Dry Eye Syndrome

Amniotic Membrane as a Remedy for Dry Eyes

If you have dry eyes, amniotic membrane may be the solution you’ve been waiting for.

How is your ocular health?

Ocular health is important! The eyes are important to enjoyment of life and mobility, but also are essential for our optimum performance at work. The term “ocular” refers to the eye and its organ system. Ocular health includes vision, and the health of eye, meaning whether they are disease free.

There are many things we all do to protect our eye health. We have regular eye exams discussing family history can help anticipate and prevent and treat eye disease. Sunglasses can help prevent damage and sunshine cataracts, or even macular degeneration, solar retinitis, and some corneal dystrophies. Patients can wear protective goggles when performing yard work or other dangerous activities to prevent injuries.

But what happens when something DOES go wrong?

Dry eyes are not healthy eyes. In addition to the general reduction in quality of life from stinging and burning, dry eyes are prone to eye infections. Tears protect our eyes. Yet 4.88 million people over 50 struggle with dry eyes, and many younger people do, too. Other risks from chronic dry eyes include:

  • corneal ulcers, sores  on your cornea. Sometimes these develop after an injury where dry eyes prevent healing. Debris can scratch the eye, causing a bacterial infection. If not treated, ulcers can get worse and cause scarring, and partial or complete blindness.
  • conjunctivitis. This is where the clear layer of cells over the white part of the eye, and the inner surface of the eyelids, become inflamed, causing discomfort and redness.
  • inability to wear contact lenses. As anyone who has ever worn contact lenses knows, a dry eye is a nightmare surface for a contact lens, which will stick to the eyeball. A gritty sensation and discomfort are also common.
  • headaches, including migraines.
  • light sensitivity.

How do you know if you need a remedy for dry eyes?

According to the Mayo Clinic, you may have dry eyes if you regularly experience the following symptoms:

  • a scratchy sensation in your eyes;
  • stringy mucus in or around the eyes;
  • light sensitivity;
  • poor night vision;
  • difficulty wearing contact lenses;
  • blurred vision or eye fatigue.

In addition, surprisingly, you might have very watery eyes. Your body responds to the irritation of dry eyes by making them water.

If you have these symptoms, you should see a physician for a remedy for dry eyes. You may have keratoconjunctivitis sicca, or the inability to produce enough tears.

What causes decreased tears?

You might have dry eyes due to:

  • aging;
  • Sjogren’s syndrome, rheumatoid arthritis, or lupus;
  • thyroid disorders;
  • vitamin deficiencies;
  • medication;
  • tear gland damage.

Your doctor will test for the composition of your tears to make sure they are balanced correctly and measure the quantity of tears.

What can amniotic membrane do for dry eyes?

An exciting use of regenerative medicine is for people suffering from chronic dry eye, due to age or often after laser or other eye surgery. Amniotic membrane has been used for eyes for over two decades.

There are products on the market that can help some patients by encouraging the eye to produce tears. These products generally are used daily indefinitely, and possibly help only 15% of patients. For some people, a one-time treatment using amniotic membrane may be the answer.

Amniotic membrane as a remedy for dry eyes is obtained from consenting mothers after birth and comes from the placenta that was used to nourish the baby. Donors are screened for transmissible diseases and the amniotic membrane is treated with antibiotics after collection.

There are two ways amniotic membranes can be used for dry eyes. The first is as a surgical graft. The amniotic membrane acts as a scaffold for skin to grow on to.

The second way an amniotic membrane can be used for dry eyes is as a biological corneal bandage. In this case, the amniotic membrane is not absorbed, but is removed after healing. The device supports the corneal-healing process.

In either case, the amniotic membrane is glued or sutured in place.

When used as a biological bandage, the amniotic membrane can be inserted in the doctor’s office or in a hospital setting during other procedures.

Not only can the bandage act as a barrier, it can reverse scarring.  The patient experiences reduced pain from the friction involved in blinking. The membrane is absorbed into the eye. The amniotic membrane also can promote regeneration of corneal nerves.  Some studies have also found amniotic membranes to be antimicrobial.

Amniotic membranes can be used to improve visual acuity, optimize the eye’s surface before cataract surgery, and can be used for other conditions such as ulcerative keratitis, acute Stevens-Johnson syndrome, and neurotropic disease.

Cryopreserved or dehydrated?

The FDA has approved cryopreserved amniotic membrane for use in eyes. You might be wondering why a “fresh” amniotic membrane wouldn’t be used as a remedy for dry eyes. This is because it presents a significant risk of disease transmission, whereas using processing methods may nearly eliminate this risk while preserving effectiveness of the tissue graft.

There are two methods primarily used to preserve amniotic membrane for use as a remedy for dry eyes. First, in cryopreservation, as the term implies, the tissue is quickly frozen. The integrity of the tissue and its biochemical functions are preserved.

Although there are some drawbacks to cryopreservation, for example that the product must be refrigerated and has a limited shelf life, it is preferable to the second method of preservation, dehydration. With dehydration, the proteins in the amniotic membrane might be denatured and the membrane can even lose some of its function and structure, defeating the purpose. One of the benefits of cryopreserved amniotic membrane is that it retains hyaluronic acid, a lubrication, while there are concerns that the dehydrated form does not. Furthermore, the extracellular matrix components found in cryopreserved amniotic membrane regulate and promote regenerate healing processes and tissue remodeling. Although studies are unclear, it appears that dehydrated may not have the same anti-inflammatory benefits as cryopreserved.

Conclusion

We take many steps to ensure our eyes continue to serve us throughout our lives; we shouldn’t settle for dry, unhealthy eyes. If you are suffering from the symptoms mentioned above, see a doctor to see if you suffer from dry eye disease, and if amniotic membranes can be your remedy. Amniotic membrane for dry eyes is the new horizon in healthy eyes.

References

FOR DOCTORS – CPT CODE 65778

https://www.mayoclinic.org/diseases-conditions/dry-eyes/symptoms-causes/syc-20371863
https://www.reviewofophthalmology.com/article/treatment-options-with-amniotic-membrane