Dry Eyes

How are tears made?

There are three layers that make up healthy tear film that coats and protects the eye.

Lipid:The outer, or lipid, layer provides an oil-based surface that retards evaporation of tears. If this layer did not exist, tears would evaporate 10 to 20 times faster than they do.

Aqueous:The middle, or aqueous, layer includes salt and protein in a base that is 98% water.

Mucin:The inner mucin layer coats the surface of the eye, allowing the other layers to form a film. Without this layer the tears would "bead up," much like rain on a waxed car.

Dry Eye

What are the Symptoms of Dry eyes?

  • A stinging, burning or scratchy sensation in your eyes
  • Stringy mucus in or around your eyes
  • Sensitivity to light
  • Eye redness
  • A sensation of having something in your eyes
  • Difficulty wearing contact lenses
  • Difficulty with nighttime driving
  • Watery eyes, which is the body's response to the irritation of dry eyes
  • Blurred vision or eye fatigue

When tears lack the important components shown above, or when too few tears are produced, the tear film can break down. This breakdown produces dry spots on the cornea, causing the symptoms associated with dry eye. Aside from the wearing of contact lenses, perhaps the most important cause of dry eye is the natural aging process. At age 65, the eye produces about 60% fewer tears than it did at age 18. But dry eye can also result from disruption of the blinking reflex, medications such as antihistamines, decongestants, and heart medications, vitamin A deficiency, and environmental factors (sun, wind, smoke, and air conditioners). Even low humidity or high atmospheric pressures can produce dye eye in some individuals.

What can I do Help my Dry Eyes?

Although no cure exists for dry eye syndrome, many treatments are available. Treatment is dependent on the severity of dry eye syndrome; some people may only require a humidifier or occasional eye drops while others may require surgery to help decrease dry eyes.

Artificial tear drops and ointments. The use of artificial teardrops is the primary treatment for dry eye. Artificial teardrops are available over the counter. No one drop works for everyone, so you might have to experiment to find the drop that works for you. If you have chronic dry eye, it is important to use the drops even when your eyes feel fine, to keep them lubricated. If your eyes dry out while you sleep, you can use a thicker lubricant, such as an ointment, at night.

Temporary punctal occlusion. Sometimes it is necessary to close the ducts that drain tears out of the eye. This may be done temporarily with a dissolving plug that is inserted into the tear drain of the lower eyelid to determine whether permanent plugs can provide an adequate supply of tears.

Non-dissolving punctal plugs and punctal occlusion by cautery (application of heat to tear exit duct). If temporary plugging of the tear drains works well, then longer-lasting plugs or cautery may be used. These measures increase the tear level by blocking the “drainpipe” through which tears normally exit the eye and enter the nose. The plugs can be easily removed. Rarely, the plugs may come out spontaneously or migrate down the tear drain. Many patients with particularly bothersome dry eyes find that the plugs or surgical occlusion (cautery) improve comfort and reduce the need for artificial tears.
Lipiflow. Lipiflow is a medical device that uses heat and pressure on the eyelids to unclog blocked glands. These glands produce oil as part of the tear film. The oil lubricates the eye and prevents the tears from evaporating.

Restasis or Cyclosporin Prescription eye drop for the treatment of chronic dry eye. It is currently the only prescription eye drop that helps your eyes increase their own tear production with continued use.

Other medications and nutrition. Other medications, including steroid eyedrops, can be used for short periods of time as an adjunct to other long-term measures. There is growing evidence that increasing the oral intake of fish oil and omega-3 via diet or supplement is very helpful to those suffering with dry eye.