Dry eyes are a vague term describing a spectrum of symptoms and signs including irritated, dry, and red eyes.This is a very common problem, especially in today’s world where people would be handicapped without technology.This is due to the fact that computers, TVs, IPhones, blackberries etc. are all major causes of Dry Eyes.When people use a computer they tend to blink less.This means they do not replenish their eyes with tears as much as they should, which eventually leads to Dry Eyes.Meibomian Gland Probing (MGP) is a groundbreaking technique that relieves dry eyes and is now performed by Dr. Gulani.The goal of this project is to see how MGP affects people’s lifestyle after years of suffering with dry eyes.
Having Dry Eyes can cause irritation, burning, and redness of the eye.Artificial tears have been found to help, but these have never been a permanent solution.Dry eyes can be aggravated by allergies, or even smoke.Wearing contacts rapidly dries out eyes, unless properly hydrated with drops.Dry eyes can occasionally cause extreme tearing up, and also stickiness and inability to open eyes.Light and air-condition can be unbearable if you have dry eyes.Dry eyes are more prominent in women, and people with diseases like arthritis and hypothyroidism.Certain medications can also worsen dry eyes, the most common of which are anti-allergy medications (Mayo Clinic).
Eyes have tears with three different layers: oil, aqueous, and mucus.The Oil layer is the outermost layer.It contains lipids which prevent water evaporation.This layer plays a major role in stabilizing tears.The aqueous or water layer is the middle tear layer which contains the vital chemicals and essential ingredients.The last layer is the mucus layer which makes the aqueous layer stick to the ocular surface.
Dry eyes can be diagnosed with the symptoms and signs and also by special tests like the Schirmer tear test (Mayo Clinic).During this test a strip of paper (which is marked in millimeters) is placed on to the patient’s eye, under the lower lid.5 minutes later it is taken off and dryness is based on how wet the strip of paper is.The less soaked the strip is, the drier the eye is.Another way to treat dry eyes, other than MGP is placing tear plugs in the ducts of the eyelids.This prevents the drainage of the tears (Keenan, John).These plugs can be temporary or permanent.Dr. Gulani provides this method among the full spectrum of dry eye management. This treatment is more familiar with eye doctors, whereas MGP is a fresh and innovative technique that he has been practicing since two years.
ReStasis ™ is a medical form of dry eye treatment which helps produce more tears in patients with aqueous deficiency.This eye drop is prescribed by most eye doctors to their dry eye patients.Most patients are not content with these drops because they have to apply it twice a day and are also expensive long term, so they are looking for a permanent solution to their dry eyes which is why they seek to get MGP done.
Meibomian Gland Probing relieves Dry Eyes by releasing the entrapped meibomian gland secretions (lipid layer of the tear film) which stabilizes and preserves the main tear layer (aqueous) in the eye.Dr. Gulani helped people who had dry eyes with this new technique by working on their lipid layer by opening blocked meibomian glands in their lids.The oil (lipid) layer of tears is produced by the meibomian glands which can be compared to 20-30 toothpaste tubes vertically arranged in a row in each lid.He probed the meibomian glands releasing oil that will preserve water.So when the water (aqueous) layer in the eyes evaporates too quickly, then the released oil from opened meibomian glands will prevent the water layer from evaporating too fast thus keeping the eye properly hydrated. This may additionally improve vision since tears are such an important part of the visual system and also result in more healthy and sparkling eyes (Gulani, Arun).
Although MGP is technically a surgery and/or procedure, the duration, discomfort and recovery is very minimal.The procedure itself takes about five minutes, and is done with numbing drops and a special gel so that patients only feel a slight tickle in their eyes when their glands are being probed.The recovery is really only one day, and after that patients are free to drive and go out into the sun.Relief can be immediate or it can take up to one week, depending on the patient.At first the patient sees excess tearing, and then the glands adjust so that the patient has lubricated eyes.
This project was chosen because over 69 million people suffer with dry eyes today.It is a very common and increasingly prevalent malady of the present time we live in.Patients with dry eyes have to make lifestyle changes to live with dry eyes, so by doing this project the causes of dry eyes will be known to the public, and real outcomes of MGP will also be known thus convincing dry eye patients to seekthis procedure and live a normal life.
The patients who have the “driest” eyes will be those who spend the most time on a computer due to their job.After they will answer that their eyes feel new and glossy due to the water.
The first step of the procedure is getting MGP done.MGP is Meibomian Gland Probing; this is a surgical technique that relieves dry eyes.Immediately after the procedure the patients were asked if they would like to participate in this project by the office staff.They were informed that it was completely voluntary.After having MGP and recovering for a week the patients were called and interviewed for this project.
The people questioned were patients who already had set an appointment to get relief from dry eyes; this project just made their thoughts and reasons for dry eyes known anonymously.They were informed that it is optional, and that any question on the survey could have been omitted if thought of as too personal.
The Questions asked were about their symptoms, and how they felt with and without Dry eyes.The occupation people have and its toll on their eyes were compared and contrasted.Their occupation was analyzed to see if that caused them to have dry eyes because of too much time spent on the computer.For example, if someone is a computer engineer they will more likely have a higher incidence of dry eyes since they stare at the computer screen for long periods of time thus decreasing the blink rate and letting tears evaporate faster.The data of fifty two patients was then analyzed and results were calculated based on answers to each question.
The results of the survey were dramatically positive.MGP did drastically improve most patients’ eyes and lifestyle.For some patients getting MGP done meant that they could comfortably open their eyes after years of not being able to.When asked how dry their eyes were before getting MGP done on a scale of one to five, 57.7% rated their eyes as a five.23.1% answered four, and 17.3% said three.Only 1.9% said one, and no one said two.This concludes that most of the patients were severely suffering with dry eyes before they came to Dr. Gulani.The second question resulted in a plethora of symptoms and lifestyle changes due to dry eyes.The most common symptom given was itchy, scratchy, sandy, red, and burning eyes.20 people said their eyes were itchy, scratchy, and felt like sandpaper.Other common symptoms were avoiding public places, difficulty in wearing contacts, and using excessive drops.Four people even said their vision was affected.Seven patients said reading fine details, or looking at computers was tough with dry eyes.Some people even replied that their sleeping and driving was affected.Only two people said they had no symptoms at all.For most of these patients, dry eyes had been controlling most of their lives, before coming to Dr. Gulani.
Redness is usually affiliated with dry eyes.This is why some people listed avoiding public excursions as a lifestyle change, because they had red eyes that were not very attractive to look at.One patient said, “My eyes were my best features before I got dry eyes.”Since redness is a very common and bothersome symptom for dry eyes patients; they were asked if their eyes got red and how often?53.8% of the patients answered that their eyes were always red.21.2% answered that their eyes were sometimes red, and 25% answered that their eyes were never red.Over half of the patients always had red, dry eyes but at the same time one fourth of them never had red eyes.
When asked about their occupations, patients replied with numerous occupations, some that included a lot of time on the computer, and others not so much.57.7% of the people had jobs and a lifestyle that made them watch a screen for over six hours a day.25% would look at a screen between three to five hours a day and 17.3% would almost never look at a screen.These results are based on the patients’ jobs.If a patient was retired, their previous job was surveyed.Looking at a screen for long periods of time is a risk factor for dry eyes.Patients were also asked if they thought that their occupation affected their dry eyes.50% believed it did affect their eyes, whereas 36.6% did not think it did.The other13.5% said maybe and was unsure.This means that 50% believed their job was the cause of their dry eyes proving the hypothesis correct, because if a job causes someone to spend a lot of time on the computer it most likely causes them to have dry eyes.This is the reason dry eyes is a very common disease in today’s technology world.IPods, blackberries, IPhones, videogames, and computers are all screens.Most people spend a lot of time on these electronic devices leading them to having dry eyes.MGP is an innovative technique because it will relieve many people throughout the world of dry eyes.
Patients who came to Dr. Gulani could have previously been diagnosed with dry eyes.75% of them were, if they were diagnosed, they were asked what their doctor did to relieve their dry eyes.7 people had been diagnosed with dry eyes and had gotten the plug procedure done.This procedure also relieves dry eyes by placing s plug in the canaliculi.This prevents aqueous from leaving the eyes.11 people were simply diagnosed.21 people were diagnosed and given drops, and when asked what type of drops they were prescribed, majority answered with ReStasis ™.ReStasis™ is a medicated eye drop that needs to be put in the eyes twice a day.Patients who were prescribed with Restasis were looking for a more permanent solution to their dry eyes, MGP.4 people were diagnosed with a previous eye surgery, like pterygium, or Lasik.13 people were not diagnosed at all.
Gender plays a major role in dry eyes, because women tend to get it more.80.8% of the patients were women; while a mere 19.25% were men.There were also women of all ages; from 30 years old to 60 years old.They also had various jobs, from teachers to accountants.
Almost all of the patients were relieved.94.2% said their eyes were relieved, and were very happy with the whole procedure.Patients were also asked if their eyes looked clearer, and 40 people said yes.This is a great outcome considering MGP is not directly supposed to affect vision quality.After getting MGP done, most if not all, symptoms were gone.The procedure left people with glossy, lubricated eyes.Patients were not embarrassed of their eyes anymore, but rather they were proud to go out and flaunt their new and moist eyes.One patient replied, “My eyes actually water when I yawn now.”Eyes were also described as less irritating, and cool and comfortable.Patient number 13 described her eyes, “It felt like my eyes were swimming.” She is describing her eyes as very moist and 100% better.Most of the patients described their eyes after having MGP in the same way.For example sixteen people said their eyes were better.Six people said their eyes were lubricated.Fourteen replied with their eyes being wet or moist, and the list goes on with numerous words like these.
There were some unrelieved patients.One patient had pterygium, and this condition affected their dry eye relief.The other patient was in the 1% of people who had an adverse reaction to eye drops.The last patient had gotten MGP done after a previously failed Lasik surgery that was referred to Dr. Gulani.For these unrelieved patients, it was not MGP that affected them, it was another eye issue they had had before getting MGP done that affected the outcomes of MGP.
The hypothesis was proven correct.Occupations do affect dry eyes, because certain occupations require more time looking at a screen than others, and over half of the patients spend more than six hours a day watching a screen.Most of the patients described their eyes afterwards as moist and lubricated, or better.MGP does relieve dry eyes, and gives patients their lives back, because with dry eyes patients were constantly putting in drops and avoiding driving.The causes of dry eyes are looking at a screen, but also gender and age.The effects of MGP were astounding to the patients who were relieved.They could now open their eyes in the morning without going through a process to do so. Many patients who were told that they were not candidates for Lasik surgery due to dry eyes could now have Lasik surgery and lead a life free of glasses.
Overall MGP was a life changing procedure for dry eye patients; they could now live a normal, drop free life.
Gulani, Arun. “Dry Eye Cases.” www.gulanivision.com. 2010. Gulani Vision Institute. 25 July 2011
Gulani, Arun. “Dry Eye Treatment.” www.gulanivision.com. 2010. Gulani Vision Institute.25 July 2011
Charters, Lynda. “Intraductal Meibomian Gland Probing Reduces Inflammation”. Ocular Surgery News (OSN). Feb. 2010. 16 and 63.
Department of Health and Human Services. “Code of Federal Regulation (CFR), Title 45 (Public Welfare), Part 46-Protection of Human Subjects (45CFR46).”(2003).
Gulani, Arun. Personal interview. 26 Jun. 2011
Hovanesian, John. “Squeezing and Probing those Meibomian Glands-Does it Work?” Osn Super Site. Feb. 2010
Keenan, John. “Dry Eyes.” Medicine Net. 26 Sept. 2009
Kinshuck, David. “Sore or Dry Eyes”. Good Hope Eye. March 2011.Good Hope Eye Dept. 18 Sept. 2011.
Lee, Judith. Bailey Gretchyn. “Dry Eye Syndrome.” All about Vision. June 2011. Access Media Group LLC. 21 Oct. 2011
Maskin, SL. “Intraductal Meibomian Gland Probing Relieves Symptoms of Obstructive Meibomian Gland Dysfunction.” The Dry Eye and Cornea Treatment Center. 29 Oct. 2010
Maskin, Steven. “Dry Eye Relief.” Ophthalmology Management. July 2011
Maskin, Steven. “Dry Eye Treatments”. Dryeye.me. Dryeye.me. 18 Sept.2011
Mayo Clinic Staff. “Dry Eyes Symptoms”. Mayo Clinic. 12 June 2010. Mayo Clinic. 18 Sept. 2011
Mayo Clinic. “Dry Eyes.” Mayo Clinic. 12 June 2010
Oasis. Are your Eyes Dry, Burning, Irritated, Watery? You may have Dry Eyes. Glendora, CA: Oasis Medical Inc., Feb 2008
Science Service. "International Rules for Precollege Science Research: Guidelines for Science and Engineering Fairs / 2006-2007." 1 Sep, 2006.
Article By: Aaisha Gulani