Dry Eye
If your eyes sting, itch or burn, you may be experiencing the common signs of "dry eye." A feeling of something foreign within the eye or general discomfort may also be caused by dry eye.
What is dry eye?
Dry eye describes eyes that either do not produce enough tears or produces tears that evaporate too quickly. The natural tears that your eyes produce are composed of three layers:
- The outer oily layer prevents or slows the evaporation of the tear film.
- The middle watery layer moisturizes and nourishes the front surface of the eye.
- The inner mucus layer helps maintain a stable tear film.
Dry eye may occur because the volume of tears produced is inadequate (we all produce fewer tears as we get older, and in some cases this can lead to dry eye symptoms). It may result because the composition of the tears has changed, so that they are unstable and evaporate more quickly.
What causes dry eye?
Dry eye symptoms can result from the normal aging process. Exposure to environmental conditions (sun, wind, and smoke), air conditioning, being a woman, as well as medications, such as antihistamines, oral contraceptives or anti-depressants, can contribute to the symptoms of dry eye as well. Dry eye can result from chemical or thermal burns to the eye. Dry eye may also be symptomatic of general health problems or other diseases. For example, people with arthritis are more prone to dry eye. Lastly, the use of technology, such as computers, cell phones, tablets, and television can cause many problems with dryness and eye irritation.
Will dry eye harm my eyes?
If untreated, it can. Excessive dry eye can damage tissue and possibly scar the cornea at the front of your eye, impairing vision. Dry eye can make contact lens wear more difficult since tears may be inadequate to keep the lenses wet and lubricated. This can lead to irritation and a greater chance of eye infection. Therefore, it is important to follow the recommended treatment plan.
How is dry eye diagnosed?
During the examination, you will be asked about your general health, use of medications, and work and home environments to determine factors which may be contributing to dry eye symptoms. This information will help decide whether to perform specific dry eye tests.
To test for dry eye, diagnostic instruments that allow a highly magnified view of your eyes or small strips of paper or threads and special dyes assess the quantity and quality of the tears may also be used.
We also utilize the Oculus Keratograph 5M at Visualeyes, the latest and best instrument to not only diagnose dry eye or abnormal tear function, but also the type of dryness that an eye may have. When we know the type of dryness, it is much easier to treat. The Keratograph 5M has a high-resolution color camera and is equipped with intelligent software to analyze the collected data and document the findings. It can alwo compare the results and show the success of the dry eye treatment.
To measure the quality and stability of the tear film, the Oculus Keratograph measures the tear film break-up time non-invasively. This test takes less than 30 seconds and does not require touching the eye.
To evaluate the quantity of the tear film, the Keratograph takes a picture of the lower eyelid to measure the tear meniscus height.
The Keratograph can document a movie of the oily layer of the tear film. A healthy and thick lipid layer is colorful and protects the tears from fast evaporation. If there is not enough lipid, the tear film becomes unstable the moisture dissipates quickly and both vision and comfort can be compromised.
Located in both upper and lower lids, the meibomian glands produce complex oils that stabilize the tear film and prevent tear evaporation. If the meibomian glands do not function properly, dry eye usually occurs. Our optometrists can utilize the advanced features of the Keratograph 5M to directly assess the health of your meibomian glands.
Once dry eye has been diagnosed, sometime our optometrists will want to perform a dry eye evaluation to determine exactly what type of dry eye you have. Different types have different treatments. The correct treatment cannot be determined until we have performed the battery of tests to determine which type of dry eye you have.
How is it treated?
There has been an explosion in the understanding of the causes of dry eye. A variety of options are now available to help patients who suffer from dry eyes. Current approaches include advanced artificial tear eye drop formulations, prescription eye drops that incease tear production and reduce inflammation, and new approaches to effectively treat meibomian gland dysfunction, which is now understood to play a primary role in most dry eye cases.
Dry eye treament can not be targeted to address the underlying cause of the problem. Some patients suffer from a lack of tear production, others from excessive evaporation of their tears. Most suffer from a combination of both problems. After a comprehensive examination using the advanced diagnostic tools provided by the Keratograph, our optometrists can more accurately assess the precise case and severity of your dry eye. Using this information, they will ercommend the best course of treatment to address your specific problem.
Dry eye cannot be cured, but your eyes' sensitivity can be lessened and measures taken so your eyes remain healthy. The most frequent method of treatment is the use of artificial tears or tear substitutes. For more severe dry eye, there can be prescription eye drops, ointments, especially at bedtime, or special contact lenses. In some cases, small plugs may be inserted in the corner of the eyelids to slow drainage and loss of tears. Other in-office procedures can be performed as well. All of this will be discussed by our optometrists.
If you have been prescribed Blinking Exercises, you can find them here.
To keep dry eye symptoms in check, you and your optometrist need to work together. If you have increased dryness or redness that is not relieved by the prescribed treatment, let us know as soon as possible.
In-Office Procedures
-
Meibomian Gland Expression