Dry Eye Treatment Specialist

New England Dry Eye & Aesthetics

Dry Eye Disease Specialists & Aesthetic Specialists located in Waterbury, CT

Dr. Jaccoma is considered an expert and a pioneer in dry eye care, having performed numerous studies, invented new treatments and lecturing extensively on these treatments as well as dry eye diseahttps://ppadmin.patientpop.com/practice/edit/12946#ses in general. If you frequently experience dryness and irritation in your eyes, you may have a condition known as dry eye syndrome. Dry eye can make it uncomfortable for you to read a book or use your computer for long periods of time. At New England Dry Eye & Aesthetics in Kittery, Maine, Dr. Edward H. Jaccoma and his staff offer state of the art diagnostic and treatment services for dry eye to restore your eyes to good health. Schedule a consultation online or by calling the office to learn more.

Dry Eye Treatment Q & A

New England Dry Eye & Aesthetics

What is dry eye?

Dry eye happens when your eyes don’t produce sufficient tears or if the tears evaporate too rapidly. As a result, your eyes don't receive the proper lubrication, protection, nourishment, and support offered by a healthy tear.

You may find it difficult to read, work on a computer or perform other activities when your eyes are dry. It may also be difficult to tolerate dry environments for extended periods of time.

Dry eye is a chronic, progressive condition. Without proper treatment, it worsens over time.

How are tears related to dry eye?

Your tears are made up of water, salts, fatty oils, and multiple proteins (think salad dressing!). Each time you blink your eyes, tiny glands (the “sprinkler system”) produce the tears, which flow across the surface of your eye to provide cells with nutrients. Tears also serve as a protective liquid for your eyes. Without enough oil, the tear water evaporates, leading to “evaporative dry eye disease.” This leaves higher levels of salts that can become toxic to the cells lining the surface of the eye. As these cells die and drop out, little open sores can develop. As salts get washed into these open sores, the nerves supplying these areas become irritated. Stinging, burning and scratchy feelings can follow.

Without adequate tear production, your eyes don’t receive the proper nutrients and become dry, irritated and inflamed. Your vision may also become affected as your tears are essential for focusing light. Ironically, a common symptom of dry eye is reflex tearing (where the “firehose” gland turns on to flood the eye with water). The fire hose makes a salty tear that is good at washing away loose lashes and our saddest emotions but the living cells of our eyes need the food, support, and lubrication we can only get from the sprinkler system. The driest eyes will therefore sometimes present as red, teary eyes that make us look sad and feel bad.

What causes dry eye?

Age is a common cause for dry eye. As you age, your tear production may naturally slow down and result in dry eye. Women are also at higher risk than men for developing the condition, possibly from hormonal changes due to menopause, or due to the toxic effect of certain chemicals contained in some frequently used cosmetic products (especially many mascaras and certain makeup removers).

Other causes of dry eye include:

  • Certain medications
  • Hormone therapies
  • Autoimmune disorders (especially Sjogren’s Syndrome, where the mouth, eyes, and vagina can become severely dry)
  • Seasonal allergies
  • Prolonged screen time
  • Laser eye surgery
  • Cataract surgery

Also, if you have specific skin diseases, like rosacea, it can affect the health of your tear production glands and disrupt tear production.

 

New England Dry Eye and Aesthetics offers comprehensive, advanced diagnostic services including an assessment of the amounts of tear volume, tear salts, tear oils and the relative stability of the tears on the surface of your eyes. Redness is graded by an international scale that helps indicate the degree of inflammation affecting your eyes. Special infrared photography can image the anatomy of the glands responsible for tear oils, and drops combined with filtered blue light, images the layer of tears as they cover the eye, highlighting irregularities that can contribute to poor vision and dry eye symptoms. Videography tracks blinking and monitors the spreading of oils over the eye. Detailed history and a comprehensive, microscopic dry eye examination, including grading of the oils expressed from eyelid glands, helps to give an accurate picture of the range of problems that can contribute - and allow the best recommendations to restore tear functions. Please note:

  • We recommend you allow up to several hours* for your visit. This allows us to gather a complete history and do all the diagnostic testing necessary. More importantly, it will allow plenty of time for us to educate you on what we find and recommend. (*Most new patient visits exceed an hour and some take up to several hours. When you come for a treatment, we can advise how much time will be required and whether a driver will be necessary.)
  • If you have had eye evaluations, surgery or medical care from other eye doctors, we ask that you request they forward their records to our office in advance of your visit, so we can have the most accurate history possible at the time of your visit.
  • Please bring your glasses, contact lenses (but don’t wear contacts to the visit) and all dry eye medications, supplements and general eye care items with you so we can see exactly what you are using. A complete list of all general medications and supplements is also very helpful as many oral and some topical medications can have an effect on dry eyes. Please let us know if you have ever had Accutane for acne if you use retinoids (or other age-defying creams or serums) topically around your eyes as these can “shut down” the vital oil glands in your eyelids.
  • We ask that you do not use any eye drops or eyelid cleansing agents for at least 12 hours before your visit, no contact lenses, creams, gels, any kind of makeup or ointments for at least 24 hours before your visit and avoid rubbing or hot packing your eyes the day of your visit. This allows us to get an accurate “read” on what your own, native tears look like (so as not to contaminate them in a way that throws off our sensitive instruments during your exam).
  • We welcome one or two family members or caregivers to accompany you to your visit. While we do not typically dilate or diminish your vision with our testing, the amount of information we provide can be of such volume that having a second (or third) pair of ears (and eyes) often helps in fully comprehending and retaining what is discussed during this comprehensive evaluation. A customized, comprehensively detailed handout will be provided to you as an additional resource when you leave. Opportunities exist for family members or caregivers to look on with Dr. Jaccoma to see what he then explains as they look through a microscope together.
  • If you are traveling a great distance or have difficulty with transportation and believe you would like to have some treatments initiated during your first visit, we will do our best to accommodate you - but it is helpful if you make this clear at the time you schedule your appointment and we may request you wait to allow freeing up sufficient staff to help you. Most times we prefer to schedule treatments after you have a chance to consider the (frequently multiple) options and to ensure we will have adequate time to give you the best care.

What treatments are available for dry eye?

Dr. Jaccoma offers many effective treatments for resolving the irritation of the dry eye and preventing a recurrence. He performs a full eye exam to confirm a dry eye diagnosis and determine the best treatment for you. This includes tear osmolarity (the TearLab® measures the salt level in your tears), the Oculus Keratograph® (measuring the volume of tear, the stability of the tear to evaporation, what the surface looks like to your tear and what the oil-producing glands look like among other functions), and can measure the oil levels and even how you blink (with the TearScience Lipiview®). A Korb MGE® determines the utility of the tear-oil-producing-glands under the simulation of normal blinks. See “causes” (above) for a more detailed description of these diagnostic services.

Treatment options may include:

  • Prescription eye drops: includes Restasis® and Xiidra®
  • Advanced artificial tears (such as Oasis products)
  • BlephEx®: in-office treatments to clean eyelids
  • Prokera®: therapeutic device to repair surface eye damage
  • LipiFlow®: uses heat to increase the release of tears from the eye glands
  • Intense pulsed light (IPL): a laser therapy effective in treating rosacea that affects eyelids and tear production
  • Radiofrequency (using Ellman® and thermiRF® devices) to smooth the conjunctival surfaces when indicated (see below) and to assist in the heating and expressing of clogged oil glands while offering an aesthetic repair of thin, wrinkled skin. RF can also be used in certain surgical indications to bloodlessly remove skin lesions and alter the position of malpositioned lids or remove unwanted eyelashes
  • eyeThera dry eye kits (designed to provide the products and supplements necessary for good lid hygiene and tear-gland nutrition, in an affordable, convenient, renewable kit)
  • Eyeeco brand products, including sleep masks, heat masks, and tea tree oil cleansers
  • Punctal plugs (small plugs designed to impede the flow of tears through the tear ducts, thereby allowing tears to remain longer on the surface of the eye)
  • Prescriptive antibiotics (sometimes small doses of oral or topical antibiotics can help relieve inflammation and improve tear health. Dr. Jaccoma can help assess if these could be useful in each case.
  • Regener-Eyes® ( a prescriptive eyedrop developed to help patients suffering from inflammation and dry eyes, it is a sterile, natural material made from placental-derived fluids that have been shown to reduce inflammation and help restore the ocular surface to health)
  • Therapeutic contact lenses (unlike contacts used to replace glasses, these contacts help to stabilize the ocular surface while it is being repaired).
  • Eyelid surgeries (when eyelids or eyelashes are misaligned or overly exposing the eye to trauma or dryness, then corrective procedures are often possible to realign the lids or lashes. Some procedures may be offered in-office and others may require more extensive and/or microscopic correction in the hospital OR setting). 

Dr. Jaccoma also offers an in-office procedure, commonly covered by most insurances, to correct a condition called conjunctival chalasis, a restorative procedure to correct the relationship of the eye’s thin, translucent membrane (the conjunctiva) to the lower eyelid. This helps to form a smooth surface for the tears to flow over and establishes an effective gutter that helps your eyes retain its freshest tears. For more information on Dr. Jaccoma's groundbreaking research on the treatment for this disorder at the American Society of Laser Medicine and Surgery in Dallas in April 2018, please visit: HERE

If you’re suffering from dry eye, book a consultation online or by calling the office.