Dry Eye Syndrome
Dry eye syndrome, or keratoconjunctivitis sicca, is one of the common reasons for patients to visit our office. All of our doctors treat mild to severe dry eye.
Many people, whether they are aware of it or not, suffer from dry eyes. Dry Eye Syndrome (DES) is one of the most common, yet most underdiagnosed conditions affecting the health of the eye.
Dry eye affects up to 15% of the U.S. population. It is more common in women and tends to worsen with age. Disease severity ranges from mild to severe, and is often quite bothersome.
Symptoms of Dry Eye
Patients may experience burning, tearing, eye redness, light sensitivity, eye fatigue, and a gritty sensation. Dry eyes can affect contact lens wear, computer use, reading, and other visual endeavors.
The front surface of the eye, the cornea, needs continuous lubrication by tears to stay clear and healthy. Tears are composed of three layers. These include an inner mucous layer, a middle water layer, and an outer lipid layer. Both the quality and quantity of these layers affect the ability of the eye to stay lubricated. If the tear glands do not produce enough tears or the tears evaporate from the surface of the eye too quickly, eye irritation can occur.
What Causes Dry Eye?
There are many causes of dry eye syndrome. Environmental causes such as low humidity, pollution, and allergies contribute to dry eye. Certain medications, especially for depression and allergies, can cause dry eye. Computer use and some medical conditions, including Rheumatoid Arthritis, Sjogren’s Syndrome, and Parkinson’s Disease, can also lead to, or worsen dry eye syndrome.
Treatments for Dry Eye
Dry eye syndrome cannot be cured, but it can be managed. There are a variety of over the counter solutions and ointments that replenish natural tears and lubricate the cornea. These drops and gels often need to be administered several times a day and night in order to provide relief.
Preservative-free artificial tear formulations are best for patients who need drops 4 or more times a day. Preservative free ointment is very useful at night to reduce dry eye symptoms. Applying a small amount with your finger on the lower lashes before bedtime will coat the eye, without being too greasy in the morning.
Steroid eye drops, when used for a short period of time, can relieve the inflammatory symptoms of dry eye, such as redness, burning, and pain. These drops are safe if used under your doctor’s supervision.
Restasis FDA Approved
Restasis is another prescription medication approved by the FDA for treatment of dry eye. It is a topical form of cyclosporine, an anti-inflammatory immunomodulating medication. It has been proven to reduce inflammation associated with dry eye and to increase natural tear production. It is dosed twice a day and is safe for long- term use. Restasis has been used effectively since April 2003.
Restasis is effective for many people. It can often take several months to reach its full effect, so it is often used in conjunction with other treatment modalities until this time.
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Punctal Plugs
Tears are removed from the surface of the eye through specialized drains in the upper and lower lids. Each drain is called a puncta.
Punctal plugs can be inserted into each tear drain. By “plugging up” one or both tear drains in the lids, tears remain on the eye longer. This often decreases the need for artificial tear drops, improves contact lens comfort, and reduces the symptoms of dry eyes.
Plug insertion is a painless office procedure. Most plugs dissolve in four months time, they can be replaced if desired. Permanent punctal occlusion can be achieved with heat, or cautery, in patients with severe dry eye syndrome.
Oral Supplements for Dry Eye
In addition, oral supplements of Omega-3 fatty acids have shown to be effective in managing dry eye by improving the quality of tears and quieting inflammation on the eyelids.