Dry Eye and How to Treat it with Dr. Ronald Gaster
Dr. Ronald Gaster on “The Doctors” with Dr. Andrew Ordon
If you have had surgery in your life, you may have found that immediately after an operation your vision can sometimes become blurry. However, after a few weeks, it returns to normal. Having had several surgeries myself, I didn’t give it much thought when, after hip replacement surgery, my vision underwent changes. I kept waiting for it to clear up but unfortunately it didn’t, my vision was blurry and it was getting difficult to drive, especially at night. I decided to consult my ophthalmologist, Dr. Ronald Gaster to Gaster Eye Center to find out what was going on.
Dr. Gaster was named by US News and World Report as one of Southern California’s Top Physicians and selected by his peers for inclusion in the Best Doctors in America. He provides his patients with the latest and most technologically advanced surgeries and treatments as a board-certified and fellowship-trained ophthalmologist in Beverly Hills, CA and Orange County, CA. He treats patients suffering from a wide variety of conditions including corneal diseases such as keratoconus and Fuchs dystrophy, cataracts, pterygia, dry eye and trauma.
His unique combination of skills and experience as an ophthalmologist allows him to be on the cutting edge of the latest developments in eye disease and surgery. He is an international expert in corneal cross-linking, also known as CXL, or Collagen Cross-Linking. He specializes in bladeless, all-laser LASIK surgery which uses only lasers instead of metal blades, resulting in safer surgery and a faster recovery period, often with 20/20 or better vision.
After a quick test I was told I had dry eyes. I had never heard of it before. Dr. Gaster explained to me what my eyes were going through. In short, dry eye syndrome occurs when tears cannot provide adequate hydration. It is a condition that often increases with age. It is also more common in postmenopausal women. Symptoms consist of red, inflamed eyes with discomfort and sensitivity to light. The latter was my biggest problem. Once diagnosed, the first step was to control the disease. I would have to go on a diet to see if my eyesight would come back on its own. I needed frequent artificial tears (preferably non-preserved) and lubrication with ointment to nourish the eye surface, warm compresses and eyelid scrubs. The doctor recommended that I sleep with a humidifier and use Restasis eye drops. Morning and evening I had to put 1 drop of Xiidra in each eye. It stinged a bit, but it really helped. When I returned for a second visit two months later, my eyesight hadn’t improved much. We would continue treatment for another two months, after which we would decide if I should try Intense Pulsed Light (IPL), a therapy for dry eye. Here is another procedure that I had no knowledge of.
How does IPL work?
IPL uses bursts of light directed at the lower eyelids and upper cheeks which heat the Meibomian glands which are blocked by thick secretions which cannot be evacuated to slow the evaporation of tears. Once these thickened secretions are warmed and become more liquid, Dr. Gaster can manually express them more effectively and completely.
How long does the treatment last?
Most patients need 4-6 monthly treatments for best results, but some patients notice slight improvement after the first or second treatment. Once the full effect has been achieved, maintenance treatments every 3 to 6 months are recommended to keep the Meibomian glands healthy and functioning.
The light treatment is delivered through a handpiece attached to the light source and aimed at the affected areas of the lower eyelids, upper cheeks and nose. As the pulse of light is delivered there is a tingling sensation which most patients tolerate quite well. After IPL therapy, the treated areas may be slightly reddened and red for a short time.
How is the treatment administered?
Dr. Gaster uses a machineM22 IPL machine, which is not a laser; it is light therapy on a range of wavelengths. A filter is used to select the appropriate range of wavelengths for the best treatment to apply the right amount of heat to warm the skin and close abnormal blood vessels associated with ocular rosacea, dry eyes, blepharitis and to the dysfunction of the Meibomian glands which causes the abnormal inflammation of the eyelids.
To be honest; this all sounds a bit scary, but for now that left untreated, chronic dry eyes and blepharitis can lead to scarring in the eyes and possibly loss of vision. If all else fails, I think I should give it a try. Meanwhile, Dr. Gaster also recommended glasses for watching TV and driving.
The best advice I can give anyone is to see your eye doctor and optometrist every year, especially if you’ve had Lasik surgery. Dry eye syndrome is a common occurrence in Lasik patients. Thank you Dr Gaster for the knowledge and treatment.
Take care of your precious eyes.
Dr. Gaster has also taught ophthalmic microsurgery courses for many years and recently received the prestigious American Academy of Ophthalmology Honor Award and the American Academy of Ophthalmology Achievement Award. He is also a clinical professor of ophthalmology at the Jules Stein Eye Institute at UCLA School of Medicine and the Gavin Herbert Eye Institute at the University of California, Irvine. He has trained hundreds of residents and Cornean Fellows and continues to teach them at UCI.