Dry eye syndrome (DES) is a lack of sufficient lubrication and moisture on the front surface of the eye. Our tears help maintain the health of the cornea as well as provide clear vision. Dry eye syndrome is a label for various disorders of the tear film, which is usually classified into two categories: decreased tear production, and excessive tear evaporation. In fact, most patients (50-70%) have both types of the abnormality.
DRY EYE SYMPTOMS
The most common symptoms are burning, scratchiness, redness, gritty/sandy sensation, and an overall dryness feeling. These symptoms alone can be enough to diagnose dry eye syndrome. Other symptoms include blurred vision, tired eyes (especially on a computer), and contact lens intolerance. It may seem paradoxical, but dry eye syndrome can cause watery eyes. This is because dryness on the eye’s surface sometimes will overstimulate production of the watery component of your tears as a protective mechanism.
WHO IS AT GREATEST RISK?
Dry eye syndrome is the most common eye disorder, affecting 1 in 5 people. It is more common with age and as body hormone changes occur, especially in post-menopausal women. Medications taken by mouth can cause dry eyes, including antihistamines, blood pressure medications, decongestants, and antidepressants. Complaints of dry eyes are particularly common in patients with certain medical conditions such as Rosacea, rheumatoid arthritis, thyroid disease, and certain autoimmune conditions like lupus. The most severe form of DES is related to a condition known as Sjogren’s Syndrome. This condition affects several million people throughout the world and patients experience dry mouth/throat in addition to dry eyes.
DRY EYE TESTING
There are various tests performed to determine the presence and type of DES, but the most important is conducting a careful case history to uncover dry eye symptoms from the patient’s perspective. The dry eye tests done in the office at Vision Care Associates are as follows:
-Tear break up time: A measurement to determine how quickly the tears evaporate off the front surface of the eye. This should measure 8 seconds or more.
-Schirmers strip: A wetting strip that measures the tear volume produced over a 5 min period.
-Ocular Surface Disease Index Survey: A questionnaire based on patient symptoms to categorize the specific type and severity of dry eye syndrome.
-Biomicroscope eyelid evaluation: Investigation of the eyelid margins to determine eyelid involvement and underlying inflammation.
-Lissamine green: A water based green dye used to target specific dry spots on the front surface of the eye.
DRY EYE TREATMENT
Dry eye syndrome is a chronic disease for which there is no permanent cure. The goal of treatment is to relieve the symptoms and protect the health of the ocular surface. Mild dry eyes can sometimes be managed with non-prescription artificial tears. Lubricating gels and ointments may also be recommended, but are best used at night as they can blur your vision. Restasis is another excellent treatment option. It’s a prescription eye drop that has been shown to cause a person’s eyes to produce more tears and better quality tears by reducing inflammation. Punctal plugs are a great remedy for the patient that has tears that evaporate too quickly. Silicone plugs are gently placed into the tear ducts to block the tears from draining away and allowing longer contact time on the ocular surface. Oral supplements such as Omega-3 fatty acids can improve meibomian gland function and thus improve the tear film.
The latest breakthrough for severe dry eye syndrome is autologous serum eye drops. It is made out of blood drawn from the patient. The blood is centrifuged; the serum is drawn off and then packaged as an eye drop. The benefit of this modality is the biochemical properties of blood serum are very similar to that of the tear film. The components have an anti-inflammatory effect as well as providing essential nutrients to the cornea and tear film.
If you or someone you know is experiencing dry eye symptoms, call to schedule a consultation today. Drs. Franken and Arnold have experience and expertise when it comes to dry eye syndrome. The sooner proper treatment is applied to the ocular surface, the better the outcome.