Dry Eyes

DRY EYES

14 million Americans suffer from dry eyes.  Dry eye syndrome is defined as a chronic lack of sufficient lubrication to the eyes leading to discomfort.  Dry eyes can lead to chronic ocular inflammation and affect the quality of your vision.  The causes of dry eyes include: eyes not producing enough tears or tears evaporating too quickly from the surface of your eye.  A comprehensive eye exam with a customized dry eye evaluation will help determine the cause of your dry eyes.

 

SYMPTOMS

  • Grittiness
  • Scratchy
  • Burning
  • Itching
  • Irritation
  • Redness
  • Blurred vision that fluctuates with blinks
  • Excess tearing
  • Contact lens intolerance
  • Increased discomfort as the day goes on

 

TEAR FILM

There are three layers to our tear film.  The first layer is the mucus layer which sits closest to the eyes.  The second layer is the aqueous layer and is comprised of 98% water.  The final layer is the outermost lipid layer.  The lipid layer is oily and helps prevent tear evaporation.  The three layers must be present in balanced ratios in order for our eyes to be properly lubricated.  If any of the layers are out of balance, dry eye symptoms will occur.  Reflex tearing will often occur to help soothe the dryness.  Reflex tearing will often lead to excess tearing and can sometimes become chronic tears running down your cheeks.  However, the reflex tears being produced are out of balance and will not properly lubricate the eyes. 

 

CAUSES

  • Age related
  • Menopause
  • Side effect of medications such as antihistamines (Benadryl, Claritin, Allegra, etc.), decongestants (Mucinex, Theraflu), antidepressants, acne medications, birth control pills, and some blood pressure medications.
  • Systemic problems: thyroid disease, arthritis, lupus, and Sjorgrens Syndrome.
  • Lid disease such as blepharitis or meibomian gland dysfunction.
  • Insufficient blinking: patients who stare at computer screens all day, accountants, people who spend long hours with one specific task, etc.
  • Lasik surgery/ cataract surgery/ blepharoplasty (eyelid surgery)

 

DO I HAVE DRY EYES?

Dr. Thao Nguyen will listen to your symptoms and perform the appropriate customized dry eye testing to evaluate and treat your dry eyes.  Special testing will often often Tear Break-Up Time, Schirmer’s Test, Quick Zone Phenol Red thread test, Flurescien testing, Rose Bengal stain test, and or Lissamine Green stain test.

 

TREATMENT OPTIONS

  • Environment: help limit the amount of direct air blowing at you (ceiling fans while sleeping, desktop fans, ac vent directed at your face in the car).
  • Computer screen position: lower the height and angle of the screen so that your eyes do not have to open as wide while you are working (helps to decrease the amount of tear evaporation).
  • Artificial tears: there are many types.  Each artificial tear has a different base (oil, water, etc.) and active ingredient.  Dr. Nguyen will help explore your options and decide which artificial tear ingredient will be best for your eyes.  This is NOT a cure but will help alleviate symptoms.
  • Punctual plugs: our eyes have four drainage holes (2 per eye- think of a drain in a sink).  Plugging two of the four will often help reduce the amount of tears leaving the surface of the eye.  Sometimes plugging all 4 drainage holes is required in very severe cases of dry eyes.  These plugs are made of either silicone or collagen and are reversible.  Most health insurances will cover this procedure.
  • Restasis: a prescription eye drop that helps you PRODUCE more tears and reduce inflammation.
  • Omega-3 fatty acids:  increase your intake of fish or flaxseed.  This will help you produce better QUALITY tears that will take longer to evaporate.
  • Prescription anti-inflammatory eye drops: to reduce inflammation and redness. These drops will often offer instant relief.
  • Blepharitis treatment: blepharitis is eyelid inflammation.  Blepharitis can be treated with prescription eye drops and regular lid scrubs.