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Associates in Ophthalmology’s Dry Eye Center of Excellence
AIO is Advancing the Diagnosis and Treatment of Dry Eye Disease.

Dr. Ryan McBee, Optometrist, is a native of Lake Tahoe, Nevada and comes to AIO with a vast knowledge in all aspects of optometry. A graduate of the Pennsylvania College of Optometry, Dr. McBee graduated in the top five percent of his class obtaining honors in both the clinical and applied science.

His wide span of experience includes the managing and training of employees for ocular based studies that he conducted. He also possesses knowledge and experience in credentialing and billing in which he used to set up optometric practices in Nevada. Dr. McBee works closely at AIO treating patients with many ocular diseases.

Q: What Causes Dry Eye?

A: Dry eye is a lack of adequate tears and a loss of homeostasis due to inflammation on the ocular surface relating to eyelid margin disease. Tears are a complex mixture of water, fatty oils and mucus. This mixture helps make the surface of your eyes smooth and clear, and it helps protect your eyes from infection. For some people, the cause of dry eyes is decreased tear production. For others it's increased tear evaporation and an imbalance in the makeup of your tears.

Q: How Is It Managed?

A: The goal is to try any underlying systemic conditions causing dryness along with treating the eye itself. Treatment usually consists of OTC drops, prescription eye drops, eyelid therapy or a combination of multiple therapies.

Q: What Are the Usual Manifestations?

A: The most common symptom of dry eye is watering eyes. However, patient also experience burning, stinging, discomfort, heaviness, eye fatigue, decreased vision and even an increase in glare at night. When the eye is dry it sends a signal to the brain to produce more tears. However, the glands that are used to produce more tears tend to be salty and therefore evaporate much quicker on the ocular surface. Therefore, the eye will constantly water.

Q: What is the examination like to determine whether someone is suffering from Dry Eyes?

A: The examination for dry eye to the patient might not look any different than their routine eye exam. However, a dry eye evaluation has specific testing geared towards this disease that will then help determine the proper treatment protocol.

Q: Are some people more prone to having Dry Eyes than others?

A: There are definitely age and gender predilections with women over the age of 50 more adversely affected. However, a majority of the oral medication people take these days have a side effect of causing dry eye and as computers/cell phones become more widely used the incidence of dry eye has also increased. A recent study out of dry eye clinic in California found that children between the ages of 4-18 were already showing some signs of dry eye and eyelid margin disease due to increased cell phone and computer use. I think we are going to see a lot more people at a younger age with dry eye disease and eyelid margin disease in the practice within the next few years.

Q: What are the typical treatments used to help people suffering from Dry Eyes?

A: Treatment usually consists of a combination of drops and eyelid therapy. As we learn more about dry eye we are finding that the eyelids play a more important role than we originally thought. I find myself treating lid margin disease (i.e. blepharitis and meibomian gland dysfunction) where I would have treated with only drops in the past. If the dryness cannot be managed effectively with OTC therapy then patients have the option of two prescription drops, which are Restasis and Xiidra.

Lid margin disease is typically treated with some form of heat along with a cleaning product. If the disease progresses or if it cannot be managed simply, then antibiotics are generally prescribed both orally and/or topically. Certain patient will need further treatment including eyelid debridement and expression through devices like the BlephX and iLux respectively.

Q: Do you have any recommendations for people to help them avoid Dry Eye issues?

A: Unfortunately, no, since there are so many variables that can affect patients with dry eye disease. The best thing to do is to seek help if any symptoms or changes are noted.

Q: Is there anything else you would like to add about Dry Eye?

A: I think the hardest thing about treating patients with dry eye and eyelid margin disease is that nothing is instantaneous. Patients need to understand that treatment can often take months for symptoms relief and that a majority of therapy is chronic. The good new is that the disease is treatable and that there are many more things to come in the next few years for dry eye therapy. For the past ten plus year we only have one eye drop option for patients and soon we will have multiple drops options as well as a variety of eyelid treatments to offer patients who have been suffering for so long.

For more information, contact Associates in Ophthalmology at 888-634-9800 or visit AIOvision.com.

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