Dry Eye

Dry Eye Causes

Dry eye syndrome is a condition in which the eyes are not producing enough tears to lubricate the eye. This chronic lack of moisture can cause discomfort, redness, blurriness, and pain. A film of tears keeps the eye's surface moist and smooth. The tear film plays a role in cleaning the eyes and in keeping vision clear. The tear film consists of three layers:

  • An oily layer

  • An aqueous layer

  • A mucus layer

 

Each layer plays an important role.

The oily layer is on the outside, providing a smooth surface and prevents tears from drying too quickly. This layer is produced in the meibomian glands. The aqueous layer is found in the middle. This layer is what we see as tears when we cry or when our eyes are irritated - the tears help flush away any particles that do not belong in the eye. This layer is produced by the lacrimal glands found in the eyelids. The mucus layer is the deepest layer of the tear film, which adheres to the epithelial cells of the cornea. It allows the tears to stick to the eye and is produced in the conjunctiva (the clear part covering the white of your eye).

Our eyes may produce more tears when they are irritated, especially in cold and windy weather. We tend to produce less tears as we get older due to hormonal changes. Both women and men are affected, but it is found that it is more common for women who have gone through menopause. 

Here are some common causes of dry eye syndrome:

  • Blepharitis 

  • Other conditions such as Sjögren’s syndrome, thyroid disease, rheumatoid arthritis, and lupus 

  • Activities that reduce blinking for extended periods of time, such as looking at a computer screen

  • Wearing contact lenses for a long time

  • Refractive eye surgery

  • Medications such as diuretics, allergy medications, sleeping pills, high blood pressure medication, anxiety medication, and etc. Be sure to inform your ophthalmologists of all the medications you currently take. 

Dry Eye Symptoms

 

Here are some common symptoms of dry eye syndrome:

  • Stinging, burning sensation

  • Blurred vision, blinking sometimes helps 

  • Scratchy feeling or foreign body sensation inside the eye

  • Redness, irritation 

  • Pain when wearing contact lenses

  • Overabundance of tears

Treatments and Prevention

It is important to keep your eyes lubricated for your comfort and the best vision. Lifestyle changes can be made to prevent your eyes from becoming dry such as taking a break from looking at a screen to blink and lubricate your eyes, wearing sunglasses outdoors to prevent wind from directly hitting your eyes, and cleaning or disposing of contacts as directed (daily, bi-weekly, or monthly). Studies have shown that it is beneficial to eat more foods high in Omega-3 fatty acids in your diet such as salmon and walnuts. 

 

Our ophthalmologists recommend patients with dry eye syndrome to use artificial tears, which can be found over-the-counter. This can aid in keeping the eyes moist and comfortable when they feel dry or irritated. These drops can be used up to 2 or 4 times a day - there are preservative-free artificial tears that can be used as often as needed. 

Other medicated eye drops can be prescribed to alleviate inflammation and dryness. There are topical ointments that may be prescribed as well. For patients with severe dry eye syndrome, you may be prescribed an anti-inflammatory eye drop to use until the symptoms are cleared.

Punctal Plugs

Our ophthalmologists will offer different options of treatment options. Inserting punctal plugs consists of inserting tiny plugs into the tear duct to block drainage. This minimally invasive procedure will keep the eye surface moist for a longer duration. Most patients report that they do not feel the plug. 

LipiFlow

Lipiflow is an in-office treatment that uses single-use devices inserted in between the eyelid and the cornea itself to deliver heat and massaging pulses to remove blockages from the meibomian glands, allowing them to properly secrete oils onto the tear film. The heat and pulses are controlled in a manner that make this treatment very safe and comfortable. The heat and pulses only make contact with the inner and outer portions of the eyelid, avoiding the cornea. The treatment is 12 minutes long and only requires numbing drops to minimize any discomfort the patient may feel. The treatment allows the glands to properly excrete oils onto the outer layer of the tear film and the results are experienced 6-8 weeks after treatment, which is when you will have a follow-up with your ophthalmologists. Our ophthalmologists will be able to do a diagnostic test in-office, called LipiScan, to evaluate the structure of your meibomian glands to check for any tissue loss. 

Watch the following video for an animated demonstration of how LipiFlow works: 

 
 
 

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