Perfect, Sandra — you’ve already got a strong Master Q&A Guide for Eye Conditions with categories, treatments, and references. What we can do now is merge the detailed Q&A you uploaded from Dr. Cremers with this structured outline, so the final guide is both organized by condition and rich with patient‑friendly FAQs. Here’s how the combined version would look:
🌸 Dry Eye Disease (DED)
Symptoms: Burning, scratchy sensation, blurred vision, redness, light sensitivity.
Causes: Tear glands produce too few tears, tears evaporate too quickly, or tear layers are imbalanced.
Diagnosis: Eye exam, Schirmer’s test, tear breakup time, slit lamp evaluation.
Treatment: Artificial tears, prescription drops (Restasis, Xiidra, Cequa, Vevye, Miebo), punctal plugs, lifestyle changes.
Lifestyle: Humidifiers, limit screen time, sunglasses, hydration, avoid smoke/wind.
FAQs
- What does a low Schirmer’s test mean? → Usually reduced lacrimal gland output; causes include aging, autoimmune disease, or rare tumors.
- Can coffee worsen dry eye? → No studies show harm; moderate coffee is fine.
- Does pregnancy affect treatment? → Avoid steroids or stem cell injections in the first trimester.
- Can medications cause dry eye? → Yes, e.g., oxybutynin.
🌼 Meibomian Gland Dysfunction (MGD)
Symptoms: Burning, itchy eyes, swollen lids, blurred vision, recurrent styes.
Causes: Blocked oil glands, poor oil quality, hormonal changes, rosacea.
Diagnosis: Oil expression, meibography imaging, tear breakup time.
Treatment: Warm compresses, eyelid hygiene, omega‑3s, LipiFlow, TearCare, IPL, meibomian gland probing.
Complications: Chronic dry eye, corneal damage, recurrent infections.
FAQs
- How often can I do warm compresses? → No limit, but avoid burning skin.
- What’s the best way to clean lids? → Diluted tea tree oil, Avenova spray, or hypochlorous acid.
- Can probing help? → Yes, it opens scarred ducts; often combined with PRP for longer relief.
- What does a “gland pop” mean? → Scar tissue breaking open, allowing oil flow.
💧 Aqueous Deficient Dry Eye (ADDE)
Symptoms: Burning, gritty sensation, fluctuating blurred vision.
Causes: Lacrimal glands produce too little watery layer (aging, menopause, autoimmune disease).
Diagnosis: Schirmer’s test, slit lamp, systemic evaluation.
Treatment: Artificial tears, punctal plugs, anti‑inflammatory drops, systemic disease management.
FAQs
- Is biopsy ever needed? → Rarely; only in end‑stage cases, since biopsy can cause scarring.
- Can autoimmune disease cause ADDE? → Yes, e.g., Sjögren’s syndrome, lupus, rheumatoid arthritis.
🌹 Ocular Rosacea
Symptoms: Red lids, flare‑ups, burning, styes.
Diet triggers: Gluten, dairy, sugar.
Treatment: Heat therapy, lid hygiene, IPL.
FAQs
- Does rosacea affect both eyes? → Usually yes.
- Can rosacea go into remission? → Inflammation fluctuates, but genetic predisposition remains.
🍯 Optimel Gel (Manuka Honey)
Effectiveness: Natural anti‑inflammatory and antibiotic properties.
Risks: Rare infection in autoimmune patients.
Usage tip: Wash off in the morning; alternate eyes if patching overnight.
🔆 IPL (Intense Pulsed Light)
Mechanism: Reduces inflammation, liquefies meibum, dilates glands.
Safety: Safe when tailored to skin type.
Best for: Evaporative dry eye, ocular rosacea.
FAQs
- Are there risks? → Rare; main issue is variable duration of relief.
- How often is it needed? → Sometimes 2-4wks; others need 6-8 sessions before symptom relief. Some patients just need 1 session.
- The GOAL: decrease the mountain (ie monster of inflammation that destroys our cells). The oil glands are each like a car motor: if you use your motor a great deal, you will need more oil changes to avoid sludgy oil and a motor break down. Patients who use electronic screens more than 4hrs per day need more oil changes. Patients with rosacea or any autoimmune disease need more oil changes.
- Avoid UV and blue light as much as possible especially before and after IPL (ie sunglasses & a hat which we recommend always).
- Botox and Filler: IPL will make these not last as long but IPL is not contraindicated if needed.
- IPL can make eyelid tattoos bleed or start to disappear over time. IPL is often a medical necessity so patients are willing to risk this tattoo bleeding risk.
- IPL is not a cure for inflammation or aging but is one of the best ways to decrease inflammation and slow down aging.
🔥 LipiFlow (Thermal Pulsation)
What it does: Heat + pressure to melt and express gland oils. It is not an anti-inflammatory device.
Frequency: Every 6 months if not doing compresses.
Comfort: Generally well tolerated.
🩺 Meibomian Gland Probing (MGP)
Purpose: Opens scarred ducts to restore oil flow.
Risks: Rare worsening; technique sensitive.
Best use: For obstructed, painful glands.
FAQs
- Does probing hurt? → Can be uncomfortable; Dr. Steve Maskin uses an injection of lidocaine anesthesia. But Dr. Cremers has not had to use injections since using IPL before the MGP. The IPL appears to help alleviate discomfort of the probe.
- How often is it repeated? → Every 6-12 months depending on scarring.
- Is PRP insertion a cure? → Not yet; experimental but promising. We have shown you can regrow meibomian glands with insertion of your own PRP by about 25% but this has not been published yet.
💧 TearCare
What it does: External heat device allowing blinking during treatment.
Benefit: Alternative to LipiFlow; helps express oils.
🧪 PRP & Autologous Serum Drops: these are healing cells from your own blood in addition to being anti-inflammatory.
PRP: Platelet‑rich plasma has increased growth factors.
Autologous Serum: Fluid component of blood.
Preference: Many patients prefer PRP; both safe when prepared properly.
These are non-preserved so have to stay frozen or cold like you would if you had to use insulin in a cooler or refrigerator.
You cannot put these in your warm pocket/purse. If they get warm or hot, you cannot use it in your eye.
Use bottle for 7-10 days if remains in refrigerator or cold thermos. After that, do not use in eye but you can use remaining drops for your face or hair.
If it is older than 6months in the freezer, do not use for your eye: you can still use it for your hair or face as there are no case reports of an infection or reaction when used on the hair or face.
👁️ Cataract Surgery Options
- PanOptix (trifocal IOL): Distance, intermediate, near vision.
- Light Adjustable Lens (LAL): Adjustable post‑surgery.
- Envy multifocals: Advanced multifocal option.
Considerations: Prior LASIK/PRK, macular health, astigmatism.
🌀 Glaucoma
Diagnosis: Eye pressure, optic nerve imaging, visual fields.
Treatments:
- SLT (Selective Laser Trabeculoplasty): First‑line, safe, repeatable.
- MIGS (Minimally Invasive Glaucoma Surgery): Often combined with cataract surgery.
Goal: Lower intraocular pressure to slow progression.
📊 Summary Table
| Condition | Symptoms | Treatments |
|---|---|---|
| Dry Eye | Burning, blurred vision | Artificial tears, drops, plugs |
| MGD | Burning, swollen lids | Warm compresses, LipiFlow, IPL, probing |
| ADDE | Gritty, fluctuating vision | Tears, plugs, systemic care |
| Ocular Rosacea | Red lids, flare‑ups | Diet, heat, hygiene, IPL |
| Cataract | Cloudy vision | PanOptix, LAL, Envy IOL |
| Glaucoma | Vision loss, high pressure | Drops, SLT, MIGS |
📚 References
- Dr. Sandra Lora Cremers, EyeDoc2020 Blog (eyedoc2020.blogspot.com)
- PubMed (https://pubmed.ncbi.nlm.nih.gov)
- Open Evidence (https://openevidence.org)
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