THE “HOW AND WHY” OF DRY EYES

Dry Eye

Dry eye is one of the most common complaints we encounter during our eye exams at Parrelli Optical®. The tear film is designed to act as a lubricant to allow the lids to comfortably slide across the eyeball during the blink. The tears also form a nice smooth surface on the cornea located on the front of the eye.

Dry Eye Causes

As we age the eye becomes drier. Any concentrated work, computer use, driving or reading slows the blink rate and can lead to dry eyes. There are environmental influences: seasonal pollens, dry heated air and even air conditioning can contribute to dry eyes. Many medications can contribute to eye dryness. Irritated, dry eyes can accompany contact lens wear. Excessively dry eyes can lead to blurred vision.

Dry eye can be a temporary or chronic condition. (From the National Eye Institute)

Dry eye can be a side effect of some medications, including antihistamines, nasal decongestants, tranquilizers, certain blood pressure medicines, Parkinson’s medications, birth control pills and anti-depressants.
Skin disease on or around the eyelids can result in dry eye.
Diseases of the glands in the eyelids, such as meibomian gland dysfunction, can cause dry eye.
Dry eye can occur in women who are pregnant.
Women who are on hormone replacement therapy may experience dry eye symptoms. Women taking only estrogen are 70 percent more likely to experience dry eye, whereas those taking estrogen and progesterone have a 30 percent increased risk of developing dry eye.
Dry eye can also develop after the refractive surgery known as LASIK. These symptoms generally last three to six months, but may last longer in some cases.
Dry eye can result from chemical and thermal burns that scar the membrane lining the eyelids and covering the eye.
Allergies can be associated with dry eye.
Infrequent blinking, associated with staring at computer or video screens, may also lead to dry eye symptoms.
Both excessive and insufficient dosages of vitamins can contribute to dry eye.
Homeopathic remedies may have an adverse impact on a dry eye condition.
Loss of sensation in the cornea from long-term contact lens wear can lead to dry eye.
Dry eye can be associated with immune system disorders such as Sjögren’s syndrome, lupus, and rheumatoid arthritis. Sjögren’s leads to inflammation and dryness of the mouth, eyes, and other mucous membranes. It can also affect other organs, including the kidneys, lungs and blood vessels.
Dry eye can be a symptom of chronic inflammation of the conjunctiva, the membrane lining the eyelid and covering the front part of the eye, or the lacrimal gland. Chronic conjunctivitis can be caused by certain eye diseases, infection, exposure to irritants such as chemical fumes and tobacco smoke, or drafts from air conditioning or heating.
If the surface area of the eye is increased, as in thyroid disease when the eye protrudes forward, or after cosmetic surgery if the eyelids are opened too widely, dry eye can result.
Dry eye may occur from exposure keratitis, in which the eyelids do not close completely during sleep.

Dry Eye Symptoms

Dry eye symptoms include scratchy or itching sensation when watching television, using the computer, reading or even driving. A burning or gritty sensation when you wake up is common. The feeling that there is something in your eye, a foreign sensation is a typical dry eye complaint.

Dry eye symptoms may include any of the following:

stinging or burning of the eye
a sandy or gritty feeling as if something is in the eye
episodes of excess tears following very dry eye periods
a stringy discharge from the eye
pain and redness of the eye
episodes of blurred vision
heavy eyelids
inability to cry when emotionally stressed
uncomfortable contact lenses
decreased tolerance of reading, working on the computer, or any activity that requires sustained visual attention
eye fatigue

NOTE: If symptoms of dry eye persist, consult an eye care professional to get an accurate diagnosis of the condition and begin treatment to avoid permanent damage.

Dry Eye Treatments

Most research suggests that there are several effective treatments for dry eye with or without contact lenses.

All of us are dehydrated. Simply increasing your clear fluid intake will make your eyes fell better. Caffeine and alcohol contribute greatly to dry eyes.
Rewetting or lubricating eye drops can relieve dry eye symptoms. Preventative rewetting, placing drops in the eye periodically throughout the day, is more effective than reactive rewetting, putting the lubricating drops in the eye in response to dryness or irritation.
During sleep tear production is greatly diminished and there is no blink to spread those tears across the front of the eye. Overnight the tissue dehydrates and feels very uncomfortable in the morning. One of the most effective dry eye treatments is to rewet your eyes before sleep, so that they will be more hydrated in the morning. Several manufacturers make a night time gel that lingers in your eye longer, for dry eye treatment.
The tear is produced in the lacrimal gland located in the area of your temple. The tears then cascade across the front of your eye lubricating the lids and forming a smooth surface across the cornea. The moisture is then drained out into the sinuses through small holes in the lids called punctum. By blocking these holes we can back the moisture up into the eye relieving dry eye symptoms. Initially the doctor will insert collagen plugs that will slowly dissolve over seven to ten days. If you experience an improvement a more permanent silicone plug can be used.
Many patients find relief from dry eye symptoms with dietary supplements. Omega-3 fatty acids and flaxseed oil have proven efficacy. The use and dosage of nutritional supplements and vitamins should be discussed with your primary medical doctor.

Medical Intervention

Depending on the causes of dry eye, your doctor may use various approaches to relieve the symptoms.

The first priority is to determine if a disease is the underlying cause of the dry eye (such as Sjögren’s syndrome or lacrimal and Meibomian gland dysfunction). If it is, then that underlying disease needs to be treated.

Cyclosporine, an anti-inflammatory medication, can be used to treat dry eye. It can increase tear production and reduce your symptoms. It can take six months of twice-a-day dosages for the medication to work.

If dry eye results from taking a medication, your doctor may recommend switching to a medication that does not cause the dry eye side effect.

If contact lens wear is the problem, your eye care practitioner may recommend another type of lens to improve your comfort and to protect your eye health.

Dry Eye Prescription Relief

Prescription Restasis® is the first clinically proven dry eye therapy to increase tear production and relieve your dry eye symptoms.

Learn more: http://www.restasis.com/default.htm?x=Restasis

Xiidra^® is a newly approved prescription eye drop used to treat the signs and symptoms of dry eye disease.

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LACRISERT ® is a preservative-free, slow-release, prescription lubricant which is placed into the eye to treat moderate to severe dry eye symptoms. LACRISERT acts to stabilize and thicken the tear film while lubricating and protecting the eye.

Let the Eyecare Professionals at Parrelli Optical® in Beverly, Cambridge, Danvers and North Andover help make your eyes more compfortable.