Dry Eye Syndrome

Dry eye syndrome is very common condition, and the
cause is unclear in most cases. The tear film, when
healthy, covers the surface of the eye, providing
nutrition and moisture to the surface of the cornea
and conjunctiva. It is made up of an inner mucous
layer, a middle aqueous (water) layer, and an outer
lipid layer. Having all three parts of the tear film
are critical. In the absence of any of the three, a
patient will suffer the symptoms of dry eye syndrome.

Patients with dry eye syndrome will complaint of
irritation, stinging, redness, and, ironically,
tearing. These symptoms may be intensified during
computer use or extended periods of reading. Most
patients are surprised that the ophthalmologist
diagnosed them with dry eye syndrome, given that their
primary complaint was tearing. However, their tearing
is a reflex action from the eye in response to a dry
and rough ocular surface in an attempt to wash the eye
and/or rehydrate the surface. Unfortunately, this
reflex tearing is purely aqueous in nature, and tends
to evaporate quite rapidly in relation to the normal 3
layered tear film. Therefore, the cycle of reflex
tearing and irritation from dry eyes will viciously
continue unless there is intervention.

Although most cases of dry eyes have no specific
underlying etiology, some cases are secondary to
medications or changes in hormones. Patients who take
antihistamines for seasonal allergies take up a large
percentage of patients with dry eyes secondary to a
medication. While the antihistamine solves the
symptoms of a runny nose and congested sinuses, it
also has a significant drying effect on the eyes.
Perimenopausal women or those with a thyroid condition
can have increased dry eye complaints as well due to
the changes in hormones. Lastly, there is a systemic
condition called Sjogren's syndrome in which dryness
in both the mouth and eyes is a presenting feature.

Patients who have the complaints of dry eye syndrome
should visit their ophthalmologist for an examination.
The history of the disease is usually sufficient to
diagnose the condition, but the examination of the
eyes will confirm the diagnosis and also allow the
ophthalmologist to grade the severity of the dry eye
syndrome. In select cases, dry eye syndrome can be
severe enough to cause blurring of one’s vision,
leading a patient to think a change in glasses is

Treatment for mild dry eye syndrome consists of
artificial tears, usually one drop 3 to 4 times a day.
Over the counter artificial tears possess aqueous and
lipid qualities, thereby restoring a stable moisture
layer to the ocular surface. Artificial tears should
be used before times of extended visual attention,
such as before reading a long novel or spending a lot
of time in front of the computer. In addition, any
direct fans or heaters that radiate towards the eyes
or face should be redirected, and a portable
humidifier may be helpful.

In more severe cases of dry eyes, your ophthalmologist
may recommend preservative-free artificial tears, used
6 or more times a day. These drops, while slightly
more expensive, have no preservative additives and are
therefore less harmful to the ocular surface when used
more than the standard 4 times a day.

In addition, your ophthalmologist may recommend
placing punctual plugs in your eyes. The punctum is a
small opening in your eyelid close to your nose, and
is the site where tears drain from the eye. By
occluding the puncta with collagen or silicone plugs,
the available tears will be increased, thereby
reducing or eliminating the need for eye drops. This
procedure in painless and lasts less than 2 minutes,
and results may be felt almost immediately. The plugs
are virtually invisible to the naked eye and usually
never cause any irritation.

For more details and options concerning dry eye
syndrome, or if you suffer from the aforementioned
symptoms, call the Mack Eye Center today!

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