Dry eye relief

We specialize in dry eye evaluations and relief.  The following are some frequently asked questions and answers about dry eye.

What are the common symptoms of dry eye?

  • Sandy or gritty feeling
  • Dryness
  • Redness
  • Watery eyes
  • Constant or occasional tearing
  • Burning
  • Itching
  • Contact lens discomfort
  • Dryness when staring at a computer screen
  • Sensitivity to light
  • Eye pain or discomfort
  • Stickiness
  • Tired eyes
  • Fluctuating or decreased vision

 

What are the common causes of dry eye?

  • Decreased aqueous production– This may be caused by lacrimal gland dysfunction, systemic disease, medications, or trauma.
  • Evaporation of tears – Evaporation causes decreased tear volume.
  • Eyelid anomalies
  • Ectropion – The lower lid turns away from the eye which may increase evaporation of the tears.
  • Entropion – The lid and lashes turn toward the eye which may affect the tear film.
  • Exopthalmos – The eye bulges forward abnormally causing the eyelids to spread apart.
  • Lagopthalmos – With this condition it is difficult to completely close the eyelids.
  • Lipid deficiency – Decreased lipid layer causes increased evaporation of the aqueous layer
  • Blepharitis – This eyelid inflammation often has dandruff-like skin cells t rapped on the eyelashes.
  • Meibomianitis – This is meibomian gland inflammation.
  • Inspissated meibomian glands – Meibomian gland secretion hardens leaving a cap over the gland orifice.
  • Mucin deficiency – Loss of this layer decreases tear film stability leading to evaporation of the aqueous layer.
  • Reduced blink reflex – Loss of corneal sensitivity leads to decreased blink reflex and less reflex tearing.
  • Causes of decreased corneal sensitivity
  • Post refractive surgery – Creation of the corneal flap may decrease the function of the nerves in that area reducing corneal sensation and the blink reflex. This tear film status should return to normal approximately six to nine months after the surgery.
  • Contact lens wear - This may decrease corneal sensitivity. Excessive wear of contact lenses may compromise the corneal surface and lead to abnormal wetting of the surface.
  • Systemic disorders – These may affect corneal sensitivity.
  • Uneven distribution of tears – Can lead to exposure of the cornea and conjunctiva.

 

Are there other factors which may affect dry eye?

Symptoms may be more apparent with:

  • Wind (environmental or vent from air conditioning, etc.)
  • Changes in humidity or temperature
  • Focused activity decreasing blink rate (including computer use)
  • Smoke
  • Dust
  • Timing during day
  • Contact lens use
  • After injury or surgery to eye (LASIK) 

 

Are all eye drops the same?

  • Low viscosity artificial tears – These drops are added to increase the aqueous portion of the tear film. Preservatives are added to multi-dose (larger) bottles to maintain sterility. Sterile, non-preserved, single-dose containers are also available. Multi-dose bottles can also be made with preservatives that dissipate when in the eye yet still maintain sterility in the bottle.
  • High viscosity artificial tears - These solutions have an increased concentration of viscosity agents.
  • High viscosity ointment – These ointments provide a coating over the eye that will not evaporate or drain from the eye as quickly as artificial tears.
  • Contact lens rewetting drops – These solutions are formulated to apply to the eye while wearing soft or hard contacts. 

 

Are there other treatments for dry eye?

  • Cyclosporin A – This immunomodulator is used in patients whose tear production is reduced due to ocular inflammation.
  • Topical steroid – This is used to treat inflammation.
  • Doxycycline – This is used when dry eye is caused by blepharitis.
  • Collagen punctal plug – The drainage areas are plugged to retain tears. This temporary plug will dissolve within days.
  • Silicone punctal plug – This plug does not dissolve and is used as a long term solution to treat severe dry eyes. The plug may be removed if needed.
  • Mist spray – This spray increases the aqueous layer of the eye.
  • Humidifier – This device increases the moisture in the environment.
  • Moisture chamber goggles – Humidity is maintained within the protective glasses due to decreased evaporation.
  • Nutrition and supplementation – Proper balance of fatty acids may affect the dryness of the eye.