What is Dry Eye?
Normally, the eye constantly bathes itself in tears. By producing tears at a slow and steady rate, the eye stays moist and comfortable. Sometimes people do not produce enough tears or the appropriate quality of tears to keep their eyes healthy and comfortable. This condition is known as dry eye. The eye uses two different methods to produce tears. It can make tears at a slow, steady rate to maintain normal eye lubrication. It can also produce large quantities of tears in response to eye irritation or emotion.
What are the symptoms of Dry Eye?
When a foreign body or dryness irritates the eye, or when a person cries, excessive tearing occurs.
- Stinging or burning eyes
- Scratchiness
- Stringy mucus in or around the eyes
- Excessive eye irritation from smoke or wind
- Excess tearing
- Discomfort when wearing contact lenses
Excess tearing from “dry eye” may sound illogical, but it can be understood as the eye’s response to discomfort. If the tears responsible for maintaining lubrication do not keep the eye wet enough, the eye becomes irritated. Eye irritation prompts the gland that makes tears called the (lacrimal gland) to release a large volume of tears, overwhelming the tear drainage system. These excess tears then overflow from your eye.
What is the Tear Film?
When you blink, a film of tears spreads over the eye, making the surface of the eye smooth and clear. Without this tear film, good vision would not be possible.
The tear film consists of three layers and each layer has its own purpose:
- an oil layer
- a watery layer
- a layer of mucus
The oily layer, produced by the Meibomian glands, forms the outermost surface of the tear film. Its main purpose is to smooth the tear surface and reduce evaporation of tears.
The middle watery layer makes up most of what we ordinarily think of as tears. This layer, produced by the lacrimal glands in the eyelids, cleanses the eye and washes away foreign particles or irritants.
The inner layer consists of mucus produced by the conjunctiva. Mucus allows the watery layer to spread evenly over the surface of the eye and helps the eye remain moist. Without mucus, tears would not stick to the eye.
What causes Dry Eye?
Tear production normally decreases as we age. Although dry eye can occur in both men and women at any age, women are most often affected. This is especially true after menopause. Dry eye can also be associated with other problems. For example, people with dry eyes, dry mouth and arthritis are said to have Sjögren’s syndrome.
A wide variety of common medications — both prescription and over-the-counter — can cause dry eye by reducing tear secretion. Be sure to tell your ophthalmologist (Eye M.D.) the names of all the medications you are taking, especially if you are using:
- Beta-blockers for heart or high blood pressure
- Antihistamines for allergies
- Sleeping pills
- Medications for “nerves”;
- Pain Relievers
Since these medications are often necessary, the dry eye condition may have to be tolerated or treated with eyes drops called Artificial Tears.
Artificial tears are available without a prescription. There are many brands on the market, so you may want to try several to find the one you like best.
Preservative-free eye drops are available for people who are sensitive to the preservatives in artificial tears. If you need to use artificial tears more than every two hours, preservative-free brands may be better for you. You can use the artificial tears as often as necessary — once or twice a day or as often as several times an hour.
Conserving your Tears
Conserving your eyes’ own tears is another approach to keeping the eyes moist. Tears drain out of the eye through a small channel into the nose (which is why your nose runs when you cry). Your ophthalmologist may close these channels either temporarily or permanently. The closure conserves your own tears and makes artificial tears last longer.
How are dry eyes diagnosed?
Dry Eyes are often diagnosed with a dye test or simple eye examination. The Schirmer Test, which measures tear volume, may be used. In the Schirmer tear strip test, filtered paper strips are placed just inside the lower eyelid to measure the amount of tears present.
In some cases, temporary closure of punctum may by performed to determine if eye discomfort is resolved. A tiny punctual plug, smaller than a grain of rice, is painlessly placed in the tear drainage canals. The plug permit only a small percentage of tears to pass into the punctum, thus building up a layer of tears on the surface of the eye. The plugs are absorbed by the body in a few days, giving the patient and doctor time to evaluate the effectiveness and comfort provided by an increase in the amount of tears on the surface of the eye.
How are dry eyes treated?
Eye drops called artificial tears are similar to your own tears. They lubricate the eyes and help maintain moisture. Artificial tears, ointments and gels are the most common treatment for dry eyes. Eye drops are used to lubricate the eyes and replace missing moisture. Some patients who are sensitive to preservatives require special preservative free artificial tears. Slow release inserts, filled with medicine and placed just inside the lower lid, which gradually release moisture during the day may also by helpful. An ointment at bedtime may be required in more severe cases.
Treatment
If you are suffering from dry eyes or other eye discomfort, you should obtain a complete eye examination. Left untreated dry eyes can lead to other more serious conditions including corneal ulcers, infection and conjunctivitis. Compliance is the biggest hurdle. Call us at 916-446-220 for an examination and we can provide you with the proper treatment you need to alleviate your Dry Eyes.
Treatments an Ophthalmologist may recommend
- Use Artificial Tears
- Punctal Plugs-Temporary/Permanent
- Omega 3 Fatty Acids– Fish Oil 1000mg
- Restasis or Ziidra (prescribed by MD) 2 times per day
- Intense Pulse Light Therapy (IPL)
- Lipiflow
