Dry Eye

As many as 33 million Americans may have dry eye. While there are many different causes of dry eye, simple and generally effective forms of treatment are available. The majority of those suffering from dry eye have not consulted an eye doctor. Dry eye can also make wearing contact lenses more difficult. In some cases if left untreated, dry eye cause damage to eye tissue. 

Dry eye symptoms can result from the normal aging process, exposure to environmental conditions, problems with normal blinking, or medications such as antihistamines, oral contraceptives, or antidepressants. Dry eye can also be symptomatic of general health problems or can result from allergy or injury to the eye.

Normal Tears are composed of three different layers:

All three layers must be produced in the proper formulation for tears to properly lubricate the outer surface of the eye. Dry eye occurs when the eye doesn't produce enough tears or produces poor quality tears due to blocked or diseased oil glands, which can cause rapid tear evaporation. 

SYMPTOMS

  • Red eyes
  • Burning
  • Itchy eyes
  • Scratchiness
  • Tearing eyes
  • Light Sensitivity
  • Gritty sensation
  • Blurred vision
  • Watering eyes

Ironically, one of the symptoms of dry eye is excessive watering or tearing.  Excessive tearing is a natural response to irritation of the cornea from poor quality tear production.  This is why so many people with watering eyes are so surprised when they are told that their symptoms are diagnosed as dry eye. 

CAUSES

  • Age
  • Medications
    • Antihistamines
    • Oral contraceptives
    • Antidepressants
    • Decongestants
    • Certain heart medications (beta-blockers)
    • Diuretics
    • Glaucoma medications
  • Wind
  • Allergies
  • Sun
  • Cold
  • Indoor heating and air conditioning (low humidity)
  • Computer screens
  • High Altitudes
  • Systemic arthritic conditions or autoimmune disorders

TREATMENT

  • Artificial tears (OTC-many different kinds)

  • Restasis (prescription 2x/day)
  • Xiidra (prescription 2x/day)
  • Cequa (prescription 2x/day)
  • Prescription steroid eye drops
  • Puntal plugs (plugging up the drainage tear ducts, which is reversible)
  • Oral doxycycline
  • Fish oil or Omega-3 tablets
  • Warm compresses on the lids
  • Lid wash with baby shampoo
  • Home humidifier
  • Lacrisert (a little capsule placed in the sac of the lower lid that constantly releases fluid)
  • Scleral contact lenses


Artificial tears may provide relief of dry eye

Some causes of dry eye cannot be permanently cured but can be effectively managed. Initial treatment recommended is the use of over-the-counter artificial lubricating eye drops and/or ointment at night, often combined with warm compresses and Omega 3 supplements. Next would be the addition of Restasis, Xiidra, or Cequa. Adding a humidifier at home or at work may profide relief. In office insertion of tiny, removable plugs in the tear drainage canals (punctal occlusion) may help by allowing more tears to stay on the eye for a longer period of time. Early detection of dry eye leads to more effective treatment and the prevention of serious damage to your eyes. 

 

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