Everyone knows that tears run from our eyes when we cry or when our eyes are irritated. But tears have a much more important everyday function. A film of tears, spread over the eye by a blink, makes the surface of the eye smooth and optically clear. The quality and the quantity of this tear film is important for comfort and clear vision.

What are the Common Symptoms of Dry Eyes?

Stinging, burning, scratchiness, stringy mucus, redness, lid crusting and inflammation from environmental irritants are usual symptoms. Problems wearing contact lenses can be caused by dry eyes.  Surprisingly, increased tearing may also be a symptom of dry eyes. If the basic tear secretion is below normal or of poor quality, excess tears are produced by the lacrimal gland in response to irritation.

What are the Different Kind of Tears?

There are at least two kinds of human tears: those that lubricate the eye and watery tears that are produced as a reaction to irritation or emotion. Tears that lubricate the eye are produced around the clock. Excessive tears occur when a foreign body irritates the eye or when a person experiences extremes in emotion, as in crying.

What Causes Dry Eye?

Normally, tear production decreases with age. Dry eyes are more common in women, especially after menopause, but can occur at any age in both men and women.  A major underlying cause of decrease in the quality of tears is meibomian gland dysfunction (MGD). There are nearly 30 million people in the US and over 300 million worldwide who have been diagnosed with dry eye. It is estimated that about 86% of dry eye cases are caused by MGD. Millions suffer from MGD and yet most are unaware or have not yet developed symptoms.  Diagnosing and treating MGD is essential to protect further gland destruction and keep dry eye symptoms under control.

MGD occurs when the protective oil that normally flows from the meibomian glands located in the eyelids (called meibum) slows or stops. Meibum acts as the front line of protection for the tears and lubricates the surface of the eyes during blinking. Over time, if blockage persists in the meibomian glands, structural damage can occur. A potential result of the meibomian glands not producing enough meibum is that the tear film rapidly evaporates, leaving the eye’s surface exposed. This exposure can cause discomfort that increases over time, causing negative effects on quality of vision, uncomfortable contact lens wear and other irritating dry eye symptoms.

Dry eye can also be associated with arthritis. In addition, the inside of the mouth may become dry due to inadequate production of saliva. Patients with dry eyes, dry mouth, and arthritis are may have a condition known as Sjogren’s Syndrome.

Drugs and medication can also cause dry eyes by reducing tear secretion. Since these medications are often necessary, the dry eye condition may have to be treated with artificial tears or another form of treatment.

How is Dry Eye Diagnosed?

Previously, eye care professionals diagnosed dry eyes only by visually examining the eyes and discussing symptoms. However, as Eyesight Associates has evolved into a Dry Eye Center of Excellence they are accredited to perform TearLab and InflammaDry® tear testing.  These tests collect a tiny drop of tear and provide an objective measurement to diagnose and monitor treatment.  Additionally a LipiView® testing unit examines the Meibomian glands, patient blinking function and tear layer quality to quantify MGD.

 

What are the Treatment Options for Dry Eye?

No one treatment works for every patient.  Your eye care provider may suggest a periodic treatment and a maintenance routine of drops, gels and supplements to help alleviate dry eye symptoms

LipiFlow

Eyesight Associates is proud to offer patients Lipiflow: a new procedure designed to treat Evaporative Dry Eye, which is caused by blocked Meibomian glands (MGD).

LipiFlow is the only FDA-cleared electronic device for treatment of MGD. Through advances in the application of Vectored Thermal Pulsation (VTP) technology, the LipiFlow treatment utilizes a patented algorithm of heat applied to the inner eyelids and massage to remove the obstructions in your Meibomian glands. The procedure is painless and helps restore secretion of the natural lipids (oils) that are needed for healthy tears.  Effects of this treatment have been reported up to two years.

IPL Treatment for Dry Eye

Many people already know the amazing benefits of the IPL (Intense Pulsed Light Treatment) to create beautiful skin. But this technological breakthrough is also used to treat patients with dry eye syndrome. IPL is not a laser, but is light therapy over a broad range of wavelengths.  IPL is used to unplug the surface of the oil glands that line the upper and lower lid margins. The light serves as a warm compress to liquefy any secretions that may be blocking the oil-secreting gland of the eye (called the Meibomian glands). After the IPL application, the glands are manually expressed restoring the production of the oily layer of the tear film.  This treatment generally needs to be performed monthly for the first few months and then several times a years.

Blephex

Blephex is a treatment to clean the eyelid margins of debris.  It is performed in the office and is refreshing and painless.  It is especially effective if the lids have a low grade infection.  For maximum effectiveness, it should be repeated periodically.  Click for more information blephex.com has an animated lid video.

Punctal Closure

Conserving the tears, which are naturally produced, is another approach to keeping the eye moist. Tears leave the eye through tear ducts in both eyelids and go down into the nose. These channels may be closed by your eye care professional to create a blockage, which will keep the eyes moist for longer periods of time.  The procedure may be performed with miniature plugs or a permanent thermal procedure.

Medications & Maintenance

Using artificial tears is a common treatment for symptoms. Artificial tears are available without a prescription and are used as eye drops to lubricate the eyes and replace the missing moisture. There are many brands of artificial tears on the market and they may be used as often as necessary, from just once or twice a day to as often as several times an hour. Eyesight Associates stocks some of the best brands of tears and they are available for purchase.  Scratchiness that is bothersome on first opening the eyes in the morning can be treated by using an ointment or gel drop at bedtime.

Nutritional supplements

Nutritional supplements with Omega fats have been shown to help patients produce better quality tears and increase tear production.  Eyesight Associates recommends HydoEyes which is available at the front desk.

If you suffer from dry eye, schedule your consultation online or call 478-923-5872.

Who Can Treat Dry Eye?

A person suffering from dry eye may only need over-the-counter artificial tears, but since extreme dryness can cause serious damage to the eye, an examination and diagnosis by your eye care professional is suggested.

Prescription Medication

Restasis is a prescription that is given to fight inflammatory causes of dry eyes.  It increases tear production over time, but is generally a long term commitment.  Some patients do not notice results until using Restasis for months.

Low doses of topical steroids may also be used for short periods of time to combat inflammatory causes of dry eyes.

A new medication, Xidra, is now available.  It is the only drop that treats symptoms of dry eyes.  Many patients are showing great success with this medication shortly after beginning to us it.

Avenova is also stocked at Eyesight Associates.  It is a spray with antimicrobial properties that is used at home to cleanse lids and lashes.

Environmental Concerns

Preventing the evaporation of tears can also prove helpful. In winter, when the heat is turned on, a humidifier or a pan of water on the radiator may help add moisture to the air. Wrap-around glasses may cut down evaporation of eye moisture due to wind.

Anything that adds to dryness such as an overly warm room, ceiling fans, air-conditioning (especially in vehicles) hair dryers, windy days will make a person with dry eyes more uncomfortable. Smoking is especially bothersome.