Dry eye syndrome (DES or dry eye) is a chronic lack of sufficient lubrication and moisture on the surface of the eye. Its consequences range from minor irritation to the inability to wear contact lenses and an increased risk of corneal inflammation and eye infections.
Signs and Symptoms of Dry Eye
Persistent dryness, scratchiness and a burning sensation on your eyes are common symptoms of dry eye syndrome. These symptoms alone may be enough for your eye doctor to diagnose dry eye syndrome. Sometimes, he or she may want to measure the amount of tears in your eyes. A thin strip of filter paper placed at the edge of the eye, called a Schirmer test, is one way of measuring this.
Some people with dry eyes also experience a “foreign body sensation” – the feeling that something is in the eye. And it may seem odd, but sometimes dry eye syndrome can cause watery eyes, because the excessive dryness works to overstimulate production of the watery component of your eye’s tears.
We have had success in many patients with dry eye problems and we have to tailor the treatment to the fundamental underlying reason for the problem. Give us a call if we can help you with these conditions.
What Causes Dry Eyes?
In dry eye syndrome, the tear glands that moisturize the eye don’t produce enough tears, or the tears have a chemical composition that causes them to evaporate too quickly.
Signs and Symptoms of Dry Eye
Persistent dryness, scratchiness and a burning sensation on your eyes are common symptoms of dry eye syndrome. These symptoms alone may be enough for your eye doctor to diagnose dry eye syndrome. Sometimes, he or she may want to measure the amount of tears in your eyes. A thin strip of filter paper placed at the edge of the eye, called a Schirmer test, is one way of measuring this.
Some people with dry eyes also experience a “foreign body sensation” – the feeling that something is in the eye. And it may seem odd, but sometimes dry eye syndrome can cause watery eyes, because the excessive dryness works to overstimulate production of the watery component of your eye’s tears.
What Causes Dry Eyes?
Dry eye is a common problem and can have several causes. Eyes tend to get drier as we age, and can also be a side effect of numerous drugs, such as antihistamines, antidepressants, certain blood pressure medicines, Parkinsonʼs medications and birth control pillsWindy, dry environments can also exacerbate the problem. Over-the-counter artificial tears are often used to help with dry eyes, but unfortunately the relief does not last very long.Occasionally we use punctal plugs, which are small plastic inserts that prevent your tears from escaping into a small drainage opening (the puncta) in your lid that drains the tears to the back of your nose and throat. These plugs do not hurt and can be removed at any time if they are not effective.
Dry eyes are caused by either insufficient tear production, or too rapid evaporation of the tear film. There are two eye drops we can prescribe to increase tear production. Restasis and Xiidra. Neither medication cures the problem but can increase tear production while the drops are used. Restasis takes a couple of months to have its maximum effect. Omega-3 fatty acids, such as fish oil capsules, also can be of some help.
The most common reason for dry eyes is either a poor quality tear film or too rapid evaporation of the tears. Our eyes produce oils which float on top of the tears and greatly reduce the evaporation rate. These glands are called Meibomian glands and they are located in the upper and lower lids. They run vertically and release the oils on the edge of the lid margins. Ideally,a thin yellowish oil should flow from the approximately 30 glands in each lid. These unfortunately frequently become clogged and/or produce an oil of poor and thickened quality. This is called meibomian gland dysfunction. A major contributing factor to this problem is the bacterial that live on the edge of our lids. The bacteria travel down into the glands and live there and reduce the quality and quantity of oil produced. The bacteria also create a biofilm material that accumulates on the edge of the eyelids and blocks the openings and also can irritate the eyes. The biofilm and bacteria can cause red, irritated, dry, sticky eyes.
Blepharitis
Blepharitis usually coexists with meibomian gland dysfunction and can also be caused by bacteria living on the edge of the eyelids. This is seen as crusty material on the edge of the eyelids, which can feel scratchy, sticky, and contribute to dry eyes.
A very important part of controlling both blepharitis and meibomian gland dysfunction is daily lid scrubs with cleaning pads like Ocusoft pads. We also have an in-office cleaning procedure called Blephex (http://www.rysurg.com/patients/), which provides a lid margin debridement and deep lid cleaning which also helps with both theses problems. Occasionally we use oral antibiotics like doxycycline or azithromycin ( Z-pack). It is important to understand that these are chronic conditions that require long-term treatment. Both problems normally worsen with age without treatment.
If your home or office has air conditioning or a dry heating system, that too can dry out your eyes. Another cause is insufficient blinking, such as when you’re staring at a computer screen all day. Dry eyes are also associated with certain systemic diseases such as lupus, rheumatoid arthritis, rosacea or Sjogren’s Syndrome (a triad of dry eyes, dry mouth, and rheumatoid arthritis or lupus). Long-term contact lens wear, incomplete closure of the eyelids, eyelid disease and a deficiency of the tear-producing glands are other causes.
Dry eye syndrome is more common in women, possibly due to hormone fluctuations. Recent research suggests that smoking, too, can increase your risk of dry eye syndrome. Dry eye has also been associated with incomplete lid closure following blepharoplasty – a popular cosmetic surgery to eliminate droopy eyelids.
Treatment for Dry Eye
Dry eye syndrome is an ongoing condition that treatments may be unable to cure. But the symptoms of dry eye – including dryness, scratchiness and burning – can usually be successfully managed.
Your eyecare practitioner may recommend artificial tears, which are lubricating eye drops that may alleviate the dry, scratchy feeling and foreign body sensation of dry eye. Prescription eye drops for dry eye go one step further: they help increase your tear production. In some cases, your doctor may also prescribe a steroid for more immediate short-term relief. Another option for dry eye treatment involves a tiny insert filled with a lubricating ingredient. The insert is placed just inside the lower eyelid, where it continuously releases lubrication throughout the day.
If you wear contact lenses, be aware that many artificial tears cannot be used during contact lens wear. You may need to remove your lenses before using the drops. Wait 15 minutes or longer (check the label) before reinserting them. For mild dry eye, contact lens rewetting drops may be sufficient to make your eyes feel better, but the effect is usually only temporary. Switching to another lens brand could also help.
Check the label, but better yet, check with your doctor before buying any over-the-counter eye drops. Your eye doctor will know which formulas are effective and long-lasting and which are not, as well as which eye drops will work with your contact lenses.
- Dry eyes can creep up depending on a variety of factors, so taking an additional step in your nutrition by choosing specific foods or supplements will ensure better results & less dryness.
- "Burning Eyes” is often associated with either dry eye syndrome, an allergic reaction, blepharitis, or even pink eye.
- The risk for dry eye increases with age, especially for women.
- Dry eye is a common ailment for older people, and can be serious if not treated.
- BlephEx is a technological device that provides powerful and effective treatment for blepharitis Read on to learn how this treatment method can provide you with the relief you need.
To reduce the effects of sun, wind and dust on dry eyes, wear sunglasses when outdoors. Wraparound styles offer the best protection. Indoors, an air cleaner can filter out dust and other particles from the air, while a humidifier adds moisture to air that’s too dry because of air conditioning or heating.
For more significant cases of dry eye, your eye doctor may recommend punctal plugs. These tiny devices are inserted in ducts in your lids to slow the drainage of tears away from your eyes, thereby keeping your eyes more moist. If your dry eye is caused by meibomian gland dysfunction (MGD), your doctor may recommend warm compresses and suggest an in-office procedure to clear the blocked glands and restore normal function.
Doctors sometimes also recommend special nutritional supplements containing certain essential fatty acids to decrease dry eye symptoms. Drinking more water may also offer some relief.
If medications are the cause of dry eyes, discontinuing the drug generally resolves the problem. But in this case, the benefits of the drug must be weighed against the side effect of dry eyes. Sometimes switching to a different type of medication alleviates the dry eye symptoms while keeping the needed treatment. In any case, never switch or discontinue your medications without consulting with your doctor first.
Treating any underlying eyelid disease, such as blepharitis, helps as well. This may call for antibiotic or steroid drops, plus frequent eyelid scrubs with an antibacterial shampoo.
If you are considering LASIK, be aware that dry eyes may disqualify you for the surgery, at least until your dry eye condition is successfully treated. Dry eyes increase your risk for poor healing after LASIK, so most surgeons will want to treat the dry eyes first, to ensure a good LASIK outcome. This goes for other types of vision correction surgery, as well.
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- Fax: (910) 484-1333
- Email: villageeyecarenc@gmail.com
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Fayetteville, NC 28304
- Dry eyes can creep up depending on a variety of factors, so taking an additional step in your nutrition by choosing specific foods or supplements will ensure better results & less dryness.
- "Burning Eyes” is often associated with either dry eye syndrome, an allergic reaction, blepharitis, or even pink eye.
- The risk for dry eye increases with age, especially for women.
- Dry eye is a common ailment for older people, and can be serious if not treated.
- BlephEx is a technological device that provides powerful and effective treatment for blepharitis Read on to learn how this treatment method can provide you with the relief you need.