Dry eye syndrome results from a reduction in the quality of the tear film that helps to lubricate the eye. There are many causes for the reduction in quality, including the normal aging process, dry climate, high altitude, exposure to recycled air or cigarette smoke, as well as some medications, thyroid conditions, vitamin deficiencies and some systemic diseases. Contact lens wearers may also experience dry eye syndrome as the contacts absorb the tear film and cause proteins to form on the contact lens. Women may also experience dry eye syndrome as they enter menopause.
Dry eye syndrome is a common complaint and one that is commonly treated by the eye physician. Symptoms of dry eye syndrome include, burning, redness, itching, blurry vision that improves with blinking, excess tearing, increased symptoms after engaging in activities such as reading, watching television, or looking at a computer monitor for a sustained period.
In order to understand dry eye syndrome, it is helpful to understand a little bit about the normal tearing process. Tears have three components. A layer of mucus coats the cornea. Next, the aqueous layer provides the cornea with oxygen and other nutrients as well as supplying addition moisture. The outmost lipid layer seals the tears with an oily film and helps to prevent the remaining layers from evaporating.
Several glands produce tears which are spread by the eyelids across the eye with every blink of the eye. Two small drainage ducts in the corner of the eye collect excess tears, which are then drained into the nasal passage through small canal-like structures. The tear glands also produce tears as a reflexive response to perceived dryness. Accordingly, people with dry often experience excess tearing.
Detection and Diagnosis
Treating dry eye syndrome is important not only for the patient’s comfort, but also to maintain the health of the cornea. In order to diagnose dry eyes, the eye doctor will first assess the tear film, including how much is produced, the quality of such production and the evaporation rate. The eye doctor may use certain eye drops to analyze problems that may not otherwise be visible. The eye doctor may also use a “schirmer test” in which he will place very small paper tabs in the lower eyelids. When the strips are removed, the wet area is measured to determine whether production is sufficient to lubricate your eye.
There are a variety of treatments for dry eye syndrome which the eye doctor will tailor to the specific individual needs of each patient. Some patients may find adequate relief from symptoms by the regular use of artificial tears. A number of such products provide temporary relief, while other such products may provide more sustained relief. Many eye doctors recommend preservative-free tears in order to avoid introducing potential irritants in the eyes.
“Patients with dry eye may complain of anything from irritation, itching, and burning to blurred vision and excessive tearing.”
Closing the opening of the tear drain in the eyelid with special inserts called punctal plugs is another option. This works like closing a sink drain with a stopper. These special plugs trap the tears on the eye, keeping it moist.
Punctum plugs are a rapid and safe solution to dry eyes in most cases. They are painlessly inserted in the office in under a half a minute. There are few to no downsides to plugs. In the unlikely event that a plug causes irritation, it can be painlessly removed in seconds. Treating dry eye problems is important not only for comfort, but also for the overall health of the eye.