The MICHEL GUILLON Dry Eye “AIM” Programme is in three phases:

 

Phase I is an extensive Analysis of the problem to quantify its severity and discover any association.

 

Phase II is the Identification of the causes of the problem via an exhaustive assessment of the tear film, tear film producing glands and ocular surface.

 

Phase III is the customised Management of the problem: “each dry eye is different, hence each patient is managed individually”. The management targets the causes of the problem but also deals with the associated complications and symptoms.

 

In order to precisely quantify the severity of the problem, detect any important association, such as time of day, specific activities or environmental conditions the analysis begins with the patient answering a series of questionnaires. The questionnaires include standard dry eye questionnaires and proprietary questionnaires that have been developed and validated by our Research and Consultancy Division.

 

The analysis of the problem continues with a review of the questionnaires by the optometrist along with additional specific questions based upon the answers given. The final step of the analysis by the optometrist is the comparison of the answers given with the practice extensive internal database.

 

At the conclusion of the Analysis the severity and the type of dry eye problem is fully quantified. This information will be used to customise the Management of the condition.

 

The Identification of the causes (aetiology) of the problem involves an exhaustive clinical assessment by the optometrist that includes at least two series of examinations and measurements.

 

Firstly, each layer of your tear film is analysed with the The Tearscope and whenever necessary, for either permanent record or case discussion with a colleague in the practice, a digital video recording of the tear film is made.

 

Secondly, the front part of your eye (anterior segment of the eye) is examined with the slit lamp biomicroscope using a range of lightings and eyedrops to identify specific anomalies; these are photographed for accurate and permanent records.

 

In some cases tear samples are also taken for analysis by our Tear Biochemical Laboratory; the results permit to quantify the chemical anomalies or compositional insufficiencies of the tear film that cause the dry eye problem. In other cases, additional specialised evaluations are carried out in our Research & Consultancy Clinic to determine contributing associations (e.g. dry environment or computer use)

 

The management of dry eyes at MICHEL GUILLON goes well beyond using simple eyedrops to rewet the eye.

 

The management is by way of individualised programmes that combine some of the following interventions:

 

i. Special eyelid hygiene regimen to deal with meibomian gland anomalies and associated blepharitis.

ii. Punctal plugs to maintain a normal volume of tears in the front of the eye.

iii. Diet modification and/or use of specific supplementation to help control the ocular inflammation

iv. Prescription of eyedrops specific to the problem, rather than just replenishment eyedrops.

v. Referral to specialised general practitioner for the management of associated systemic conditions, of which thyroid anomalies are particularly common.

vi. Co-management of associated ocular immunological or pathological conditions with a specialist ophthalmic surgeon.