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Corner of University and 128th St, across from The Iowa Clinic

Located at Corner of University and 128th St, across from The Iowa Clinic

Woman with dry eye, using eye drops

Dry Eye Center at Premier Vision Clinic In West Des Moines, IA

Dry Eye Treatment In West Des Moines

Even without knowing the term “dry eye syndrome” or “ocular surface disease“, if you suffer from it, then you are all too familiar with the soreness, discomfort, fluctuating vision, and even the constant misery that can come with dry or inflamed eyes.

Dry Eye Specialist For You

Fortunately, there is a West Des Moines Dry Eye Specialist seeking to bring relief and healing from Dry Eyes in its many forms to patients from the state of IA. With Dr. Jennifer DenHartog at the helm, Dry Eye Center at Premier Vision Clinic, in West Des Moines, specializes in treating the entire range of Dry Eye Syndrome and Ocular Surface Disease, from mild to severe. Whether it’s an occasional irritant or a debilitating daily problem, we’re here to help, with years of experience specializing in treating dry eyes.

Advanced Diagnostic Equipment And Tools For Dry Eye

Dry Eye Center at Premier Vision Clinic uses the most advanced diagnostic equipment and tools to quickly and accurately pinpoint the cause and type of dry eye problem you’re suffering from. We don’t just throw any old drops at you either. We provide custom, tailored treatment plans designed to maximize the relief of your dry eye symptoms AND treat the underlying cause of your discomfort.

What Is Dry Eye?

Dry Eye Syndrome can range from a mild irritant to chronic problem. The symptoms of Dry Eye Syndrome may include:

  • Dry, irritated, or red eyes
  • Excessive tearing/watery eyes
  • Sore or sensitive eyes
  • Itchiness
  • Burning or inflammation
  • A gritty or pasty feeling in the eyelids
  • Crusty or gunky eyes
  • Blurriness
  • Fluctuating vision
  • Tired eyes, worse as the day goes on
  • Frequent styes or irritation or redness of the eyelid

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Colorful Art, Depicting Eyes

What Causes Dry Eye?

Dry eyes, or, Dry Eye Syndrome, is a complex condition that can have multiple causes but tends to share common symptoms. Our optometrist, Dr. Jennifer DenHartog, uses the latest technology to assess the cause of your dry eye symptoms, in order to provide the best possible care.

Poor Tear Quality

For tears to effectively moisturize and lubricate your eyes, they need to have the right balance of:

  • Aqueous – water and salts produced by the lacrimal gland
  • Lipids ―oils produced by the meibomian glands
  • Mucin – a protective layer produced by the cornea

The aqueous(water) provides moisture and keeps the eyes clean while simultaneously delivering oxygen to the tissue of the eyes.

The lipids (oils) produced by the meibomian glands provide essential lubrication and control the rate at which the water of tears evaporates. The time it takes for the tear film to evaporate is referred to as the tear-film break-up time.

The mucin in tears helps to keep the tear-film evenly distributed and stable.  

When someone is suffering from Dry Eye Syndrome or another Ocular Surface Disease, one or more of these layers is out of balance, the normal state of the tear film is disrupted and your eyes suffer for it. In 85% of cases, Meibomian Gland Disorder is responsible for dry eye syndrome.

Meibomian Gland Disorder

Our eyes have glands which produce the lipids (fatty oils) essential for proper lubrication. These are referred to as the meibomian glands. The blockage or dysfunction of these glands causes a condition known as Meibomian Gland Disorder. This condition is responsible for roughly 85% of all instances of Dry Eye Syndrome.

Blepharitis

Blepharitis is related to Dry Eye Syndrome and is often a contributing cause or a parallel condition. It involves inflamed eyelids which may also have a dandruff-like flaking at the base of the lashesBlepharitis is usually caused by a disruption in the biome, or the healthy bacteria balance, on the eyelid. It may also be caused by other skin conditions resulting in similar symptoms to dry eye syndrome in general.

Poor Tear Volume

A low supply of tears is a less common cause of Dry Eye Syndrome. This can be caused by a number of factors such as medication and certain health conditions, resulting in Dry eyes.

Age, Gender & Dry Eye

As we age, we experience hormonal changes. These changes are known to cause or contribute to dry eyes. While this is true of both men and women, it seems that women over 50 are particularly more prone to developing dry eye symptoms. Pregnancy is also known to contribute to or exacerbate dry eye syndrome.

Environmental Factors & Irritants

By increasing the rate at which our tears evaporate, the following environmental factors are known to play a huge role in causing or contributing to dry eyes:

  • Smoke
  • Pollution
  • Cold-climate and central heating
  • Dry climate
  • Sandy or dusty conditions
  • Altitude
  • Air conditioning
  • Wind
  • Ceiling Fans
  • Allergens
Contact Lenses & Dry Eye

Poor cleaning habits, not changing the contact often enough, and sleeping in contact lenses can contribute to dry eyes. However, even for those who take proper care with their contacts, they can still be a contributing cause of dry eyes. In fact, one of the main reasons people discontinue contact lens usage is due to dry eyes. The good news is there have been major improvements across all the brands with special contacts that are aimed at preventing dry eye symptoms.

Medical Conditions

Various diseases contribute to or even cause, dry eyes. Autoimmune diseases are a known factor. Rheumatoid arthritis, Sjogren’s syndrome, Celiac disease, Lupus, IBS, Chrons and Colitis, and others can also contribute to dry eyes. Diabetics or those with Glaucoma who require medication are also more likely to have dry eye syndrome.

Lifestyle & Dry Eyes

As with everything, proper balanced diet and exercise are important in preventing or managing dry eye syndrome. Specifically, increasing intake of healthy fats with Omega 3 fatty acids, and limiting processed foods with inflammatory Omega 6 fatty acids is helpful. There are two specific activities that relate directly to Dry Eyes.

Does Staring At A Screen Cause Dry Eye?

Continuous staring at a fixed object, such as a phone or computer screen, usually results in a decreased blink rate. The lack of blinking actually causes the eyes not to replenish the tears often enough. The meibomian glands, therefore, can become blocked or even atrophy and die.

Prolonged And Continuous Use Of Digital Devices Is Thought To Be The Likely Culprit In The Significant Increase Of Dry Eye Syndrome Throughout The General Population.

Does Drinking More Water Help With Dry Eye?

The main component of tears is water. Most of us don’t drink enough water. If you are dehydrated or not drinking enough, then you may not produce enough tears to keep your eyes moist. Soft drinks and other caffeinated drinks like coffee and tea may feel like they quench your thirst, but they actually dehydrate the body. Your body needs water to prevent dry eyes symptoms.

Medications & Dry Eye

Whether prescription or over-the-counter, certain medications are known to decrease tear production which may contribute to Dry Eye symptoms. These include:

  • Beta-blockers / blood pressure medications
  • Antihistamines
  • Decongestants
  • AntiDepressants
  • Oral Contraceptives

dry eye video

How Can I Improve My Lifestyle To Prevent And Treat Dry Eye Syndrome?

There are many ways to treat dry eye. The first recommendation is to prevent dry eye symptoms before they start, and to address lifestyle factors that may be making it worse.

Blink a lot and drink a lot. Avoid eye irritants, use lubricating eye drops if you are taking medication that puts you at risk for dry eye. Over the counter eye drops for dry eye are widely available. Maintain a healthy lifestyle with a focus on vitamins like Omega 3.

One of the most common treatments we recommend is simple. Just BLINK! Blink regularly. Good, hard, fully closed blinks help restore the tear film.

The 20-20-20 Rule! During prolonged computer or digital device use, take 20 seconds, every 20 minutes, to look at an object at a distance of at least 20 feet away. This gives your eyes a needed rest.

 

Drink adequately. Women need at least 91 oz. of water a day. Men need even more. Poor intake of water directly contributes to a poor supply of tears, especially in hot and dry conditions.

A healthy diet is always essential for maintaining optimal health. Omega 3 fatty acids have been conclusively shown to help maintain good vision and eye health, as well as decrease dry eyes symptoms.

Fish and flax are good natural sources of Omega 3 fatty acids, also available in tablet/supplement form. There are even formulations specific for dry eyes. These usually consist of Omega 3 with DHA from flaxseed oil and includes vitamin C, vitamin E, Vitamin B6, magnesium, and a variety of other vitamins specifically geared toward patients with dry eyes. Our Dry Eye doctor can recommend one or more of these for your specific needs.

We carry the following supplements: 

Eye Promise EZ Tears

HydroEye

How Is Dry Eye Syndrome Diagnosed?

Sometimes, a visual inspection of the eyes isn't enough. Since a problem with the meibomian glands (which produce those essential lubricating lipids) is most often to blame for chronic dry eyes, it's important to get the best digital image of the meibomian glands possible. That's why dry eye specialists use LipiScan, which takes a high-resolution digital image of the lower AND upper glands.

Such imaging tells us a lot about how healthy your oil glands are. Are they open and secreting? Blocked? Damaged or Atrophied? Thickened? Is the oil cloudy or clear? Cloudy oil results from unhealthy meibum or oil within the gland, which is often caused by inflammation and an overgrowth of bacteria leading to decreased flow of the meibum. It is helpful to treat this condition before the chronic thickening damages the glands and they no longer produce healthy meibum.

Our Dry Eye Specialist in West Des Moines provides cutting-edge treatment for dry eyes that's fully tailored to your specific situation. We diagnose and assess your eyes using the latest technology combined with a thorough vision exam, a review of your medications, health history, and lifestyle factors and all-around great patient care that will get to the core cause of your condition. For example:

  • How effectively are you blinking? How often?
  • What’s the osmolarity of your tears?
  • How fast do your tears break down?
  • What is your tear volume?
  • What shape are your meibomian glands in? Are they blocked? Dirty? Infected?
  • Is inflammation present in your tears?
  • Could your skincare or makeup be aggravating your symptoms?

Our dry eye doctor will also conduct an in-depth assessment of indicators for other diseases and health problems which might be contributing factors to your dry eyes. We then develop a personalized treatment plan based on what we find, and ongoing treatment plan based on what's working for you.

On every patient questionnaire, we ask if you are suffering from any of the typical symptoms of dry eyes. Do your eyes feel gritty? Sore? Do you feel like something is in your eye or that you just don't seem to have any tears? If you report symptoms of dry eye, or appear to exhibit those symptoms, then we recommend beginning the dry eye exam process, which is quick, easy, and painless.

The first thing we want to check is the stability of the tear-film. We use TearLab to test the osmolarity of your tears― that is, the relative concentrations of salts, water, and lipids (fatty oils). These lipids are produced by the meibomian glands. Most cases of dry eyes occur where there is a problem with these glands. They could be blocked, atrophied, or otherwise damaged. If your tears evaporate too quickly (which causes burning), it's usually caused by a lack of these lipids.

A strong imbalance between the osmolarity of one eye vs. the other is a strong indication that someone has dry eye disease.

Depending on the results of the TearLab, our West Des Moines Dry Eye specialist will also want to see if the overall volume of tears could be the problem. In some cases, the meibomian glands are producing the lipids needed for lubrication, but there just isn't enough of the aqueous layer (this means tears) to spread it around effectively.

In order to test this, our optometrist will place a thin piece of red thread draped over the eyes for a few seconds in order to measure how wet the eye gets and comparing the differential between the eyes.

Another tool in the arsenal of our dry eye experts is InflammaDry, a specialized diagnostic tool which measures whether or not a patient has elevated levels of MMP-9 in their tears from the inner lining of the lower eyelid. MMP-9 is a protein which indicates inflammation, which is fairly common for anyone suffering from dry eyes.

Our eye doctor will typically prescribe steroids in order to get the eye inflammation under control.

Our dry eye doctor will also test your tear breakup time. Sometimes, tears don't last long enough to work effectively. In order to test this, we use a fluorescein orange dye to test the breakup time (as well as any other corneal diseases, conditions, or foreign bodies). Using a small blotting paper, the optometrist will lightly touch your eye. As you blink, the dye spreads and gently coats the tear film covering the cornea. Using a blue light (the dye is orange), problems will be revealed to the eye doctor as green.

How Is Dry Eye Treated?

Custom Treatment

Depending on the underlying cause or causes of your dry eyes, as well as the severity, our West Des Moines Dry Eye Specialist will develop a custom treatment plan that is tailored to your specific needs. The following are some of the treatment options in our arsenal for treating dry eyes.

Debridement for Blepharitis

Debridement is a painless in-office procedure performed by our Dry Eye Specialist to treat blepharitis, demodex, meibomian gland dysfunction, and inflammation of the lids which are all common causes of severe dry eyes. In our Clive Dry Eye Clinic, we use several devices to effectively remove scurf and debris, exfoliating along the edge of your eyelids and lashes.

LidPro

Treating Anterior blepharitis, the LidPro is the perfect tool to help.

Its ergonomic design allows for comfort when treating both upper and lower eyelids. Using silicone disposable textured cleaning discs with fast spinning action will effectively exfoliate the eyelid margin with only a few passes.

Less friction being needed in cleaning results in less irritation and more comfort for the patient.

Punctal Plugs

For cases of severe or chronic tear-film insufficiency, our West Des Moines Dry Eye doctor will sometimes use punctal plugs. These are small devices that are inserted into the tear ducts to slow or even block the drainage of tears. This increases the tear-film and moisture present in the eyes.

In most cases, the procedure is quick, painless, and uneventful. Find out if punctal plugs are right for you.

Prescription Eye Drops

This often occurs because of the constant inflammation they experience. Unlike artificial tears, Restasis and Xiidra are prescription eye drops which have been shown to decrease inflammation and to increase they eye’s ability to make its own tears. Instead of having to constantly replenish your eyes’ moisture, with Restasis or Xiidra, you are controlling inflammation and helping to restore balance to the tear film, and therefore stimulating your eyes to make more healthy tears over time.

When do I need prescription eye drops and when is a dietary supplement enough?

Typically, Restasis or Xiidra is used for chronic cases, while a recommended omega-3 supplement usually can and should be used in most cases even as a preventative measure and to maintain optimal eye health.

Our eye doctors are experts in treating dry eye syndrome and will diagnose and guide you through the right treatment plan for you. You don’t have to continue to suffer. Book an appointment with our West Des Moines dry eye specialist today.

Restasis vs. Xiidra

Restasis has been in use for a number of years. It is an eye drop that is used twice a day. It’s the teardrop form of cyclosporine, an autoimmune suppressant which is prescribed for many chronic conditions, and it has been found to alleviate the symptoms of dry eyes by reducing the inflammation and increasing tear production. However, Restasis doesn’t necessarily help to improve the outflow of the oil that needs to be produced on top of the tears so that the tears don’t evaporate. Right now some of the studies are suggesting that over 50% of people with dry eyes actually have meibomian gland dysfunction. So, if the first lines of treatment are failing to manage dry eye symptoms, consider more rigorous treatments for dry eyes and blepharitis. Restasis also has side effects, with some patients experiencing burning and discomfort.

Xiidra is a newer drug that has recently received FDA approval for the treatment of Dry Eyes. Clinical studies have shown it to be significantly effective in alleviating symptoms, and it works far faster than Restasis, providing significant relief within as little as 2 weeks without the side effects of Restasis. However, the long-term benefits for dry eyes have yet to be conclusively proven. Nonetheless, it is considered a very safe drug.

Scleral Lenses

Scleral lenses are special contact lenses that are a large diameter to cover the entire corneal surface. They sit on the sclera, rather than the cornea, leaving a space between the cornea and the lens wihch is filled with saline and bathes the cornea in moisture. At Premier Vision Clinic, our optometrists use scleral lenses to treat a variety of eye conditions, including keratoconus, pellucid marginal degeneration, post-refractive surgery complications, corneal ectasia, and for people with sensitivity to regular contacts.

Scleral lenses are also highly useful in treating Dry Eyes. Studies have shown that the use of scleral lenses is effective in treating moderate to severe dry eyes. In more than 50% of cases, patients fitted with scleral lenses report reduced discomfort and dry eye symptoms, decreased use of artificial tears and improved visual acuity.

Amniotic Membrane

This is a revolutionary treatment that has been developed in the past few years for treating severe and chronic cases of dry eye. Amniotic membranes are collected during elective cesarean births from the placenta. Amniotic membranes protect and nurture the baby in the womb. When placed over the eye, this membrane dramatically heals the eye surface which has been damaged by prolonged dry eyes. Absolutely no sale of body parts is involved, and absolutely NO harm comes to the infant or the mother in extraction.

The results of using an amniotic membrane to treat dry eye are dramatic. At our dry eye clinic, we make use of both wet and dry membranes, which differ slightly in use. Both types offer significant, dramatic, and real healing and relief for inflamed and scarred eyes due to dry eyes. The use of amniotic membranes is a game-changer in the treatment of dry eyes.

Wet Amniotic Membrane

The "Wet" amniotic membrane is a thin membrane held together by a small plastic ring. Applied directly to the eye, the ring holds it in place right where the eyelid meets the sclera (the white part) of the eye. The healing from this method is very fast. Usually, the membrane needs to be worn for no more than a week before dramatic improvement occurs.

Dry Amniotic Membrane

Looking more like a thin dry bit of tiny corrugated cardboard, the dry membrane is placed right on the cornea and held in place with something called a "bandage contact lens" on top.

Artificial Tears

For those with tear-film insufficiency, artificial tears are a basic solution that literally introduce more tears into your eyes in the form of non-medicated (or lightly medicated) drops. While not enough for a severe case, these can help maintain overall hydration of the eyes. We will recommend a specific artificial tear which will help your given situation.

Hot Compresses

For mild to moderate dry eyes resulting from Meibomian Gland Disorder or Blepharitis, a hot compress or eye mask is helpful in alleviating the symptoms. The warmth of the mask softens the meibum and stimulates the oil glands to open, allowing the meibum to more easily lubricate the surface of your eye.

What Our Patients Are Saying...

Meet Our Dry Eye Doctor

jennifer_GSP_UID_8b8f3f5e-7bfc-4f79-ac9d-6d93d45f795d.jpeg
Dr. DenHartog received her Doctor of Optometry from Indiana University School of Optometry. She earned her Bachelor of Arts with a major in Psychology from the University of Iowa. She has been practicing in the greater Des Moines area since 2000. She is an active member of the Iowa Optometric...

Serving Patients From:

West Des Moines and the state of IA

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