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What is Dry Eye?
Dry eye is a term used to describe a group of different diseases and conditions that result from inadequate wetting and lubrication of the eye. Although millions of people worldwide experience dry eye, it is not always easy to diagnose; it can easily be mistaken for other conditions such as infections or allergies. Dry eyes not only cause discomfort, but can lead to serious cornea diseases if left untreated.

What is the Tear Film?
The tear film has three main layers: Oily, Watery, and Mucus.

Oily : The oily layer, produced by the meibomian glands, forms the outermost surface of the tear film. Its main purpose is to smooth the tear surface and reduce evaporation of tears.

Watery : The middle watery layer makes up most of what we ordinarily think of as tears. This layer, produced by the lacrimal gland, cleanses the eye and washes away foreign particles or irritants.

Mucus : The inner layer consists of mucus produced by the conjunctiva. Mucus allows the watery layer to spread evenly over the surface of the eye and helps the eye remain wet. Without mucus, tears would not adhere to the eye.

What are the Symptoms?
When tears do not adequately lubricate the eye, a person may experience:

Pain

Stinging or burning

Light sensitivity

A feeling of a foreign body or sand in the eye

Itching

Redness

Blurring of vision (corrected by blinking)

Tearing- constant or occasional

Difficulty wearing contact lenses

Sometimes, a person with a dry eye will have excess tears running down the cheeks, which may seem confusing. This happens when the eye isn't getting enough lubrication. The eye sends a distress signal through the nervous system for more lubrication. In response, the eye is flooded with tears to try to compensate for the underlying dryness. However, these tears are mostly water and do not have the lubricating qualities or the rich composition of a normal tear film.

What Causes Dry Eyes?
Dry eyes Syndrome (DES) has many causes, which explain why millions are affected. The most common causes include:

The Aging Process: Tear flow normally decreases with age. In fact, approximately 75% of individuals over age 65 suffer from DES symptoms.

Contact Lens Wear: Contact lens wear can dramatically increase tear evaporation, causing discomfort, infection, and /or protein deposits. DES is the leading cause of contact lens intolerance.

Hormonal Changes in Women: Various hormonal changes associated with pregnancy, oral contraceptives and menopause can contribute to DES.

Environmental Factors: People who are exposed to smoke, air pollution, high altitudes, and windy, cold or dry air conditions are at risk for DES.

Side Effects of Disease/Medications: There are several diseases and medications which can lower your ability to produce tears. Be sure to give your doctor a complete medical history.

Structural problems with the eyes that don't allow the eyes to close properly or a problem with the tear ducts.

How Are Dry Eyes Treated?
Though dry eyes cannot be cured, there are a number of steps that can be taken to treat them. Talk to one of our doctors to discuss your treatment options.

Artificial tear drops and ointments :
The use of artificial teardrops is the primary treatment for dry eye. Artificial teardrops are available over the counter. No one drop works for everyone, so you might have to experiment to find the drop that works for you. If you have chronic dry eye, it is important to use the drops even when your eyes feel fine, to keep them lubricated. If your eyes dry out while you sleep, you can use a thicker lubricant, such as an ointment, at night.

Temporary punctal occlusion :
Sometimes it is necessary to close the ducts that drain tears out of the eye. This is done via a painless procedure where a plug that will dissolve in a few
days are inserted into the tear drain of the lower eyelid. This is a temporary procedure, done to determine whether permanent plugs can provide an adequate supply of tears.

Permanent punctal occlusion :
If temporary plugging of the tear drains works well, then silicone plugs (punctal occlusion) may be used. The plugs will hold tears around the eyes as long as they are in place. They can be removed. Rarely, the plugs may come out spontaneously or migrate down the tear drain. Many patients find that the plugs improve comfort and reduce the need for artificial tears.

Restasis :
In 2002, the FDA approved the prescription eye drop Restasis for the treatment of chronic dry eye. It is currently the only prescription eye drop that helps your eyes increase their own tear production with continued use. The full effects of Restasis is achieved with time and will subside if the medication is discontinued.

Surgery :
If needed, the ducts that drain tears into the nose can be permanently closed to allow more tears to remain around the eye. This is done with local anesthetic on an
outpatient basis. There are no limitations in activity after having this surgery.