Dry Eyes

About Dry Eye

Tears are needed to help prevent infection and keep your eyes clear from debris. If you do not produce enough tears, the condition is called dry eyes, and it can be highly uncomfortable and affect your quality of life.

In some extreme cases, dry eye can cause inflammation of the eye's surface. Without treatment, this can lead to pain, ulcers, or scars on the cornea (the clear, dome-shaped outer shell that covers the center of the eye) and some vision loss.

There are two different types of dry eye:

• Aqueous tear-deficient dry eye – a disorder in which the eye does not produce enough of the watery part of tears.
• Evaporative dry eye – This disorder is caused by inflammation of the glands that produce the lipid or oily layer of tears. Without this layer, tears can be unstable and evaporate too quickly.

Causes

Several factors cause dry eye, including:

• Inflammation of the surface of the eye, the lacrimal gland, or the conjunctiva
• An increase in the surface of the eye from other diseases such as thyroid disease
• Cosmetic surgery if the eyelids are opened too widely
• Skin disease on or around the eyelids
• Diseases of the glands in the eyelids, such as meibomian gland dysfunction
• LASIK surgery, which can cause dry eye to last three to six months or longer
• Not blinking enough when staring at a computer or video screens
• Vitamin dosages that are either too high or too low can cause dry eye
• Homeopathic remedies
• Loss of sensation from long-term contact lens wear
• Pregnancy or menopause
• Old age
• Certain medications include antihistamines, nasal decongestants, tranquilizers, certain blood pressure medicines, Parkinson's drugs, birth control pills, and anti-depressants
• Allergies
• Certain immune system disorders such as Sjögren's syndrome, lupus, and rheumatoid arthritis
• Exposure keratitis is when the eyelids do not close completely during sleep

Symptoms

Dry eye can cause the following symptoms in the eye:

• Stinging or burning
• A sandy or gritty feeling, as if something is in the eye
• Periods of excess tears that happen after periods of dryness
• Stringy discharge
• Pain and redness
• Periods of blurred vision
• Heavy eyelids
• Inability to cry
• Uncomfortable contact lenses
• Difficulty reading, working on the computer, or any activity that requires focused vision
• Eye fatigue

Treatments We Offer

In many cases, using over-the-counter artificial tears, gels, gel inserts, and ointments is an excellent first step. These can help relieve symptoms and provide an essential source of tears, especially in people who do not produce enough. Avoid artificial tears with preservatives if you need to apply them more than four times a day and products with chemicals that cause blood vessels to constrict.

Wearing glasses or sunglasses that fit close to the face (wrap around shades) or with side, shields can help slow tear evaporation and keep the eye moist. Indoors, an air cleaner to filter dust and other particles, can help dry eyes. A humidifier can also help by adding moisture to the air.

Avoid doing activities requiring conditions and allow your eyes to rest when perform you to focus your vision for long periods. You can also use lubricating eye drops while performing these tasks.

Other treatment options for dry eye include:

• Medication - Cyclosporine, an anti-inflammatory medication, is the only prescription drug available to treat dry eye. It reduces corneal damage, increases tear production and helps with dry eye symptoms. It might take three to six months for the medication to work. In some cases of severe dry eye, we might recommend short-term use of corticosteroid eye drops to decrease inflammation.
• Lacrimal Plugs – This treatment involves plugging the tear drainage holes. These are small circular openings at the inner corners of the eyelids where tears drain from the eye into the nose. Lacrimal plugs, also called punctal plugs, can be inserted painlessly by an eye doctor. Some types of plugs are temporary, but others are permanent.
• Punctal Cautery – This is a simple surgery for severe cases of dry eye that permanently closes the drainage holes. This helps keep the small number of tears on the eye for longer.
• Diet and Supplements – In some patients with dry eye, supplements or dietary sources (such as tuna fish) of omega-3 fatty acids (especially DHA and EPA) might help with symptoms.

Why Choose Columbia?

Many treatments involve treating the underlying source of the dry eye, and the experienced and compassionate Columbia ophthalmologists will find the start of the dry eyes. They will find the best treatment approach so you will not suffer.