Dry Eye

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Dry Eye

You may not think about tears until you're sad, hurt yourself, or are laughing out loud with good friends, but, actually, your eyes produce tears all the time.

Healthy eyes are continuously covered by fluid — a tear film which allows you to maintain clear vision and comfortable eyes.

What causes Dry Eyes?

Decreased production of fluids from your tear glands can destabilize that tear film and create dry spots on the surface of your eyes. An imbalance in the substances that make up the tear film can also cause dry eyes.

Tears are made up of a complex mixture of water, fatty oils, proteins, electrolytes, bacteria-fighting substances, and growth factors that regulate various cell processes. This mixture helps make the surface of your eyes smooth and clear. Without tears, good vision is impossible.

The tear film has three basic layers: oil, water, and mucus. Problems with any of these layers can cause dry eye symptoms.

For some people, the cause of dry eyes is an imbalance in the composition of their tears. Other people don't produce enough tears to keep their eyes comfortably lubricated. Eyelid problems, medications including certain antidepressants, antihistamines, cold medicines, hypertensive, and birth control pills, as well as environmental factors such as cold, dry, sunny, or windy conditions can lead to dry eyes. Also, patients that use oxygen or even a CPAP machine at night may experience Dry Eyes.

Although dry eyes can affect both men and women at any age, the condition is more common among women, especially after menopause. This may be due in part to hormonal changes.

Spending long hours, either at work or at home, reading, on the computer, or watching tv can cause dry eyes, because these activities require focus and naturally we blink less often when focused.

Damage to the tear glands from inflammation or radiation can also hamper tear production.

Dry eyes are also associated with some medical conditions such as hyperthyroidism, diabetes, rheumatoid arthritis, lupus, scleroderma, Sjogren's syndrome, and vitamin A deficiency.

Regardless, when you're unable to produce enough tears, your eyes become dry and easily irritated. Dry eyes are a common source of discomfort, especially in people over 40, as tear production tends to diminish as you get older.

Common symptoms

No two people experience dry eyes exactly the same way. You may experience a stinging, burning, or scratchy sensation in your eyes, stringy mucus in or around your eyes, increased eye irritation from smoke or wind, eye fatigue after short periods of reading or sitting in front of a computer, increased sensitivity to sunlight and situations with bright lighting, and “stickiness” when wearing contact lenses.

Surprisingly, Dry Eyes may cause tears streaming down your cheeks. This is due to the eyes being irritated and the tear glands are producing a lot of tears to compensate for the dryness. The tear drainage system or tear ducts can not keep up with such volume.

You may also experience blurred vision, often worsening at the end of the day.

Diagnosing Dry Eyes

Those with moderate to severe or chronic dry eyes should be examined. We can test the quantity and quality of your tears. We will perform simple tests to look at how your eyelid functions. Problems with eyelid function can impair the complex blinking motion required to spread your tear film across your eye, or if your eyelid doesn’t close properly, this can contribute to the problem.

We will also check for inflammation along the edge of the eyelids, which can cause your eyes to feel dry and scratchy.

Two common tests that are performed to evaluate Dry Eye Disease is Schirmer's Test and TearLab Osmolarity.

Schirmer's Test

A Schirmer's Test is when a numbing drop is administered on the eye and filter paper strips are place in the lower eyelid measuring basic secretion of the lacrimal glands.

TearLab

The TearLab Osmolarity System is intended to measure the osmolarity of human tears to aid in the diagnosis of dry eye disease in patients suspected of having dry eye disease, in conjunction with other methods of clinical evaluation. TearLab is for professional in vitro diagnostic use only.

Hyperosmolarity has been described in the literature as a primary marker of tear film integrity. When the quantity or quality of secreted tears is compromised (known as aqueous deficient or evaporative Dry Eye Disease), increased rates of evaporation lead to a more concentrated tear film (increased osmolarity) that places stress on the corneal epithelium and conjunctiva.

Treatment Options

Mid Florida Eye Center is an accredited Dry Eye Center and Certified Tear Testing Laboratory, we offer unique treatment plans tailored to your needs including vitamins and thermal lid therapy.

Punctal Plugs

Punctal plugs are a plastic material or silicone that are inserted into the punctum to prevent normal tear drainage; to preserving natural tears and helping to keep the cornea and conjunctiva moist.  Punctal plugs are very common and used often in a line of defense against Dry Eye. 

Dry Eye Vitamins

Omega 3's have been shown to greatly support Dry Eye relief as part of their many other healing qualities, but not all omega 3's are created equal. These supplements are proven to improve symptoms related to tear film quality. Clinical research have shown that 82% of patients using Dry Eye vitamins had a positive change in normalizing the meibum and lipid layer of the tear after 8 weeks of treatment.

Thermal Eyelid Therapy

Thermal Eyelid Therapy is a new therapeutic device for the treatment of dry eye. It employs a proprietary thermoelectric heat pump designed to liquefy secretions and improve meibomian glandular function. Thermal Eyelid Therapy improves the evaporation component of dry eye.

Thermal Eyelid Therapy delivers an effective temperature of 108 degrees within a variance of less than 3%. The unit has an adjustable timer allowing for physician-controlled customization of therapy.

To watch a video of a patient having this procedure click here.

Artificial Tears

Over-the-counter artificial tears can help lubricate and protect the eyes. Some recommended artificial tears include; Refresh Optive, Systane, Blink, Genteal, TheraTears, and Soothe. Try to avoid brands such as Visine and Clear Eyes. Gel drops are a great option if you have trouble remembering to administer your drops throughout the day. Gel drops will stay on the surface of the eye longer, but they are thicker and may temporarily blur you vision. Ointments, like Refresh PM or Systane Overnight Therapy, are to be used at night before bedtime since the ointment is significantly thicker and will blur your vision for a few minutes.

It’s important not to use drops that are specifically for reducing redness. You want to be certain you’re getting drops to enhance your natural tears.

Other Treatments

Prescription eye drops may be needed. The goal of treatment is to keep your eyes moist. Your doctor will review your condition, prior treatments, and current medication to see if prescription eye drops are right for you.

If you have an eyelid condition, such as an anatomic abnormality or an incomplete blink that aggravates your dry eyes, we can help you. Dr Goldey, our oculoplastic specialist, can determine whether or not a surgical option is needed.

If your eyelids are inflamed, we may recommend warm compresses, and a special cleansing routine or short-term, nightly treatment with antibiotic drops, ointment, or treatment with an oral antibiotic, such as doxycycline.

We can also partially or completely close your tear ducts with tiny silicone plugs, to keep tears from draining.

Severe dry eyes require more aggressive treatment.

Dry Eye Prevention

Drink plenty of water! Try to remember to blink often while reading, on the computer or watching tv for long periods of time. Wear Polarized, UV-blocking sunglasses to reduce environmental exposure to the cold, sun, dust/ debris, or drying winds. Also, be sure not to point fans and car air conditioner vents directly at your eyes.

If you think you may have Dry Eye Syndrome, make an appointment today at one of our Central Florida locations including Mount Dora, Leesburg, Wildwood, The Villages, and Summerfield.