Tear Science Lab | Dry Eye

Dry eye syndrome

Dry eye syndrome is a chronic lack of sufficient moisture on the surface of the eye with reduced lubrication of the ocular surface which in turn results in a variety of symptoms which range from subtle but constant irritation or foreign body sensation to ocular inflammation of the anterior (front) tissues of the eye which presents with redness and pain in the eyes .Dry eyes also are described by the medical term, keratitis sicca, which generally means decreased quality or quantity of tears.

Dry Eye Syndrome Symptoms

Persistent dryness, itching, grittiness and a burning sensation in the eyes can be symptoms of dry eyes and may require further evaluation.Another symptom of dry eyes is a “foreign body sensation,” the feeling that something is in the eye. Dry eye syndrome can also cause excessively watery eyes. This is because dryness on the eye’s surface sometimes will overstimulate production of the watery component of your tears as a protective mechanism.

Causes of Dry Eyes?

• Tears bathe the eye, washing out dust and debris and keeping the eye moist. They also contain enzymes that neutralize the microorganisms that colonize the eye. Tears are essential for good eye health. The Tear film is normally composed of three layers:
  > The outer, oily lipid layer.
  > The middle, watery, aqueous layer.
  > The inner mucin layer.
• Each layer is produced by different glands near the eye. So a problem with any of those sources can result in dry eyes.In dry eye syndrome, either the lacrimal gland or associated glands near the eye that normally produce the tear film are not producing enough tears ( secretory dry eye), or the tears have an abnormal chemical composition that causes them to evaporate too quickly (Evaporative dry eye).
• Dry eye syndrome has several causes. It occurs as a part of the natural aging process, especially during menopause; it is also more common in women, possibly due to hormone fluctuations as a side effect of many medications, such as antihistamines, antidepressants, certain blood pressure medicines, or because of dry, dusty or windy climate.
• Air conditioning or a dry heating system can also dry out the eyes. Another cause is insufficient blinking, such as while staring at a computer screen all day.
• Dry eyes also are a symptom of systemic diseases such as lupus, rheumatoid arthritis, ocular rosacea or Sjogren’s syndrome. Long-termcontact lens wear is another common cause for worsening of dry eye symptoms.

Treatment for Dry Eyes

• Dry eye syndrome is an ongoing condition that may not be completely curable (depending on the cause). But the accompanying dryness, scratchiness and burning can be managed so that the patient is symptomatically better and can continue all normal activities.
• Evaluation for Dry eye may require a variety of tests like to measure the quantity or quality of the tear film. Schirmer’s test, Tear film break up time, etc are ways to measure tear production and stability. Tests like tear osmolarityanalyse the quality of the tear film. Once the underlying cause for dry eye has been found , treatment can be directed at that particular etiology.
• Artificial tear slubricating eye drops that may alleviate the dry, scratchy feeling.If you wear contact lenses, be aware that many eye drops, especially artificial tears, cannot be used while your contacts are in your eyes. You’ll need to remove them before using drops and wait 15 minutes or even longer (check the label) before reinserting the lenses.
• Doctors sometimes recommend specialnutritional supplements for dry eyes. Studies have found that supplements containing omega-3 fatty acids can decrease dry eye symptoms.
• Punctal plugs are used in extreme cases of dry eyetohelp keep moisture on the eye by keeping tears from draining too quickly.Temporary or permanent silicone plugs can be inserted in the lacrimal (tear) drainage ducts in your eyelids to keep tears on your eye from draining away as quickly.
• Treating any underlying eyelid disease, such as meibomian gland disease (MGD) and blepharitis, helps as well as this is a cause for evaporative dry eye disease. This may call for antibiotic or steroid eye drops plus frequent eyelid scrubs with an antibacterial shampoo.
• Recently there is a new evaluation system called the Lipiviewwhich can evaluate the tear film and quantify the severity of dry eye. If it is severe evaporative dry eye due to MGD, there is an innovative new treatment called the Lipiflowsytem for its treatment. The Lipiflow system works from the inside out by actually warming the inside of the lid, and then massaging it thus unclogging the natural oils, massaging them out . This results in a better and more stable tear film over time Each treatment is 12minutes long – and results have been shown last up to two years.