Dry Eye & LipiFlow

Tears are an important part of the eye’s functioning; they’re not only there when you tear up in sadness, but they have an important function to serve. Tears are made up of water, oils, mucus, and antibodies, and each one of those components serves an important purpose that helps the eye to function at its best. When a person has a dry-eye condition, this means that the special glands or tear system are not properly balanced.

Symptoms of dry eyes

  • Stinging or burning of the eye.
  • A sandy or gritty feeling as if something is in the eye.
  • Episodes of excess tears following very dry eye periods.
  • A stringy discharge from the eye.
  • Pain and redness of the eye.
  • Episodes of blurred vision.
  • Heavy eyelids.
  • Inability to cry when emotionally stressed.
  • Uncomfortable contact lenses.
  • Decreased tolerance of reading, working on the computer, or any activity that requires sustained visual attention.
  • Eye fatigue.

Sometimes, dry eyes create too many tears. This confusing condition is called reflex tearing. It happens because the lack of moisture irritates your eye. It sends a distress signal through your nervous system for more lubrication. Your body sends a flood of tears to try to make up for the dryness. It’s a lot like what happens when you get sand in your eye and it runs. But these tears are mostly water, so they don’t act like normal tears. They can wash debris away, but they can’t coat your eye’s surface.

Causes and Risk Factors

  • It can be a side effect of some medications, including antihistamines, nasal decongestants, tranquilizers, certain blood pressure medicines, Parkinson's medications, birth control pills and anti-depressants.
  • Skin disease on or around the eyelids.
  • Diseases of the eyelid glands, such as having a Meibomian-gland Dysfunction.
  • Pregnancy.
  • Women undergoing Hormone Replacement Therapy. (Women taking only estrogen are 70 percent more likely to experience dry eye, whereas those taking estrogen and progesterone have only 30 percent increased risk of developing the condition).
  • Dry eye can also develop after the LASIK Refractive Surgery. In such a case, the condition would usually last three to six months, but in some cases, it may actually last longer.
  • Chemical and thermal burns that scar the membrane lining the eyelids and covering the eye.
  • Allergies.
  • Infrequent blinking, especially when staring at computer or video screens
  • Excessive or insufficient dosages of vitamins.
  • Some Homeopathic Remedies.
  • Loss of sensation in the cornea from long-term contact lens wear.
  • Immune system disorders such as Sjögren's syndrome, lupus, and rheumatoid arthritis. Sjögren's leads to inflammation and dryness of the mouth, eyes, and other mucous membranes. It can also affect other organs, including the kidneys, lungs and blood vessels.
  • The condition may be a symptom of chronic inflammation of the conjunctiva, the membrane lining the eyelid and covering the front part of the eye, or the lacrimal gland. Chronic conjunctivitis can be caused by certain eye diseases, infection, exposure to irritants such as chemical fumes and tobacco smoke, or drafts from air conditioning or heating.
  • If the surface area of the eye is increased, as in thyroid disease when the eye protrudes forward or after cosmetic surgery if the eyelids are opened too widely, dry eye can result.
  • Dry eye may occur from exposure keratitis, in which the eyelids do not close completely during sleep.

Types of treatments

Artificial tears

This is the most commonly-used treatment, with many types of artificial tears widely available in the market. There’s not one type of artificial tear that works the same for everyone, so it might be a good idea to try a few times and see which ones work the best. If your dry eye condition is chronic, you might need to use those drops consistently even when you don’t feel the dryness, in order that your eyes have some moisture. If your eyes dry out during your sleep time, you can use a thicker type of product at night, such as using an ointment. 

Cyclosporine (Restasis)

This prescription eye-drop plays a role in helping your eyes have better tear production.

Steroid eye drops

Inflammation has been identified as a major contributor to dry eyes. The redness and burning associated with dry eye illness are typically caused by inflammation. Artificial tears rarely address those inflammatory changes, therefore your doctor may prescribe steroid eye drops to help manage the underlying inflammation causing the dry eyes.  

Steroid eye drops are often administered for a brief period of time to alleviate symptoms.  This form of treatment is often used in conjunction with other long-term solutions such as artificial tears and Restasis.

Punctal plugs

Punctal plugs are sometimes used in dry eye treatment to keep tears on the eye's surface for longer periods.

A punctal plug is put into the lower eyelid's tear duct to prevent the tear film from emptying too quickly. Image: Oasis Medical, Inc.¹

Tears can no longer drain away from the eye through the ducts when these openings have been blocked. As a result, the tear film stays intact on the eye's surface for longer, alleviating dry eye symptoms.

Meibomian gland expression

The Meibomian glands secrete a certain oil called meibum, and a very significant percentage of dry eye cases are caused by an inadequate production of this oil.

Those glands have openings near the base of the eyelashes. And when clogs happen in those areas, the oil can’t do its proper job, in a condition called meibomian gland dysfunction (MGD). This is a considered to be a major cause of evaporative eye symptoms.

This procedure initially entails possible warm compresses applied to the eyelids, after that, a device is used to let out any hardened meibum from the meibomian glands, or any other substances that might be there.

To achieve full expression of the meibomian glands expression, and to have them functioning in the right way, there needs to be a lot of pressure applied to the eyelids, and this can be somewhat uncomfortable, but the results definitely would make up for that discomfort during the procedure.

Warm compress

This is an alternative and more comfortable method to unclog meibomian glands. In this method, warm compresses are applied to the patient’s closed eyelids, thereby softening the hardened meibum.

That being said, there is a downside to using warm compresses, as research indicates that this method works only at a minimum temperature of 42 celsius degrees, for a period of more than 10 minutes. Moreover, this has to be done at least twice a day for this method to work. That’s why this method is not used very often, as most people are not willing to apply this method as it’s meant to be done, rendering the method ineffective.


Before LipiFlow is chosen as a viable treatment, a LipiView test is conducted to assess the patient’s level of eye dryness, giving the doctor a better chance to evaluate tear film production and to assess if there’s a meibomian gland dysfunction. In case this is confirmed, then the LipiFlow would be considered to be a viable treatment. Moreover, LipiView assesses how complete your blinks are, as incomplete blinking can be an indication of poor quality tear film, thereby increasing the symptoms of dry eye.

LipiFlow utilizes innovative engineering technology to deliver precisely controlled and directed heat and intermittent pressure to the obstructed meibomian glands. The LipiFlow Thermal Pulsation System is a significant technological shift in dry eye treatment. It applies novel engineering solutions to the long-accepted basic science of gland expression, effectively relieving obstruction of the meibomian glands and allowing the body’s natural production of lipids to resume.

This form of treatment takes around 12 minutes per eye, and according to a clinical study, 76% of patients reported that their symptoms associated with dry eye have gotten better within two weeks of doing the procedure. Moreover, there was an overall enhancement in the quality and quantity of meibomian gland secretions, as well as the duration of time that tear film had remained on the eye before evaporating.

That being said, there are cases where LipiFlow needs a few months after the treatment to show its complete effects on the patient. Usually, the LipiFlow procedure has positive effects that can last between 1 and 3 years, and sometimes lasting for longer.²