Dry Eye

 


Your eyes constantly produce tears at a slow and steady rate so that they stay moist and comfortable. Some people are not able to produce enough tears or the appropriate quality of tears to keep their eyes healthy or comfortable. Tears are made of water, oil and mucous.  Any imbalance to these three components can cause irritation to the eye and/or vision distortions.  This condition is known as dry eye, and is very common in the state of Colorado.

Symptoms of dry eye include scratchiness, stinging, stringy mucus in or around the eyes, and blurry vision. Sometimes people with dry eye will experience excess tearing. This is the eye's response to the discomfort from dry eye. When the eyes get irritated, the gland that makes tears releases a larger than usual volume of tears in an attempt to soothe the eye, which overwhelms the tear drainage system. These excess tears then overflow from your eyes, sometimes onto your cheeks even.  

Ironically, tears running down your cheek can mean your eyes are dry!

Dry eye often increases with age as tear production slows. For women, this is especially true after menopause. Dry eye can be associated with other problems like Sjögren's syndrome, which can cause dry eyes along with dry mouth and arthritis.  Dr. Haas can usually diagnose dry eye just by examining your eyes with fluoroscein (orange/yellow) eyedrops. Sometimes tests that measure tear production are necessary. The Schirmer tear test measures tear production by placing filter-paper strips between your eyeball and your lower lid.

Treatments for dry eye include eyedrops called artificial tears or preservative-free artificial tears to lubricate the eyes and help maintain moisture. Other medicated drops, such as Restasis, can work to reduce inflammatory mediators within your tear film, which overall improves the quality of the tears produced. Restasis can be an excellent medication for some people, but it can take several weeks to have maximum effect. Dr. Haas may alternatively help conserve your tears by closing the channels through which your tears drain (eyelid puncta) with a punctal plug. These plugs are permanent (though they can be removed if you do not like them), and they work by keeping your tears on the ocular surface longer (by not draining), which naturally acts like improved lubrication for the surface of your eye. You can also try to prevent tears from evaporating by avoiding wind and dry air from overheated rooms and hair dryers. Humidifiers can help as well.  Smoking irritates dry eyes and should be avoided.

Punctal Plugs in the puncta:    
 


Diet can also play a role in the symptomatic relief for dry eyes.  A well-balanced diet is always recommended, but supplements can play an important role as well.  Omega-3 fatty acids (found in fish oil and flaxseed oil) are an important element in the formation of the oily portion of your tear film.  Your body cannot produce this essential fatty acid on its own, and a lack of omega-3 fatty acids in your diet can lead to decreased oil production in your tears.  The result can be a tear film that evaporates quickly, leaving you susceptible to dry eye symptoms.  Vitamin supplements of these omega-3 fatty acids can therefore help to improve symptoms for many people.

In less developed countries, dry eye due to a lack of vitamin A in the diet is not uncommon. Ointments with vitamin A can help dry eye caused by unusual conditions like Stevens-Johnson syndrome or pemphigoid.