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Dry Eye Syndrome

Dry eye is a common eye problem which can be caused by lack of tear production, rapid evaporation, or inflammation in and around the eye. Tears normally keep the eye moistened and lubricated; however, if tears are insufficient stinging, burning, dryness and redness will result. While discomfort is the primary result of dry eye syndrome, more serious complications such as infection and corneal scarring may result if left untreated.

What is the tear film?
The tear film which covers the surface of the eye is made up of three layers. The oil based outer layer reduces evaporation. The watery middle layer cleanses the eye and washes away foreign particles and irritants. The innermost layer consists of mucous and coats the surface of the eye evenly and allows tears to adhere to the surface of the eye. It is extremely important for these three layers to remain in the proper balance, otherwise dryness may occur. For this reason, a common symptom of dry eye syndrome is actually tearing. Although there is excess watery tear production, these unbalanced, unhealthy tears do not properly moisturize the eye. Tears are constantly produced by a main lacrimal gland underneath the upper eyelid as well as many accessory glands located over the surface of the eye and inner eyelids. Tears are drained out of the eye by two tear ducts located in the inner corner of the upper and lower eyelids. These ducts drain tears into the nose and throat, which makes it possible for us to “taste” some eye drops.

What Causes Dry Eyes?
Normally, tear production decreases with age, leaving the delicate eye tissues exposed to the irritating effects of the environment. Dry eyes are more common in contact lens wearers and women; particularly during pregnancy or after menopause. Dry eyes often occur in patients with arthritis and particularly in those with a genetic condition called Sjogren’s syndrome. Medications and vitamin deficiency may also cause reduced tear secretion. In addition, environmental factors such as sun, wind, and pollution may cause dry eye outside, while air conditioning, heating, ceiling fans, and smoke contribute to dry eye indoors. Finally, abnormalities in the eyelid and tear system may cause dry eye syndrome.

How are Dry Eyes diagnosed?
Dry eyes are most often diagnosed during a complete eye exam. Special dyes and stains are used to highlight damage done by dryness and are visible under microscopic examination in our eye clinic. Schirmer’s testing allows us to measure the production of tears and can also be performed quickly and painlessly during a complete eye exam.

How are Dry Eyes treated?
Artificial tears, ointments, and gel lubricants are the most common first line treatment for dry eye syndromes. Eye drops are used to lubricate the eyes and replace missing moisture. Patients should also take steps to eliminate some of the causes for dry eye such as turning off ceiling fans and redirecting air vents to avoid air blowing directly into the eyes. For patients with mild dry eye syndrome, these conservative measures may provide relief from the symptoms of dry eye.

Many patients with dry eye will require more intensive therapy to relieve symptoms. The medicated drop Restasis® can be used to increase the quantity and quality of tears. Restasis® has given many patients a safe and effective long term solution to the pain and discomfort of dry eye. Click here (www.restasis.com) for more information on Restasis®.

Another option to increase the amount of tears in the eye is to block the tear ducts which drain tears from the eye. Temporary or permanent punctal plugs may be inserted to keep tears in the eye longer and reduce dry eye symptoms. Insertion of plugs is a quick and painless procedure which takes only minutes and can provide months or years of relief from dry eye symptoms. Plugs are always present, so your dry eye is treated even when you are not putting in eye drops. Ask your doctor if punctal plugs may be able to help your dry eye.

Other treatments for dry eye include a healthy diet high in omega 3 and fish oils. You may take fish oil and flax seed supplements to improve the quality of your tears. Adding moisture to the air with humidifiers or even moisture chamber goggles may be necessary in cases of severe dry eye.

At Atlantic Eye Institute our Dry Eye Clinic headed by Dr. Steven Lancaster is up to date on the latest dry eye treatment modalities. If you are suffering from dry eye syndrome, whether it is mild or severe, we have the latest treatments to improve your quality of life. Call today for your evaluation.

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