Dry Eye Treatment

DRY EYE Management: Raised to a SCIENCE!

Dry eye could present with mild symptoms or persistent discomfort in the form of a relentless disorder affecting millions of patients throughout the world.

There are a plethora of over the counter relief drops and remedies forDry Eye but it is essential that you have a thorough exam with an expert to have a treatment strategy best tailored for your condition. This is also vital to rule out any local surgeries as a cause ie. Lasik or associated systemic disease of which this could be the first indicator ie. Sjogren's syndrome, certain arthritis, thyroid disorders, drug side effects, etc.

Dr. Gulani teaches DRY EYE management in his courses for eye surgeons globally and provides an in-depth diagnostic evaluation along with a full spectrum of care from medical/pharmaceutical to advanced surgical applications including amniotic membrane surgeries with stem cell transplants for patients with this condition.

He approaches Dry Eye as a Specific entity with a Specific cause which warrants a Specific treatment.

Using this dedicated methodology, he has successfully helped people suffering from all levels of dry eyes who travel to our institute from all over the world.

He explains that the tear film is actually about 7microns thick and is made up of three layers:

The Innermost, Mucin Layer (produced by the Conjunctival Goblet cells on the surface of the eye) and this layer makes the tear film “Stick” to the eyeball.
The Middle, Aqueous Layer (produced by the Lacrimal glands which are located on the upper and outer side of your eye socket). This is the real Tear Film if you may and contains all of the chemicals and nutrients that are needed for the ocular health and safety.
The Outermost, Lipid layer (produced by the Meibomian glands which are arranged along the eyelid margins vertically in rows like “Tooth Paste Tubes” with their “Mouths” opening at the lid margin close to the eye lashes. This layer actually provides surface tension to the tear film and hence maintains its vertical distribution on the eye despite gravity.

Dr. Gulani classifies Dry eyes at various levels for eye care practitioners based on severity, symptomatology and vision impact.

Essentially though he explains that there are two basic kinds:

I. Quantitative (Decreased Quantity)

1. Decreased production

2. Increased Loss

II. Qualitative (Decreased quality / altered chemical content of either one or all three layers despite good quantity)

Some Pearls:

The tear film is actually dependant on the nerve sensation of the cornea (that is why people have Dry eyes following a certain kind of Lasik surgery where the nerves get cut during surgery) and inflammatory cycles related to allergy, infections etc.

Finally, the tear film leaves the eye via tear ducts (in each lid) and goes into the nose on a normal basis (remember how some eye drops taste nasty).

The above explanation is Dr. Gulani’s way of simplifying the dry eye concept for all his patients and then he gets to work further investigating the root cause of dry eye and planning an effective treatment regimen.

So lets say someone has a decreased production but good quality of tears, they can have punctual plugs inserted into their tear ducts and thereby “Retain” whatever little tears they produce (a Plumbing issue- Block the drain since the tap is producing less water so the water remains in the sink for a longer time).

This can further be augmented by tear producing eye drops like Restasis.

If the quantity is good but the quality of tears is bad then he addresses the abnormal layer effectively with appropriate eye drops, medications and even techniques.

FIRST in North East Florida:

For example, if the Lipid layer is affected because of the Meibomian glands being blocked by repeated inflammation and allergy, he can actually open these glands with a brief, in-office procedure using a new technology that he has introduced for the First Time in North East Florida.

Using MGD probes, he can actually open the closed mouths of the glands (remember the ones like toothpaste tubes) and allow for free flow of the lipid layer again.

In certain cases based on their seriousness, Dr. Gulani performs “No-Stitch” human placenta surgery, transplants etc.

Thus we can see how approaching the dry eye complaint in a systematic manner can actually make sense of the situation, rule out any associated diseases and effectively plan for a customized solution for each individual eye.

Dry Eye Testimonials

Dry Eye Testimonials I didn't know I had "dry eye" until Dr. Gulani mentioned it in my check up. After researching it on the internet, I agreed with his diagnosis.

I had a very pleasant experience in all my dealings with the Gulani Vision Institute, from Dr. Gulani and all of the staff. Everyone went out of their way to be very helpful and courteous.

I think that Dr. Gulani is an extremely knowledgeable doctor in all the innovative techniques for improving vision. I have been impressed with all of his many accomplishments and awards. I believe he exemplifies the ideal doctor. He is continually pushing the boundaries of medicine and highly motivated to provide his patients with the best vision available.

After having my dry eyes treated, the first thing I noticed was how much brighter all the colors seemed. Then I realized that I was actually seeing much clearer images as well. What I used to think was normal, waking up with eyes very red and hard to open, has completely disappeared and I wake refreshed. I also notice that my late afternoon and evening "tired eyes" are a thing of the past. I was delighted to learn at my two-week check-up that my eyes had improved one line each eye, without blinking and squinting.

I think that Dr. Gulani is highly skilled and qualified. His credentials speak for themselves. He has a very good relationship with his patients and is very anxious to make sure they completely understand everything, and is able to do so in layman's terms. I believe he cares about each patient and is a perfectionist in trying to get them the best vision possible. He is always pleasant and consummately professional.

I would recommend Dr. Gulani to anyone who needs eye care and wants nothing but the best.

Thanks for all your courtesy,
Pam Baity

Jacksonville, Florida

Sohrab Fracis

I have had Lasik surgery and multiple re-surgeries with another Lasik surgeon.

My eyes were chronically dry and this adversely affected the clarity of my vision.

A friend (who is presently one of the national champions in Table Tennis) at my table tennis center highly recommended Dr. Gulani, having been successfully treated by him.

Dr. Gulani impresses me tremendously as he is very knowledgeable about every little area of his field and exceptionally willing to take the time to inform his patients about all the relevant aspects of his condition.

Also, his staff is excellent. Everyone is courteous, helpful and personable.

I perceive Dr. Gulani as being extremely skilled and tremendously helpful and also an all-around good guy.

Sohrab Fracis
Award Winning Author
(Seen in the picture presenting his book to Dr. Gulani)

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