Tear film is made up of three layers: a watery layer that is produced by the lacrimal gland; an oil layer produced by the oil glands in your eyelids; and a mucus layer on the eye surface that provides natural lubrication. If you aren’t producing enough tears, and your oil layer gets too thin to reduce tear evaporation, the mucus layer dries up and your eyes feel dry, scratchy and irritated.

Aging, medications, heaters and air conditioners, wind, smoke or dry weather, and allergies and hay fever are all common causes of dry eyes. Additionally, eyelid inflammation, a condition called “blepharitis”, may also result in dry eyes.

How are dry eyes diagnosed?
A complete medical history often provides clues to the source of your dry eyes. In addition to certain medical conditions such as heart disease and rheumatoid arthritis, and age-related causes such as menopause in women, many factors may be contributing to your dry eyes. Be sure to include all medications you are taking, especially allergy medicines and eye drops, even if they are “over the counter”. Contact lenses may also be a factor.

During your regular eye exam, if dry eyes is suspected, the doctor or technician may examine the tear film using a special microscope called a slit lamp. He or she may also use eye drops to detect dry spots, and they may measure the amount of tears your eyes produce using a simple test. After applying a numbing eye drop, a small piece of filter paper is placed on your eye for a period of about five minutes. The amount of fluid in the paper tells us the amount of tears your eyes produce.

What is the treatment for dry eyes?
Lubricating eye drops or artificial tears, either an over-the-counter or prescription product, may be recommended. Keep in mind that lubricating eye drops are different than those intended to relieve redness and itching. Be sure to follow your doctor or pharmacist’s recommendations. In severe cases, a lubricating ointment may be prescribed for overnight use.

Nutrition is also believed to play a part in some cases of dry eyes. If so, your doctor may suggest a supplement containing certain nutritional oils to aid in maintaining correct moisture conditions in the tears and eye surface.

The puncta are two small “drains” connecting the upper and lower eyelids to the drainage canals that lead to the nose. Closing the puncta with tiny plugs is sometimes recommended to help keep tear film in your eyes. The plugs are easily and painlessly inserted while you are in the office, usually after a numbing drop is applied. Temporary plugs maybe used first to test this treatment method. They will dissolve after a few days. Both temporary and permanent plugs are not noticeable and you should not feel them once they’re in.

When nothing else works, minor surgery is sometimes needed to narrow or block the drainage canals to keep tears in your eyes. If your dry eyes are caused by an eyelid condition, other simple surgery may be prescribed.

Dry eye syndrome is a common disease in which the eye under-produces tears or tears leave the eye too quickly.  A normal functioning eye constantly produces tears to form a tear film, which acts as moisturizer and lubricant.  For someone with dry eye, the resulting lack of moisture and lubrication can cause a variety of problems.

Dry eye symptoms may include:

• A burning, stinging, or scratchy sensation in the eyes.
• Eyes may redden and become easily irritated by wind or smoke.
• The eyes may produce stringy mucus.
• Contact lenses may be difficult or impossible to wear.
• Sometimes the eye will actually produce excessive tears, and overflow.*

*Though it sounds contradictory, sometimes the eye will actually produce excessive tears, and overflow.  The eye becomes irritated by the lack of lubrication and attempts to cleanse itself with a flood of tears.  This is a similar phenomenon to the tearing that occurs when foreign matter is stuck in one’s eye.

Dry eye syndrome is typically more common in older people and women; however, there are many other factors that can cause this to happen.  A common cause of dry eye can be over the counter and prescription medications such as antihistamines, beta-blockers, sleeping pills, pain relievers and many others.  Overuse of diuretics can also play a role in developing dry eye.  For this reason, it is very important to inform your ophthalmologist about any medications you are currently taking, which can help the doctor in the proper diagnosis of the disease.

Sometimes the cause is unknown in a case of dry eye.  Known causes of dry eye may be natural, related to a larger condition, or the side effect of certain medications.  Also, tear production often slows down as people get older.  This is particularly common for women after menopause.

Treatments for dry eye:

• Artificial tears:  Mild to moderate cases of dry eye syndrome may be treated by applying artificial tear eye drops as little or as often as necessary.  There are a wide range of products available without a prescription that the doctor can recommend.

• Prescription medications:  Can sometimes increase tear production for those with chronic dry eye.  It does this by targeting inflammation in the eye.

• Conserving tears:  An effective way to make better use of the tears in the eye is surgery to close the tear ducts, thus preventing existing tears from leaving the eye as quickly.  This may be done temporarily, with punctal plugs made of collagen, or permanently with silicone plugs or by cauterizing the tear ducts closed.

• Controlling one’s environment:  Patients should avoid situations in which tears evaporate quickly; for example, by using a humidifier in a dry house, wearing wrap-around glasses in the wind, and not smoking.

If you are experiencing any symptoms of dry eye, we encourage you to contact us today to schedule a consultation.