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
- Blurred vision, heavy eyelids or eye fatigue
- 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 (especially post-menopausal women), however there is increased prevalence of dry eye in younger patients due to personal devices such as phones and computers. There are many other factors that can cause dry eyes, including:
- 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 or optometrist about any medications you are currently taking, which can help the doctor in the proper diagnosis of the disease.
- Inflammation of the eye lacrimal gland or conjunctiva
- Disease processes that alter components of tears
- An increase in the surface of the eye as a result of thyroid disease, for example
- Cosmetic surgery if eyelids are opened too widely
Testing for dry eye:
One method of testing can be done through the evaluation of meibomian glands under a microscope with gentle pressure at the lid margin.
Another fast, easy, and accurate test to help diagnose dry eye disease is called the TearLab®Osmolarity Test, and it is performed in our office, requiring only 50-nanoliters of a tear for analysis – a sample smaller than the period at the end of this sentence. It is more patient friendly than older generation tests, as it is not intrusive, and requires no anesthesia. The TearLab® Osmolarity Test gives the doctor information about the salt content of your tears, which is an indicator of dry eye disease.
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. By targeting inflammation, these drugs can sometimes increase tear production for those with chronic dry eye.
- Conserving tears: An effective way to make better use of the tears in the eye is 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 address 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.