DRY EYE INFORMATION
What is Dry Eye?
Dry eye is a term used to describe a group of different diseases and conditions that result from inadequate wetting and lubrication of the eye. We normally think of tears as the excess moisture that overflows from our eyes when we cry or when our eyes "water". However, a thin film of tears must constantly be produced and washed over our eyes to keep them moist. This type of tears is referred to as the tear film. The tear film is the body’s natural mechanism for protecting the surface of the eye from the irritating effects of dirt, dust, and other airborne particles, as well as from infection. The tear film helps to create a smooth surface so vision stays clear and undistorted, and eyes stay lubricated and comfortable. The tear film has three main components: lipid, aqueous, and mucin. Lipids form an oily layer on the outside of the tear film and help slow down evaporation of tears. The largest portion of the tear film is made of up aqueous (watery) with different types and concentrations of mucins (sticky proteins) throughout. The thickest concentration of mucins is at the eye’s surface. Since the eye’s surface is naturally water repellant, the mucins are needed to create a water-attracting surface so the aqueous will spread over the eye. All three components of the tear film are important and necessary for the eye to maintain a normal healthy environment. When the balance of the tear film components is not just right, or not enough tear film is being produced, dry eye can occur. Dry eyes are one of the most common problems that we see among our patients.
Common Symptoms are:
- Tearing and watery eyes
- Dry sensation
- Redness
- Itching or burning
- Irritation, gritty feeling
- Pain
- Blurred vision
- Lids sticking to the cornea
Watery eyes may seem like a strange sign of dryness. The eyes actually sense their dryness and flooding often occurs.
What are the causes of Dry Eye?
- Age
- Medication
- Hormone levels
- Environmental factors
- Poor lid position or function
- A decreased blinking pattern
- Chemotherapy
- Corneal scars
- Other diseases
What are the treatment options?
- Artificial tears. These are (over the counter) drops that should be used on a regular basis, not just when symptoms are noted. These drops are most often used 4 times a day or more. √Also tear gel preparations (such as Genteal Gel, or Refresh PM), used at bedtime, are popular with patients of dry eye. This may not be enough for some patients with more severe symptoms.
- Tear promoting nutritional supplements are also available Biotears, Hydroeyes and Flaxseed oil capsules are three supplements that can be found in the nutrition shop located her at Eyesight Associates.
- A new prescription tear preparation called Restasis has helped many people with dry eyes. The disadvantage is that without the help of insurance Restasis costs about $100 per month. This is an Allergan product that is said to increase tear production by stopping inflammation. It must be taken twice a day, and increase in comfort may not be noted until two months after beginning treatment.
- Punctal plugs are another option. The tears are manufactured in the brow area of each eye, and flow across the surface of the eye, to exit through the upper and lower corners of the eye that are near the nose. A plug (usually placed in the lower corner of the eye, allows some exit through the upper corner, but keeps most of the tears from exiting, creating a better tear lake. Sometimes a test run with plugs that dissolve in a few days is done, to see if a patient is more comfortable after insertion, and to be sure there will not be an overproduction of tears. If plugs are irritating, permanent closure of puncta can be accomplished by cautery.
- Tarsorrhaphy. This is done, in extreme dry eye cases and involves sewing the lids together surgically to limit the surface exposure to the air and dryness.
The first step in diagnosing dry eyes is to have a tear test performed to measure the amount of tears produced in a five-minute period. Then a plan can be discussed with your doctor to see what might be the best option for you. If you have any questions, please do not hesitate to call Eyesight Associates at (478)923-5872.