Dry Eye Syndrome

A stable tear film naturally lubricates and protects the eye from air-borne irritants and debris. Sometimes people don't produce enough or the right quality of tears to keep their eyes healthy and comfortable. This condition is known as dry eye syndrome. Dry eye syndrome is sometimes referred to as dysfunctional tear syndrome and ocular surface disease. Most often, it’s simply referred to as “dry eye.”

Dry eye is common and the prevalence of dry eye increases with age. An estimated 3.2 million women age 50 and over and 1.7 million men age 50 and over are affected by dry eye syndrome in the United States. Greater numbers of patients are experiencing symptoms of dry eye. Whatever the age, there are options for managing and even eliminating dry eye.

Common risk factors for dry eye include increasing age, a dry environment, length of time in front of personal computers and laptops, and use of certain medications.

Signs and Symptoms of Dry Eye

Signs and symptoms of dry eye syndrome include:
• Red, irritated eyes
• A burning or scratchy sensation
• Feeling something is "in" your eye (called a foreign body sensation)
• Fluctuating or blurred vision
• Eye pain
• Contact lens discomfort
• Watery eyes

What Causes Dry Eyes?

Ideally, our eyes produce tears at a slow and steady rate. This allows the eye to remain moist and comfortable and keep the surface of the eye smooth and clear, resulting in better vision. Our eyes can quickly produce a high volume of tears in response to eye irritants, including foreign bodies. Our eyes also respond to dryness as an irritant, which may cause reflex tear formation giving the eyes a moist feeling. In some cases, tears may actually overflow onto the cheek.

Dry eye is caused by the tear glands failing to secrete an adequate amount of tears or producing a tear film that, because of insufficient oiliness, evaporates too quickly. These problems may be due to aging or a side effect of many medications, such as antihistamines, anti-anxiety medications, certain blood pressure medicines, and birth control pills. Dry eye may also be caused by chronic exposure to a dry, dusty or windy climate with low humidity (Arizona!). Air conditioning and forced air heating systems at home and at the office can dry out your eyes. Another cause is failing to blink your eyes normally to remoisten them. This frequently occurs during computer work.

Dry eye syndrome is also associated with certain systemic diseases such as lupus, rheumatoid arthritis, rosacea, and Sjogren's syndrome. Long-term contact lens wear, incomplete closure of the eyelids, eyelid disease, refractive surgery (such as LASIK), and a deficiency of the tear-producing glands are other causes. Dry eye syndrome is more common in women, possibly due to hormone fluctuations. Recent research suggests that smoking, too, may increase your risk of dry eye syndrome. Dry eye also has been associated with incomplete lid closure following blepharoplasty — a popular cosmetic surgery to eliminate droopy eyelids.


Treatment for Dry Eye

There are several treatments for dry eye, based on the severity of the condition. For mild dry eye, Dr. Johnson may recommend artificial tears, which are lubricating eye drops designed to alleviate the dry, scratchy feeling and foreign body sensation of dry eye. Prescription eye drops for dry eye go one step further because they actually help increase tear production.

To reduce the effects of sun, wind, and dust on dry eyes, wear sunglasses when outdoors. Close-fitting wraparound styles offer the best protection. Indoors, an air cleaner can filter out dust and other particles from the air, while a humidifier adds moisture to air that's too dry because of air conditioning or heating.

For more significant cases of dry eye, your eye doctor might recommend punctal plugs. These tiny devices are inserted into the tear drainage ducts in your eyelids to slow the drainage of tears away from your eyes, thereby keeping your eyes more moist.

Treating any underlying eyelid disease, such as blepharitis, helps as well. This may call for antibiotic or steroid drops, plus frequent eyelid scrubs with an antibacterial shampoo. If you are considering LASIK, be aware that dry eyes may disqualify you for the surgery, at least until your dry eye condition is successfully treated. Dry eyes increase your risk for poor healing after LASIK, so most surgeons will want to treat the dry eyes first, to ensure a good LASIK outcome. This goes for other types of vision correction surgery, as well.

Preservatives in certain eye drops and artificial tears eye drops may also irritate the eye and may not be advisable for long-term use. Ask Dr. Johnson about preservative-free artificial tears and whether you might benefit from using a preservative-free eye drop or a prescription eye drop that actually stimulates healthy tear production.



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