Dry Eye

What is Dry Eye?
The eye has a tear film which coats the outer layer of the eye. This tear film is very important for the lubrication and comfort of the eye as well as for the clarity of vision. As people age, this protective tear film diminishes, and leaves the eye more exposed to the drying effects of the air, wind and dust, the resulting condition is know as Dry Eye.

How does Dry Eye develop?
Dry eye is not caused by a lack of tear production. In fact, during dry eye, the eye can still make so many tears that many patients complain of wet eyes and tearing with this malady. This occurs because the dryness causes the eye to produce more tears in an effort to replace the tear film.

Blinking is very important for the maintenance of the tear film. When performing such activities as reading or working on a computer, we blink less frequently. This aggravates the symptoms of dry eyes. Sometimes, environmental factors can also aggravate dry eye symptoms. Dry weather, either in hot or cold temperatures, robs the eye of needed lubricants. Cigarette smoke, fumes, dust and airborne particles are common irritants. In many people the dryness is worse in the afternoon and evening. Contact lens wear also may worsen symptoms.

Dry eye becomes more common with increasing age and as body hormone changes occur. Most commonly affected are post-menopausal women. Medications taken by mouth are another common cause of dry eyes. Several categories of drugs may cause or worsen the symptoms of dry eye, including blood pressure medications, antidepressants, decongestants, antihistamines, medications for Parkinson Disease and certain medications which regulate heart rhythm irregularities.

More rarely, there can be a genetic or hereditary cause of dry eyes. In most patients, this condition is not associated with systemic disease.

What are the symptoms?
Dry eye symptoms include burning, stinging or a gritty sensation which may come and go depending on many factors. Itching, tearing and light sensitivity may also occur. Occasionally, long strings of mucus are discharged from a dry eye.

Eventually, dry rough spots appear on the eye surface, which may reduce vision. In severe cases, scarring may develop.

How can Dry Eye be prevented?
Dry eye is a common condition related to aging that is estimated to affect 12 million Americans. It cannot be prevented.

What treatments are available?
Treatment helps the patients in most cases, but a complete cure is not yet available. Therefore, dry eye treatment is an ongoing project. Usually artificial tears, available over-the-counter, soothe the eyes and give temporary relief. These artificial tears work for only an hour or two, at best, and must be repeated at frequent intervals. Ointments last longer, but they may temporarily blur vision and are most effective at night.

In addition to using artificial tears, wrap-around glasses can be used to help seal in moisture. People with severe dry eyes may benefit from swim goggles or moisture shields, with a mild adhesive that adheres to the skin around the eyes.

Newer techniques to treat dry eye include punctual plugs that block the tear duct. These plugs can be placed in the two tear ducts, top and bottom, in both eyes or in only the lower ducts. Some test plugs are also available which dissolve a few days after insertion. If the dry eye symptoms disappear when the temporary plugs are inserted, then permanent punctal plugs should be considered as a treatment option.