Dry eye is a common condition in which the eyes are insufficiently lubricated, leading to itching, redness and pain. The eyes can become dry and irritated because the tear glands are not producing a sufficient number of tears, or because there is a chemical imbalance in the tears themselves. Natural tears require a particular chemical balance to lubricate the eyes efficiently.
Alleviating the symptoms of dry eye is important. Left untreated, they have the potential to damage vision. Dry eye can be diagnosed after a thorough examination of the eyes, as well as in office diagnostic testing which checks the tear osmolarity and inflammatory markers in the tear film.
Causes of Dry Eye
People usually begin experiencing dry eye symptoms as they age (they are more common in people older than 50), but they can also result from certain medications, medical conditions or injuries. Dry eye tends to affect women more than men because of the hormonal changes that take place during pregnancy and menopause. Oral contraceptives can also affect the consistency of tears. Other causes of dry eye include the following:
- Antihistamines, decongestants and blood-pressure medications
- Rheumatoid arthritis, diabetes, Sjögren's syndrome and thyroid disease
- Environmental conditions such as smoke, wind or excessive sun
- Long-term contact lens use
- Eye injury
- Eye or eyelid surgery
- Inflammation of the eye (conjunctivitis or keratitis)
Any of these factors, alone or in combination, can affect the frequency or consistency of tears, either of which can lead to dry eye.
Symptoms of Dry Eye
The symptoms of dry eye typically occur in both eyes, and include the following:
- Stinging, burning or scratchiness
- Eye fatigue
- Sensitivity to light
- Difficulty wearing contact lenses
- Excessive tearing
- Blurry vision
Dry eye can damage eye tissues, leaving tiny abrasions on the surface that can impair vision. There are, however, many treatments for relieving dry eye symptoms, restoring eye health and protecting vision.
Treatment of Dry Eye
Treatment for dry eye depends on its cause and severity, as well as the patient's overall health and personal preference.
Artificial Tears, Gels and Ointments
These products vary in their consistency, some are the consistency of water, while others are thicker, or more viscous. You should begin by using these drops 2 to 4 times each day. The gels are thicker than drops, and therefore stay on the ocular surface longer. The drawback is that they can blur vision, but only temporarily and may be best used at bedtime. If using tears more than 4 times a day, they should be preservative-free.
The underlying problem with dry eye is ongoing inflammation on the ocular surface. This ongoing inflammation causes long term damage to the surface of your eyes and to tear producing glands.
Restasis/Xiidra/Cequa: A medicine eye drop used twice a day that treats dry eye by suppressing inflammation and increasing both tear production as well as the quality of your own tears. Starts working in about 4 weeks.
Corticosteroid Eye Drops: Steroids can be used in the form of eye drops which are available in varying strengths. Throughout any treatment with steroids, we will monitor your eyes closely to make certain you don’t have any side effects.
Doxycycline: When prescribed at full strength, these medications function as antibiotics but at lower dosages, these medications act as anti-inflammatory agents. Frequently used to treat dry eye, blepharitis, rosacea, styes, etc. They can be safely used at these lower dosages for months at a time.
Omega-3 fatty acids: These anti-inflammatory fatty acids promote a better quality tear film. They counteract the pro-inflammatory omega-6 fatty acids found in our diet.
During your shower allow warm water to beat on your closed eyelids for 30 sec. Using Head & Shoulders anti-dandruff shampoo, wash the eyelids and lashes while keeping the shampoo out of your eyes. Rinse away shampoo with warm water. If shampoo enters the eye, rinse with water and apply artificial tears drops afterwards.
Punctal Plugs are tiny, comfortable, biocompatible inserts that are easily placed in your tear ducts to block tear drainage from the surface of your eyes. This passively and instantly increases the quantity of tears on your eyes, thereby increasing moisture and relieving dry eye. Right in the office, the doctor places a plug into the small openings in the nasal aspect of your eyelids. If needed, punctal plugs are readily reversible and will pop out if you rub your eyes vigorously.
Autologous Serum Eye Drops
Autologous Serum Eye Drops are special eye drops which are custom made for you taking advantage of all of the natural growth factors, immunoglobulins, vitamins and other essential components that are present in your own blood. Dr. Jachens will draw your blood and create these our drops in our EyeCare 20/20 laboratory. Your blood is then spun down using a centrifuge and the plasma rich liquid on the top is made into eye drops for you. The contents of the plasma from blood has been shown to greatly promote the health and healing of the surface of your eye (and other parts of your body).
Amniotic Membrane is a biologic therapeutic corneal bandage (like a large contact lens) used to heal and treat dry eye (and other ocular conditions). Amniotic Membrane’s natural therapeutic actions reduce inflammation and scarring, and promote and expedite healing. Dr. Jachens painlessly placed the membrane on your eye in the office. You wear this bandage for two to five days at which point Dr. Jachens removes it leaving your eye resurfaced, rejuvenated and immediately feeling better.
Complications of Dry Eye Syndrome
It is important for your condition to be diagnosed and treated in a timely fashion to prevent long-term complications such as corneal scarring & thinning, corneal infections and loss of contact lens use.