Dry eyes

Overview
The disorder is most often idiopathic or associated with older age but can also be caused by connective tissue diseases (eg, Sjögren syndrome, RA, SLE). Patients may experience either inadequate tear volume or excessive volume of poor quality tears. The loss of tear film can cause corneal injury.

Treatment option
Artificial tears are used in both types of dry eyes. Immunomodulating eye drops have been recently approved for severe dry eye disease, which may take a few months to relieve symptoms.

Acupuncture
The specific acupuncture technique we use acts on the nerves regulating lacrimal glands. It is effective in both low volume and high volume dry eyes. Acupuncture is also effective for dry eyes caused by Sjogren's syndrome, especially before immunomodulating eye drops taking effects. 

Treatment objects
In patients with mild to moderate age-related dry eyes, the aim is to restore normal tear secretion and minimize the irritation. Significant improvement is expected in severe cases, even with keratoconjunctivitis sicca. The effectiveness of autoimmune condition related dry eyes partially depends on the control of the underlying conditions. Patients with well-controlled autoimmune disease, dry eyes are likely to improve significantly.

Treatment protocol
Mild to moderate age-related: 4 sessions over 2-4 weeks Severe and autoimmune-related: 6 or 8 sessions over 6 weeks. Patients may need maintenance treatments fortnightly or monthly after initial improvement.

Safety
Acupuncture is a well-tolerated safe treatment. The specific technique with strong stimulation may be used. Local anaesthesia can be offered, but the injection fo anaesthesia agent may cause more discomfort compared to needling.

Fee
1st & 2nd treatment: $ 250
3rd and subsequent treatments: $ 200

Medicare rebate: $ 107.25

*Patients are encouraged to contact Medicare for Extended Medicare Safety Net (EMSN). 80% rebate of the out-of-pocket fee may be claimed when the threshold is reached. The out-of-pocket cost per session may be as low as $19.

http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Factsheet-EMSN1Jan2020