About Dry Eye

Dry eye syndrome is a common condition that can cause symptoms ranging from dry, irritated eyes to visual interference. Dry eye affects 15 to 20 percent of people over age 40. Until recently, treatment had been hit-or-miss. Newer understanding of the types of dry eye and improved clinical technology allow us to make a more specific diagnosis. You can now take advantage of newer and more effective treatments.

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Signs of Dry Eye

Signs of dry eye syndrome are different from person to person. The most common symptoms are discomfort in the eyes, including:

  • A burning or smarting sensation
  • Scratchy eyes
  • Sandy or gritty feeling
  • A foreign-body sensation, or feeling that there is something in the eyes

Dry eye syndrome causes discomfort because it affects the cornea, which is full of sensory nerve fibers. Less common symptoms are adverse reactions to light and problems with visual acuity. People with dry eye often note that it is difficult to read or watch television. This is because watching television (or computer screens) and reading require concentration. A person’s eyes blink less frequently when concentrating. This allows natural tears to evaporate more quickly.

Causes of Dry Eye

Dry eye syndrome can have multiple causes. Some of the most common causes of dry eye include:

  • The natural aging process.
  • Menopause.
  • Living or working in a dry climate.
  • Side effects of some medications.
  • Antihistamines, anti-depressants, and birth control pills.
  • Symptoms of systemic diseases.
  • Lupus, rheumatoid arthritis, and Sjogren’s syndrome.
  • Eyelid diseases.

Testing For Dry Eye

Testing for dry eye may include:

  • An exam of the facial skin and eyelids.
  • Evaluation of the front surface of the eyes.
  • Use of dyes to enhance the signs of dry eye and measure how tears break up and evaporate.
  • Testing for tear quantity.

There are two distinct types of dry eye. The first occurs when the eyes do not produce enough tears. The second occurs when tears evaporate too quickly. Improved technology over the last few years now allows us to detect causes and differentiate between the two types of dry eye.

Dry Eye Treatment

There is significant research in the treatment of dry eye but dry eye is generally controlled rather than cured. This means ongoing care is required.

Artificial tears, or lubricating eye drops, have been the mainstay of dry eye treatments. Avoid using some over-the-counter eye drops that “take the red out”.  These drops often contain harsh preservatives that can cause further dryness of your eyes. Our current recommendations for artificial tears are non-preserved and much easier on the eye. We recommend Systane and Similasan.

Temporary or permanent silicone plugs in the tear ducts are an effective treatment option. They attempt to hold more of your natural tear longer on your eye. The plugs can be inserted painlessly in the eye doctor’s office and are normally not felt once inserted.

New medications such as Restasis show promise in increasing tear production. Nutritional supplements might also help. Essential fatty acids and flax seed oil have been shown to increase tear quality and to reduce dry eye symptoms.

Sometimes the cause of dry eye is a medication. In this case it’s a good idea to work with your physician to see if other medications can be substituted.

If there is an underlying eyelid disease, treatments may include antibiotic or steroid drops and oral medications.