injury is mild, and in some cases, the symptoms may be very serious even though there is no injury at all.
In such cases, it is thought that the nerves on the ocular surface or the nerves in the brain are overly sensitive.For example, it's not a cavity, but it's close to the sensitivity of the tooth.
Treatment of this type of dry eye has only recently begun.Currently, at my outpatient clinic, I am using autologous serum eye drops for treatment.The purpose of this is to replenish the neurotrophic factors contained in serum eye drops.
Oral medications that are effective for chronic pain may also be used if eye drops alone do not improve the condition.Scleral lenses are also an effective treatment for corneal hypersensitivity.This is a treatment that protects the cornea with a scleral lens from irritation caused by dryness and friction from the eyelids.
This type of dry eye is actually not a special type, and is associated with many dry eye patients.It has long been said that the relationship between symptoms and findings (such as scratches on the ocular surface) of dry eye is low.This indicates that the way the ocular surface or central nervous system feels differs from patient to patient.
治療
Autologous serum eye drop treatment
The limitation of current dry eye treatments is that there is no way to increase your own tear production.Tears contain vitamins, growth factors that repair ocular surface damage, and neurotrophic factors that are not found in other eye drops.
For this reason, for people with extremely low tear secretion (severe dry eye), no matter which dry eye eye drops you use or punctal plugs, the effect may not be sufficient.For autologous serum eye drops, clear serum is separated from the collected blood and diluted to 20% before use.
The preservation method can be frozen for 3 months, and it is thawed and used every week.
Because serum has a component similar to that of tears, previous studies have shown that it is more effective in improving dry eye than regular eye drops.
The disadvantage of this treatment is that it requires blood sampling every XNUMX months.
IPL treatment
(Light energy therapy for meibomian gland dysfunction)
It is a new treatment for the hypolipidation type described above.By applying light energy to the edge of the eyelid and improving blood flow, the blockage of the meibomian glands is released.As a basic method, 4 times will be 1 course.This treatment is not covered by insurance and is self-funded.Most dry eye treatments are based on replacement treatments such as eye drops, but this treatment is characterized by being able to fundamentally improve the condition of the meibomian glands that cause dry eye.Because of the intense light, the patient is treated with a shield to protect the eyes.
cost
| 1 course (4 times) | 22,000 yen (tax included) |
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