We have an ongoing focus at Dornn Eye Care and optical gallery, to stay educated about current treatments that will empower our patients to address and manage their eye health concerns. We provide complete eye exams to detect visual and optical anomalies.We utilize advance technologies that help us diagnose and treat glaucoma, cataracts, macular degeneration, and Ocular Surface Disease.
~ Eyeeco Elite Dry Eye Practice 2018, 2019, and 2020 ~
Ocular surface disease refers to four main conditions that will cause damage and vision problems if left untreated for long periods of time, they are:
- Dry Eye Syndrome (DES) or Meibomian gland dysfunction (MGD)
- Blepharitis and Demodex
- Ocular allergies and Ocular Rosacea
- Recurrent corneal erosions and Lagophthalmos (incomplete closure of lids when sleeping)
- Once assessed, we can curate an individual treatment plan based off our diagnostic findings and symptoms and get you back to living and seeing comfortably.
Dry Eye Disease (DED) is continually being researched as it becomes more prevalent. DED can stem from other health issues and can go undiagnosed. Dry Eye treatments often include Hot Compresses, eye drops and medications. Now, for extreme dry eye cases Dr.Dornn has introduced heat therapy – Radiofrequency (RF) and Intense pulse light (IPL) treatments.This is a noninvasive, efficient and effective treatment using state of the art technology with dramatic results.
INMODE Lumecca Intense Pulse Light treatment (IPL)
INMODE Lumecca Intense Pulse Light treatment (IPL) works to control the inflammatory process and to stop the vicious cycle of inflammation and to reduce the need for medications. IPL treats ocular rosacea, Meibomian Gland Dysfunction, and Inflammatory dry eye. It has been shown to decrease demodex and bacteria around the eyelids. The powerful bursts of light also close off blood vessels that release inflammation in ocular rosacea.
INMODE Forma Radiofrequency treatment (RF)
INMODE Forma Radiofrequency treatment (RF) uses Radio-Frequency energy to generate heat which is applied to the skin around the eyes. This heat stimulates collagen formation, bringing white blood cells, and stem cells to the skin around your eyes while reducing inflammation. This treatment aids in opening up clogged meibomian glands, allowing for improved tear production and secretion. RF is usually followed by a Meibomian Gland expression.
IPL and RF reverse the signs of ageing by stimulating collagen production by smoothing wrinkles and eliminate dark spots for younger looking eyes.
WANT TO LEARN MORE?
The eyelids are critical for the production of two important components of tears: the oily layer of the tear film (hyaluronic acid) and antibodies. The oily layer is produced by the meibomian glands (composed of primarily collagen) of which there are 20 glands in both the top and bottom lids. The lower lids produce the majority of the tear film and the top lid has more of a “windshield wiper” function, to spread out the oil evenly across the surface of the cornea. The hyaluronic acid has the ability to absorb oxygen and become hyper-oxygenated and there by feed oxygen to the cornea via diffusion. Any abnormality of the tear film (too much water or too much acidity) will create hypoxia and will slowly cause problems with the cornea.
The second important function of the tear film is the prevention of infection on the surface of the eye and eyelashes. If the meibomian glands are not functioning well, then there is a reduction of immune response and the eyelid margin and the follicles of the eyelashes will become infected. The follicles can be infected with bacteria as well as a multicellular worm called Demodex. These worms are very common as we age, with approximately 80% of 65 year old showing infestation with Demodex. Patients with this parasite will develop a chronic infection of the eyelashes called blepharitis.
There are many conditions that can damage or inhibit the function of the critical meibomian glands:
- Acne Rosacea
- Meibomian Gland Dysfunction
- Auto-immune Diseases (Arthritis, Fibromyalgia, Lupus, MS, Diabetes, and Colitis)
- Hormonal changes
- Lasik surgery
- Radiation therapy
- Sjorgen’s syndrome
- Lagophthalmos (incomplete closure of the eyelids)
The above photo shows you where the lower eye lid meibomian glands are located.
The K5M machine gives us a very clear image of the condition of the glands.
IPL is best to treat inflammation/demodex in the epithelial layer and the RF works on collagen and meibum in thedermal layer. IPL treatments have shown remarkable ability to improve function and rejuvenate the meibomian glands tissue.
There are 5 mechanisms that are thought to play a role:
- IPL is selectively absorbed by chromatophores that leak from the abnormal neovascular vessels associated with rosacea.
- This allows selective destruction of these abnormal vessels and stops the influx of inflammatory mediators these vessels carry. Ablation of Demodex mites that cause blepharitis and chronic eyelid inflammation.
- Decreases the over-active epithelial skin cells on the lid margin.
- IPL decrease inflammation by directly affection immune mediators (i.e. It decreases the amount pro-inflammatory IL-6 and increases production of anti-inflammatory IL-10.
- IPL and RP will directly heat the meibomian glands to the optimal 42 degrees which helps with liquefaction of “solidified” meibum. The combination of IPL and/or RF must be combined with manual gland expression to get the maximum beneficial effect for the patients.
The majority of patients (literature shows it’s approximately 86%) presenting to our office with dry eyes have MGD (Meibomian gland dysfunction). They will typically have healthy gland tissue but the meibum (refers to the material expressed from the gland) has become solidified at the tops of the glands causing a blockage. So instead of having a liquid expression (like the consistency of olive oil) the top of the glands is plugged up with a “waxy” material. If you have a healthy gland that is chronically blocked for months or years it will eventually atrophy because of inactivity. “If you don’t use it – you lose it”. This chronic blockage will eventually create an immune response and inflammatory cells will cause a cascade of mediators that will ultimately kill that gland tissue (become a chronic cycle of mediator cells migrating the glands causing more inflammation and yet more mediators to migrate).
We are using IPL to BREAK this CYCLE! It’s always better to be proactive rather than reactive.
RF is an excellent treatment for chronic MGD because it’s the most effective way to heat the gland tissue and meibum before a manual gland expression.
The 3 benefits of RF are:
- Safely heating meiboman glands for expressions
- Tightens existing collagen at the dermal layer (which IPL does not)
- Stimulates production of NEW collagen in the deeper dermis
"I am an elderly woman who has arthritis. I had been to 2 Ophthalmologists who verified that I was not producing any tears. (The little paper technique). My dry eyes have persisted now for approximately 2 years. The recommended Blepharitis treatment which is using a wet warm washcloth 2x daily along with OTC eye drops did not alleviate my persistent problem. I needed to use eye drops several times during my sleep time to help me.
It was perchance that I was able to see Dr.Dornn at Eye Revive 15 March, 2021. Dr. Dornn was highly recommended to my husband who needed his eye sight examined along with new lenses and glasses. I decided to make an appointment also, to have my eye sight and eye dryness examined. Dr. Dornn and his professional team verified my “severe” eye dryness. As I understand …my cornea is in jeopardy because I am not producing tears from my Meibomian glands which are essential to bathe your cornea for sustainability. This verification was accomplished with “state of the art” technology. Dr. Dornn has implemented a “treatment plan” to help restore some of the Meibomian glands function ability. This treatment plan was never recommended to me previously. It involves the latest RF and IPL technology along with prescription and non- prescription eye drops, eye ointments and eye moisturizing techniques.
To date I have experienced tremendous relief and note that I do not need to moisturize my eyes as frequently during the day and night. This has given me almost a new “lease on life”.
I am eternally grateful to Dr. Dornn, his team of professionl opticians and workers for Dr. Dornn’s empathy, caring and generous helpful recommendations. Also my husband, who is diabetic, is 100% happy with his new lenses and frames, and knows that he will be taken care of professionally in the future with any eye concerns that may arise for both us.
Thank you Dr. Dornn, Eye Revive and Staff et al for taking care of us.
August 16th, 2021