Dry Eye
Dry eye occurs when people do not make enough tears or tears of a good quality. The tear film is made of three layers: the oil layer, the aqueous layer, and
the mucin layer. Dysfunction in any of these layers can cause dry eye.
The oil layer is the outermost layer and made of oil produced by glands on the eyelid margins. The oil helps to reduce evaporation of the aqueous, or watery,
tears. The aqueous layer, produced by glands around the eye, helps to cleanse the eye. The innermost layer, the mucin layer, is produced by glands on the
conjunctiva, the thin tissue that covers the white part of the eye. The mucin allows the watery tears to stick to the eye.
What are the symptoms of dry eye?
Dry eye can cause any of the following:
- Tearing: This may sound counterintuitive. However, increased tearing occurs at times in people with dry eye because the eyes are irritated.
- Redness
- Stinging
- Mucus strands
- Scratchiness or foreign body sensation
- Decreased contact lens tolerance
Who suffers from dry eye?
Patients with autoimmune diseases, such as lupus or rheumatoid arthritis, are more likely to have dry eye. Patients who have conditions that affect the sensation of the cornea, such as people who have had corneal infections caused by the cold sore or shingles virus, are more likely to have decreased tear
production.
Patients who wear contact lenses or who have undergone LASIK or other refractive surgeries may experience dry eye.
Numerous medications can be associated with dry eye, including antihistamines, blood pressure medications, and pain relievers.
A person’s environment can aggravate dry eye symptoms. For example, people who work outside and are exposed to windy conditions may experience more problems with dry eye, as may people who do a lot of computer work.
Dry eye is quite common. Sometimes, there is no specific associated medical problem, medication, or environmental exposure.
How is dry eye diagnosed?
Your eye doctor will perform a slit lamp exam, looking at the eyelid margins and surface of the eye. Sometimes, a dye called fluorescein may be used to help look for dry spots and rapid tear evaporation. A Schirmer’s test may also be performed, during which small strips are tucked inside the lower eyelid edges to measure tear production.
How is dry eye treated?
-Artificial tears: Artificial tears may be used throughout the day to provide moisture. If artificial tears are used more than four to six times per day, it may
be necessary to use drops without preservative, as the preservatives can begin to cause irritation.
-Punctal plugs or cautery: There is an opening on the inside corner of each eyelid called the punctum. The punctum is the entry to the tear drainage system. Temporary or permanent plugs made of various materials can be inserted into the punctum to block tear drainage from the surface of the eye. In severe cases of dry eye, the puncta can actually be closed by the application of heat, or cautery.
-Prescription eye medications: A short course of topical steroids may be used to calm inflammation associated with dry eye. Topical cyclosporine works by increasing tear production from the tear glands.
-Dietary modifications/supplements: Eating foods rich in omega-3 fatty acids, such as salmon and walnuts, can improve dry eye symptoms. Some people may choose to take an omega-3 or flaxseed oil supplement.
-Environmental modifications: Steps can be taken to modify one’s environment to decrease tear evaporation, including using a humidifier, wearing
wraparound sunglasses outside, minimizing use of fans, and taking short breaks during computer use.
the mucin layer. Dysfunction in any of these layers can cause dry eye.
The oil layer is the outermost layer and made of oil produced by glands on the eyelid margins. The oil helps to reduce evaporation of the aqueous, or watery,
tears. The aqueous layer, produced by glands around the eye, helps to cleanse the eye. The innermost layer, the mucin layer, is produced by glands on the
conjunctiva, the thin tissue that covers the white part of the eye. The mucin allows the watery tears to stick to the eye.
What are the symptoms of dry eye?
Dry eye can cause any of the following:
- Tearing: This may sound counterintuitive. However, increased tearing occurs at times in people with dry eye because the eyes are irritated.
- Redness
- Stinging
- Mucus strands
- Scratchiness or foreign body sensation
- Decreased contact lens tolerance
Who suffers from dry eye?
Patients with autoimmune diseases, such as lupus or rheumatoid arthritis, are more likely to have dry eye. Patients who have conditions that affect the sensation of the cornea, such as people who have had corneal infections caused by the cold sore or shingles virus, are more likely to have decreased tear
production.
Patients who wear contact lenses or who have undergone LASIK or other refractive surgeries may experience dry eye.
Numerous medications can be associated with dry eye, including antihistamines, blood pressure medications, and pain relievers.
A person’s environment can aggravate dry eye symptoms. For example, people who work outside and are exposed to windy conditions may experience more problems with dry eye, as may people who do a lot of computer work.
Dry eye is quite common. Sometimes, there is no specific associated medical problem, medication, or environmental exposure.
How is dry eye diagnosed?
Your eye doctor will perform a slit lamp exam, looking at the eyelid margins and surface of the eye. Sometimes, a dye called fluorescein may be used to help look for dry spots and rapid tear evaporation. A Schirmer’s test may also be performed, during which small strips are tucked inside the lower eyelid edges to measure tear production.
How is dry eye treated?
-Artificial tears: Artificial tears may be used throughout the day to provide moisture. If artificial tears are used more than four to six times per day, it may
be necessary to use drops without preservative, as the preservatives can begin to cause irritation.
-Punctal plugs or cautery: There is an opening on the inside corner of each eyelid called the punctum. The punctum is the entry to the tear drainage system. Temporary or permanent plugs made of various materials can be inserted into the punctum to block tear drainage from the surface of the eye. In severe cases of dry eye, the puncta can actually be closed by the application of heat, or cautery.
-Prescription eye medications: A short course of topical steroids may be used to calm inflammation associated with dry eye. Topical cyclosporine works by increasing tear production from the tear glands.
-Dietary modifications/supplements: Eating foods rich in omega-3 fatty acids, such as salmon and walnuts, can improve dry eye symptoms. Some people may choose to take an omega-3 or flaxseed oil supplement.
-Environmental modifications: Steps can be taken to modify one’s environment to decrease tear evaporation, including using a humidifier, wearing
wraparound sunglasses outside, minimizing use of fans, and taking short breaks during computer use.
