Northern Nevada optometrists using new technology to battle dry eye syndrome

Dry eye syndrome is a disease that affects 30-40 million Americans — many of whom are 50 years and older — according to the American Optometry Association.

Studies have found that 86 percent of cases of dry eye syndrome are caused by a chronic and progressive condition called “Meibomian gland dysfunction,” in which a blockage in the Meibomian glands makes it so one’s eyes cannot secrete enough oil into tears.

While the disease is chronic, it is usually manageable and probably nothing more of an annoyance to those who suffer from it. Often, physicians apply methods such as warm compresses or eye drops as treatment.

But now, optometry practices around the nation, including across Northern Nevada, are investing in new technologies, such as LipiView and LipiFlow, to treat dry eye.

EyeZone, a Northern Nevada-based optometry practice, recently opened its new Dry Eye Clinic within its Northwest Reno and Midtown Reno locations, and it features LipiView and LipiFlow.

“(Dry eye) now is classified as a disease,” Dr. Mark Michtisch, an optometrist and a partner with EyeZone, told the NNBW in a recent interview. “Before, we would give some eye drops and tell them to ‘see you in six months,’ but now we can treat the disease.”

LipiView is a non-invasive device used to give an accurate picture of an eye’s tear film, a vital component in determining what is causing a patient’s dry eyes.

While LipiView is used in the diagnostic phase of dry eye conditions, LipiFlow acts as the treatment phase. LipiFlow utilizes a technology that applies heat to inner eyelids while massaging to remove obstructions in Meibomian glands. It is the only Federal Drug Administration-approved treatment for dry eye, and clinical studies have shown that LipiFlow is 79 percent effective in treating the condition.

“Diagnostically, we’re able to identify the different layers within the tear film and measure the thickness of the layers,” said Dr. Daniel Rowan, an optometrist and partner at EyeZone. “We can now monitor the blinking through the new technology.”

Implementing the new dry eye technology is one of a few recent developments for the EyeZone brand. In December, the business acquired Dr. Tyson Kales’ practice at 535 Arlington Avenue in Reno’s Midtown District.

Dr. Amber Belaustegui also recently became a partner in EyeZone and merged her growing Fallon office — Central Nevada Vision, now named EyeZone-Fallon. With the move, Rowan and Michtisch brought on Belaustegui as a third partner.

Other technology on the horizon?

While LipiView and LipiFlow are effective methods of treating dry eye, there is at least one drawback.

Dr. David J. Ruckman, an optometrist with Sparks-based Pritchett Eye Care Associates, doesn’t dispute LipiFlow’s benefits. However, he notes that it is not covered by insurance or Medicaid, meaning cost comes out of pocket.

“It’s very cost-prohibitive, where out-of-pocket cost for a patient could be anywhere around $1,000 to $1,500,” Ruckman said in a phone interview with the NNBW. “Because of that, there’s a very narrow group of people who can utilize the technology.”

Pritchett Eye Care Associates has seven offices covering Reno, Sparks, Carson City and Minden.

Ruckman, who is Pritchett’s primary expert on dry eye conditions and treatment options, said another possible cost-effective treatment should soon be on the market — TrueTear, a recently FDA-approved approved “intranasal tear neurostimulator.”

A recent article in Ophthalmology Magazine described the technology as a nonsurgical device that is administered through a patient’s nose and stimulates the trigeminal nerve with electrical impulses to produce natural tears in the eyes.

The device was developed by Dr. Michael Ackerman in the early part of this decade and also founded by the company Oculeve. It was later acquired, along with the technology, in 2015 by the Dublin, Ireland-based pharmaceutical company Allergan.

With FDA approval last spring. Allergan now is in the process of developing a marketing strategy for the product. TrueTear could be available for market within the next few years.

Ruckman dispels the notion that dry eye syndrome is worsened by a low humidity climate in Northern Nevada.

Himself a native of the region, Ruckman said he never experienced dry eye growing up. In fact, it was when he relocated to the Pacific Northwest region, one with much higher humidity levels, that he began to experience dry eye.

While new technologies offer novel treatments for dry eye, Ruckman said there are still some simple ways people can at least minimize its effects.

“People will stare at a computer all day and then go on a break and stare at their smartphones,” he said. “People should take a mental break from the electronics and give their eyes a rest.”