Is surgery the right solution for my mother's severe dry eye syndrome?

My mother has very severe dry eye syndrome.

I went together when I had an eye examination.

The doctor was surprised...

My tears are also dried up, and the oil in my eyes is also dried out, so my dry eye syndrome is really severe.

 

I only just realized that there is oil in my eye..

Not only tears, but even the oil has dried up...

 

As presbyopia occurs and age increases, the transparency of the lens diminishes.

You had cataract surgery several years ago, which caused symptoms of corneal opacity to appear.

Also, since my mother has diabetes,

Perhaps because of that influence, the world that had become a bit brighter after cataract surgery...

He has been saying that his vision has been blurry again recently...

 

Moreover, they are having a hard time because their eyes are very dry and gritty.

You have visited the local hospital and received prescriptions for eye drops and tears, but

Some days are very foggy, and there are occasional instances of floaters flying around like fruit flies ㅠㅠ

 

You have received a simple procedure, but

I felt a slight improvement for about a day, but then I returned to my original state.

 

Since you have diabetes... I heard that intraocular pressure can increase. Could that also be a cause?

 

I looked up dry eye syndrome.

Dry eye syndrome

Dry eye syndrome refers to a condition where tear production decreases or, even if tears are produced in large amounts, their composition changes, leading to various symptoms such as dry eyes.

 

Tears are said to be composed of three layers.

I also didn't know that there are three layers like this..

 

The innermost layer is the mucous layer, which helps the aqueous layer spread evenly.

The middle layer is the aqueous layer, which forms most of the tear film. It keeps the eyes moist and removes foreign substances from the eyes. If this aqueous layer dries out, it can worsen dry eye syndrome.

And the outermost layer is the fat layer, which acts to prevent evaporation of the aqueous layer. I never thought there was a fat layer, but... if this fat layer becomes damaged due to aging, inflammation, trauma, or other injuries to the eye structures involved in tear secretion, it can lead to dry eye syndrome.

 

My mom's all three layers are dry, and she's in severe dry eye condition ㅠㅠ

 

I only thought about symptoms of dry eye syndrome such as eye dryness, foreign body sensation, and similar issues.

There are various symptoms...

Eye irritation, a foreign body sensation like sand rolling around, a burning sensation as if the eyes are on fire, discomfort feeling like the eyes are blurry, itching, glare, sudden excessive tearing!!

I only thought about the discomfort of feeling blurry or the sensation of a foreign body in the eyes...

A burning sensation in the eyes, itching, glare, excessive tearing—these are also symptoms of dry eye syndrome...

If you have these symptoms, it may be a sign of severe dry eye syndrome, and you should consider treatment.

 

 

So.. what is the cause of dry eye syndrome?

 

As expected... Number 1 is aging.

Sigh... Getting older is a word that makes me feel sad.ㅠㅠ

 

1. Aging
It's the most common cause, where tear production or tear condition changes due to normal aging processes.

 

② Comorbidities
If you have diseases such as rheumatoid arthritis, Sjögren's syndrome (a rheumatic disease that causes inflammation or dryness in the mucous membranes of the mouth, eyes, and throughout the body), lupus, antiphospholipid syndrome, diabetes, or vitamin A deficiency, it is said that tear production decreases.

My mother also has diabetes... her tear production has decreased as well ㅠㅠ

 

Chronic conjunctivitis
When goblet cells responsible for mucus secretion in the conjunctiva decrease due to chronic inflammation, the amount of mucus secretion becomes reduced, and as a result, the moisture cannot be retained in the mucus layer, causing the aqueous layer of the tear film to drain through the tear ducts into the nose.

 

4. Thyroid disease
Due to hyperthyroidism, the eyes may become enlarged, leading to excessive evaporation of tears. Alternatively, hypothyroidism may cause a decrease in tear production.

 

⑤ Decrease in female hormones
During menopause, women's hormone levels decrease, leading to a reduction in tear production.

Phew... My mother, who is in her late 60s, has already gone through menopause, so her tear production has decreased.

 

6. Medication administration
Medications such as antibiotics, antihistamines, diuretics, antidiarrheals, anticholinergic drugs like scopolamine, beta-blockers for hypertension, sleeping pills, contraceptives, some acne treatments, certain antidepressants, and some anesthetics can reduce tear production, leading to dry eyes.

Here as well, my mother is affected... She is consistently taking medication for high blood pressure.

You are continuously taking antibiotics or nerve-blocking medications because you are experiencing pain here and there...

 

7. Environmental Factors
If the surrounding environment is dry, or if the eyes are irritated by smoke, dust, sunlight, or wind, or if the frequency of blinking unconsciously decreases while reading or using a computer, it is easy to develop dry eye syndrome.

 

8. Others
It can also occur due to damage to the tear glands caused by radiation or inflammation, decreased sensitivity of the cornea, excessive evaporation of tears, or eyelid problems (entropion, ectropion, blepharitis).

 

Upon examining the cause...

There are only a few causes listed for my mom's dry eye syndrome... it really makes me feel bitter.

 

 

I looked into treatment options.

 

1. Tear supply through artificial tear solution
The most common treatment for dry eye syndrome is to supply the deficient tear components using artificial tears! This is a well-known method. It is recommended to always carry artificial tears and frequently instill them whenever discomfort occurs. My mother also carries them around and applies them to her eyes frequently... although only for a short while.

There are various types of artificial tear solutions. Some are in ointment form, and there are also different kinds of eye drops, including a mild gel-like form that is between eye drops and ointments. IPL treatment is said to be helpful for dry eyes caused by blepharitis, and I will explain more about IPL below.

 

② Eyelid cleaning
Eye lid cleaning can restore the lipid layer of tears, reduce tear evaporation, and improve dry eye syndrome. It is said that you can use a cotton swab dipped in clean saline or ophthalmic ointment prescribed by an eye doctor to gently wipe the area where the eyelashes grow about 2 to 3 times a day... Since this is a method that can be done at home, I should let my mom know.

 

Tear duct closure
It is said that blocking the tear duct through which tears are discharged can be effective. Depending on the severity of dry eye syndrome, both the upper and lower tear ducts can be blocked, either temporarily or permanently. There are tools that can be inserted to close the tear duct, and electrocoagulation methods are also available.

However... my mother went to the ophthalmologist last time and had her lower eyelid lifted, and it seemed to improve temporarily for about a day.

You said your eyes are again sticky and painful... so you didn't see much improvement ㅠㅠ

 

 

So I looked for another way... that oil layer!!

They call that oil layer the meibomian gland.. I read that opening a blocked meibomian gland is effective..

I looked into it again.

 

 

My Spring Gland is a very small oil gland with about 50 on the upper and lower eyelids, releasing oil each time you blink.

They say it coats tears so that they don't dry up.

 

However, when these Myoepithelial glands become blocked, the eyes become dry.

 

If the meibomian gland becomes blocked due to inflammation, aging, or other causes, oil does not be produced.

Tears evaporate quickly, leading to excessive tear evaporation-type dry eye syndrome.

In this case, they say that using artificial tears does not resolve dry eye syndrome.

 

So, there is a treatment method called MySpring.

There are two methods mentioned earlier: IPL treatment and ReFLO.

Both treatments are based on the principle of melting the hardened meibomian glands with warm heat and then squeezing.

 

* IPL treatment is

Using infrared laser to warm the eyes and melt the blocked meibomian glands.

It is said to be a method of squeezing the myoepithelial gland with forceps.

 

* Lipiflow is

After inserting a device called a cone into the eye to warm it up

It is said to be a method of squeezing the Mybomsaem.

 

They say it's really an effective method for severe dry eye syndrome.

The problem is that both of these methods are costly and time-consuming to treat.

My Spring Gland requires at least 4 to 8 treatments because it cannot be opened in a single session.

In cases of severe critical condition, it may need to be done dozens of times...

Even if you have insurance coverage, it's not an easy decision; without insurance, it's naturally unthinkable...

 

Moreover... this kind of treatment is said to be performed at a specialized ophthalmology department in a university hospital rather than at a local clinic.

Phew... I think my mom will just say it's okay if I tell her... ㅠㅠ

 

The cost for IPL is 100,000 to 150,000 won per session, and ReFleu can cost up to 500,000 won...

Oh... I guess I should just tell my mom and live my life... right? ㅠㅠ

 

How can I help resolve my mom's dry eye syndrome?

 

It seems that a procedure might be the answer, but I'm also curious if there's a way to try it at home just in case.