DRY EYE

Dry eye, also referred to as Dry Eye Syndrome, is a very common condition in which a person doesn’t have enough tears or the tear quality is insufficient to keep the eyes lubricated and comfortable. The tears play a crucial role in the health and the vision of a person’s eye. Tears provide lubrication, reduce the risk of eye infection, wash away foreign matter in the eye, and provide a smooth surface for light to enter the eye. In fact, it is accurate to say that the tear film is actually a lens in the optical system of the eye. This explains why dry eye issues are the most common reason that our vision is variable and fluctuates from time to time throughout the day.

 What are the symptoms of dry eye? 

  • Irritated, scratchy, gritty eyes

  • A feeling of something in your eyes

  • Excess watering

  • Blurred or fluctuating vision

  • Redness

The two main reasons for dry eye are an inadequate amount of tears and poor tear quality.

  • Inadequate amount of tears. This occurs when the glands responsible for producing the watery layer of tears are not functioning properly. 

  • Poor quality of tears. This occurs when the glands responsible for producing the oily layer of tears are not functioning properly. The oil layer of tears is responsible for preventing evaporation and coating the eye evenly. Without this layer, the tears evaporate too quickly and are spread unevenly across the eye. Although we delineate two separate forms of dry eye, many patients actually have a combination of the two forms.

What causes dry eyes?

  • Age— dry eye is a part of the natural aging process and will generally worsen over time.

  • Gender— women are more likely to develop dry eyes due to hormonal changes from pregnancy and menopause.

  • Medical conditions— people with rheumatoid arthritis, diabetes and thyroid problems are more likely to have dry eyes.

  • Medications— certain medications in each of the following classes can all cause dry eye: hypertensive agents, antihistamines, hormones, antidepressants, pain relievers, and dermatological agents.

  • Environmental conditions— exposure to smoke, wind, and dry climates can cause dry eye.

  • Other factors— improper hydration, failure to blink regularly while staring at a computer screen, history of LASIK, and long-term use of contact lenses.

How are dry eyes treated?

There are numerous options available to us for treating dry eye. Our doctors will do a thorough investigation during your exam to determine the appropriate treatment plan for your eyes. Treatment of Dry Eye Syndrome is generally approached using a stepped approach. That is, we start with the simplest remedies first and become more aggressive and invasive if these initial therapies do not adequately relieve our patient’s symptoms.

 

Common treatments might include:

  • Artificial Tears. These are to supplement the natural tear production of your eyes. This is usually our first step in treatment and in mild cases may be the only treatment required.

  • Nutritional Supplements. Omega-3 fatty acids, specifically DHA and EPA, are known to improve the quality of tears and ease the symptoms of dry eye. Not all omega supplements are created equal. Some are much more “bio-available” than others; that is, some are absorbed more readily than others, so it is important that you select

  • Treatment of Eyelids. There are glands in the eyelids that play a critical part in tear production and may require special treatment if these glands aren’t functioning properly. There are several ways we can help these glands function better, common approaches include warm compresses, hypochlorous acid spray, meibomian gland expression, and certain oral or topical medications.

  • Anti-inflammation. A common component of dry eye is inflammation. Stopping this inflammation can greatly improve the symptoms of dry eye. We utilize a few different prescription eye drops that can combat the inflammatory component of dry eye, including steroids, Restasis, and Xiidra.

  • Punctal Occlusion. This entails an in-office procedure where we insert a small device to essentially “plug” the drainage duct of your eye. This keeps the tears on your eye longer to help alleviate dry eye symptoms.

  • Amniotic Membranes / Amniotic Eye Drops. These are remarkably effective in some cases by quickly healing long-standing corneal irritation that contributes to the symptoms associated with Dry Eye Syndrome.

  • Specialty Contact Lenses. A special type of contact lens called a scleral contact lens has proven to be very effective in relieving severe Dry Eye for some patients.

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