All About Dry Eye
Symptoms, Causes, and Treatments
Think you have dry eye syndrome?
The most common symptom of dry eye is, obviously, the sensation of your eyes feeling dry! In addition to (or instead of) this sensation, you may also experience:
- Eye discomfor
- Grainy, scratchy feelings in eyes
- Itchy Eyes
- Red Eyes
- Excessive tearing
- train in focusing
Causes of Dry Eye:
Environment / Lifestyle Related Causes
Hot, dry weather
Polution
Wind
Heating and air conditioning units
Computer use and other things that encourage slowed rates of blinking
Coffee, tea, chocolate, and other caffeine-containing products
Hair Dryers
Car air vents aimed towards your eyes
Allergens, including pollen and pet dander
Health / Body Related Causes
Medication Related Causes
Antihistamine
Antidepressants
Sleeping pills
Birth control pills
Diuretics, ACE Inhibitors, and other medications for high blood pressure
Isotretinoin-type medications (frequently used for acne treatment)
Opiates and other medications commonly prescribed for extreme pain, including morphine
The natural aging process
Female body changes, including menopause, hormone replacement therapy, pregnancy, lactation, and menstruation
Sjogren's Syndrome
Rheumatoid arthritis
Collagen vascular disease
Tear film disruption
Structural problems with the eyes, lids, ducts, or glands surrounding the eyes
LASIK, cataract, or other eye surgerie
New Understandings About Dry Eye Syndrome
Doctors are constantly learning new things about dry eye. It used to just be viewed as a problem that could be helped only by treating it's symptoms, but now we understand that many times, dry eye is an autoimmune disorder. Basically, something triggers the body to start attacking healthy cells in the eye, which disrupts the signals sent in and around the eye to the brain.
he eye doesn't get the signals that tell it to produce more tears, and so, as the tears that were in your eyes drain away as they normally would, they are not replaced by new tears. This leads to damage to (and potentially destruction of) the lacrimal glands- the part of the ocular system that produces the watery layer of your tear film.
Eventually, the whole lacrimal system can shut down, and as that happens, then the tear quality is reduced as is the tear quantity. This leads to further inflammation of the ocular surface, and the whole cycle repeats itself over and over again.
Traditional Treatments
Traditionally, dry eye has been dealt with by simply treating the symptoms, as the cause of the problem was largely unknown. So the two major causes of the symptoms were believed to be 1.) not enough tears in the eye (or poor tear quality) and 2.) tears not staying in the eyes long enough.
For people who seem to be producing too little tears, or whose tears seem to be of poor quality (too little water, too many lipids, etc.), the primary solution is eye drops. Various kinds are recommended based on the severity of the symptoms, ranging from standard, OTC artificial tears, to lubricating eye drops and eye ointments. Sometimes, doctors will even prescribe stronger, prescription-strength drops, including steroids.
If the doctor thinks that the problem is that the tears being produced by the eye aren't staying in the eye long enough, then punctal plugs are usually the first treatment option. These are a reversible, sometimes temporary treatment. A more permanent option is to surgically close or narrow the tear ducts. Since this option is very difficult to reverse, ittends to be used somewhat as a last resort.
A few other treatment modalities include bandage contacts, which help maintain a layer of water between your eye and the contact, Omega-3 supplements, and, in some cases, lid scrubs (if the doctor feels that blepharitis- or inflammation of the eyelids.)
Dry Eye Medications
There are two main categories of medications prescribed for individuals experiencing Dry Eye:
medication to address issues of inflammation, and medication to address meibomian gland dysfunction.
It is important to discuss all medication use with your health care practitioner, and to follow all dosage and usage instructions given.
Restasis
(Opthalmic Cyclosporine)
Used to increase tear production in people with dry eye diseases. It works by decreasing swelling in and around the eye, which allows for increased tear production.
Lotemax
(Corticosteroid)
educes both internal and external inflammation of the eye. But because it is a steroid drop, prolonged use can be associated with conditions such as glaucoma, cataract formation, etc.
Doxycyclin
Used to treat bacterial infections by preventing the growth and spread of bacteria.
Azithromycin
One of the world's best selling antibiotics, it treats or prevents certain bacterial infections by interfering with their protein synthesis.
Dry Eye Home Remedies
While home remedies are no substitute for the advice and care of your medical professional, there are some things that you can do that will help reduce the discomfort felt because of dry eye:
- OTC (Over-the-counter) eyedrops- but not the type designed for reducing red-eye, as these will tend to make your eye problems worse.
- Wear sunglasses whenever you are outside to protect your eyes from the sun and wind.
- Make a conscious effort to blink more often, especially when using a computer or reading for long periods of time
- Be aware of any potential dry eye side effects your medications may be causing, but do not discontinue any medications without first discussing it with your doctor.
- Add Omega-3 supplements to your diet, using a combination of flax seen and fish oil
- Reduce the amount of time you spend in contact lenses.
- Get enough sleep.
- Drink plenty of water. How will your eyes stay moist if you are dehydrated?
- Use a humidifier in your house.