Dry Eye

WHAT IS DRY EYE?

A dry eye is the inability to produce enough tears and maintain a sufficient tear layer. Natural tears of the eye are made up of three layers:

• The outer oily layer, which slows down evaporation of the tear film

• The middle watery layer; which moisturizes and nourishes the front surface of the eye

• The inner mucus layer, which helps maintain a stable tear film.

 

Dry eyes can occur if there is not enough tears being produced, particularly in the aqueous layer of the tear film. It can also occur when there isn’t a sufficient oily layer, thus the tears will evaporate more quickly. Dry eye symptoms can also occur from exposure to environmental conditions, as well as medications like antihistamines, oral contraceptives or anti-depressants. It can also result from chemical or thermal burns to the eye. Dry eyes can be linked secondarily with many health or eye related conditions (example RA, Lupus, Sjogrens, Steven Johnson..etc). Dry eye syndrome is an incurable disease; but it can be managed to a point where the patient is asymptomatic.

 

There are many treatment modalities that can be done for dry eyes. Those treatment modalities are:

 

Artificial tear drops and ointments – Artificial teardrops is the primary treatment for dry eye. If your eyes dry out while you sleep, you can use a thicker lubricant, such as an ointment, at night.

Temporary punctal occlusion – A plug is used to close the duct the drains tears out of the eye. A dissolving plug is inserted into the tear drain of the lower eyelid to determine whether permanent plugs can provide an adequate supply of tears.

Non-dissolving punctal plugs and punctal occlusion by cautery – If temporary plugging of the tear drains works well, then longer lasting plugs or cautery may be used. These measures will increase the tear level by blocking the drainage path.

Lipiflow – Lipiflow is a medical device that uses heat and pressure on the eyelids to unclog blocked glands. These are the glands that secrete the oily layer of the tear film.

Restasis – Restasis is the only prescription eye drop approved for treatment of chronic dry eye. It works by increase the volume of tears produced by the lacrimal gland.

Steroid and nutritional supplements – Steroid eye drops are used for short periods to help up-regulate tear production. Studies suggest that the steroid decreases inflammation of the lacrimal gland, thus making it work at an optimal level. There is also growing evidence that the oral intake of fish oil and omega-3 supplements is very helpful to those suffering with dry eye.