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Close Up on Eyes


We are living in exciting times when it comes to treating the signs and symptoms of Dry Eye Disease. We have moved forward and progressed from the old mainstay treatment of recommending over-the-counter eye drops that worked only half the time at best. It can be quite overwhelming and at times you may wonder if it is all necessary; the recipe to success and meaningful results means you must follow the recipe diligently in its entirety. At Trifecta Optometry, Dr. Natalie Chai has a holistic approach to Dry Eye Disease with a customized treatment plan based on evidence based research and clinical findings.



Lifestyle & Diet Modifications


Artificial Tears, Gels, Ointments, Sprays


Lid & Lash Hygiene & Overnight Protection



Advanced Procedures & Medical Devices


Regenerative Medicine



Lifestyle & Diet Modifications

These are known modifiable risk factors that contribute to the signs and symptoms of Dry eye Disease and are in our control. 

Behavioural  Hygiene 
Skin Care & Make Up
General Diet and Supplementation
  • 20/20/20 Rule: Every 20 minutes, Take 20 seconds, Look at an object 20 feet away

  • Blinking Exercises 

  • Education on some known offending ingredients harmful to the eyes

  • Incorporating low inflammatory food choices

  • Staying sufficiently hydrated

  • Re-esterified Triglyceride Omega-3 Supplements

  • Vitamin A & D

  • Lutein & Zeaxanthin

  • Probiotic Intestinal Microbiome 

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Artificial Tears, Gels, Ointments, Sprays

Topical eye drops are still important for the treatment of Dry Eye Disease. They provide ocular surface supplementation and protection for ongoing maintenance. Many companies have high quality products that aim to mimic the components of a healthy tear film. 

Preservative Free 
Quality Ingredients
  • Propriety high technology dispensing bottles

  • No Benzalkonium Chloride (BAK); has been associated with and demonstrated toxic effects including Dry Eye Disease and trabecular meshwork degenetation 

  • Hyaluronic Acid (HA)

  • Trehalose 

  • Carbomer 980

  • Glycerol 

  • Ectoine 

  • Perilla Seed Extract

Different Formulations
  • Common Eye Drop

  • Gels

  • Ointments

  • Sprays

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Lid & Lash Hygiene & Overnight Protection

Another important element to your at-home Dry Eye regimen. Dr. Natalie Chai draws a parallel to that of dentistry where you have the routine of mouth-washing, flossing, and brushing your teeth daily; this should now extend to your eyes. The meticulous detail to lid/lash hygiene and care is extremely important to the maintenance of signs and symptoms of Dry Eye Disease. The long-term success of symptomatic relief can arguably be directly correlated to the individual's daily habits.

Eyelid Wipes, Gels, Sprays
Warm Compresses
Moisture Chamber Sleep Goggles
  • Products with quality ingredients targeting the microbiofilm and debris accumulating at the base of the lids and lashes

  • Microwavable bead technology with the assurance of reaching the necessary external temperature for Meibomian Gland Dysfunction

  • Electronic Alternatives 

  • For patients whose eyelids lift during sleep, these goggles provide a micro-ecosystem to minimize exposure

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Advanced Procedures & Medical Devices

This is where the treatment options for Dry Eye Disease are elevated. Our understanding of the disease has shifted the way we approach therapy and this includes using technologies conventionally found in the dermatology/aesthetics world used in the context of Dry Eye Disease. Furthermore, there are adjunctive therapies that support the rehabilitation of the tissues of the ocular surface and others provide the much sought-out relief of patients suffering from moderate to severe Dry Eye Disease.

Intense Pulsed Light (IPL) & Low Level Light Therapy (LLLT)
  • Targeting ocular rosacea and the chronic inflammatory disease process of Dry Eye Disease

Thermal Pulsation & Radio Frequency
  • Treats the obstructive nature of meibomian gland dysfunction (MGD)

  • Deep cleaning of the eyelids and lashes from the matted on microbiofilm and blepharitis 

Adjunct Procedures and Devices
  • Meibomian Gland Expressions

  • Line of Marx (LOM) Debridement 

  • Punctal Plugs

  • Intraductal Meibomian Gland Probing (MGP)

  • Scleral Lenses

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Regenerative Medicine

Biologics are steadily becoming a great option for patients with moderate to severe Dry Eye Disease. The world of medicine has always understood the power of using stem cells and growth factors for the regeneration of live tissue. Over the last decade, optometry and ophthalmology has seen some amazing outcomes using these principles.

Cryopreserved Amniotic Membranes
  • Human amniotic membranes harvested from the placenta and goes through a process of cooling to preserve the biological material with minimal disruption to the extracellular matrix

Dehydrated Amniotic Membranes
  • Human amniotic membranes harvested from the placenta and is preserved using vacuum with low temperature heat to retain the devitalized cellular components

Autologus Serum Eye Drops (ASED)
  • These are eye drops made from the patient's own blood. After the blood is drawn, the sample is placed in a centrifuge to separate the red blood cells from the blood serum. The blood serum contains healing and wetting factors to imitate the patient's own natural tears.

Platelet Rich Plasma (PRP)/Platelet Rich in Growth Factors (PRgF)
  • Similar to the ASED however this contains 1.5x higher concentration of platelets. This means there is a higher concentration of growth factors. PRgF contains plasma proteins and coagulative factors and is pre-activated by heating the sample to a certain temperature.

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There is still an important place for prescription medications for Dry Eye Disease. This is particularly true during flare up episodes where there is the need to provide immediate relief for the patient.

Topical Antihistamines
  • These are necessary during seasonal allergies as well as year round allergies to offending allergens. 

Topical Steroids
  • These are important for more than usual ocular inflammation.

Topical Immune-Modulators
  • Propriety prescription formulations designed to treat the signs and symptoms of dry eye disease. These prescription medications targets certain points of the inflammatory process to decrease inflammation while increasing tear production in some cases.

Oral Pharmaceuticals
  • Certain acute flare ups require the aid of oral medication working from the systemic side of the disease process. 

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