Dry Eye

Almost everyone has heard of “dry eyes”– for some, this is an occasional annoyance solved by artificial tears. However, for many, this becomes a chronic everyday issue that needs proper treatment. Dryness can be caused by many different reasons but ultimately has to do with inflammation and “tear film instability.”

The tears are made out of three different layers: oil, water, and mucus. When any of these layers are not being produced properly, the eye cannot make good quality tears and signs and symptoms of dryness occur.

*For many, a common sign of dry eyes is actually excessive tearing!*

Many times your eye doctor will notice the signs before you may be experiencing symptoms. It is important to address dry eyes early on because things will only get worse over time and become harder to treat.

Causes

Dry eyes can result from a variety of factors, some of which include:

  1. Aging: with age it is common to experience decrease in tear production
  2. Environment: exposure to dry and windy climates, air conditioning or heating, exposure to smoke
  3. Screens: looking at screens such as our phones and computers has been shown to cause decreased blinking frequency which results in dry eyes

*Taking frequent breaks and using artificial tears are great measures to implement daily while using screens to treat and prevent symptoms*

  1. Medical conditions: autoimmune disorders (such as Sjogren’s syndrome), diabetes, thyroid conditions, rheumatoid arthritis may contribute to development of dry eye
  2. Medications: antihistamines, decongestants, certain blood pressure medications can contribute to decreased tear production

Symptoms

Irritation *  redness * burning * itching * tired feeling * blurry vision * excessive watering * sensation of a foreign body * crusting * discharge particularly upon waking up * reduced ability to focus on computer/phone/books

Treatment

There are many options to treat dry eyes – we generally start conservatively and increase or combine measures as needed.

  • Artificial tears: usually the first line of treatment; lubricating eye drops a few times daily. Artificial tears are great for everyone to use regularly!
  • Steroid drops: often prescribed to reduce inflammation and flare ups. This is not a long-term solution but can be used occasionally to calm the eye
  • Restasis/Xiidra/Cequa: drops that have special medication like cyclosporine to help bring the eye back to homeostasis. These medications take many weeks to months to take effect as they work to change the quality of the tear being produced
  • Punctal plugs: tiny plugs that temporarily close the part of the eye that drain our tears, effectively keeping tears and any drops on the eye longer.
  • Amniotic membrane: for more severe cases, a disc that contains stem cells can be temporarily applied to the eye to help the cornea heal
  • Autologous serum: utilize a patient’s own blood to make special eye drops
  • IPL: intense pulsed light treatment to reduce inflammation and signs and symptoms associated with dry eye.