By Dr. Michael Grossman, MD, Illinois Retina & Eye Associates
Dry Eye Syndrome (DES) is a disease that can cause a variety of signs and symptoms affecting the vision and/or the comfort of the eyes.
A normal, healthy eye has a protective tear film that spreads over the eye when you blink. This tear film makes the front of the eye round and smooth and without it we could not have normal vision. It is made of three layers:
- The oily layer (outermost) reduces the evaporation of tears.
- The mucous layer (innermost) helps keep tears on the cornea.
- The watery layer (middle) functions to wash away foreign particles.
DES occurs when there is a decrease in the quantity and/or quality of the tear film. Usually a change in the balance of electrolyte composition of the film leads to inflammation causing the common symptoms we think of associated with DES:
- Dryness or grittiness
- Foreign body sensation
- Burning or stinging
- Sensitivity to light
- Scratchiness
- Excessive tearing
- Blurred vision and/or fluctuating vision
- Stringy mucus in or around the eyes
It may sound like a contradiction, but the eye can actually produce excessive tears, and overflow when it becomes irritated by a lack of lubrication. It then attempts to cleanse itself with tears as it does when foreign matter is stuck in the eye.
What Causes Dry Eyes?
Tear production often slows down as people get older. This is particularly common for women after menopause. One common cause of dry eye can be over-the-counter and prescription medications such as anti-depressants, antihistamines, beta-blockers, sleeping pills, pain relievers, and diuretics. For this reason, it is very important to inform your ophthalmologist about any medications you are currently taking, which can help the doctor in the proper diagnosis of the disease. Sometimes the cause is unknown in a case of dry eye. Known causes of dry eye may be natural, related to a larger condition, or activity related.
Risk Factors
- Aging (40+)
- Recent eye surgery
- Medications
- Eyelid inflammation
- Autoimmune disease
- External (excessive computer use, contact lens wear)
Diagnosing DES
Your eye doctor can diagnose DES during a routine eye exam. Common dry eye tests include putting special drops in the eye that can reveal changes in the corneal surface and show how well the tear film maintains itself over the eye. Also, paper strips or threads placed on the eyelids can measure the rate of tear production.
Treatment
Mild DES may be managed with basic eyelid hygiene and use of over-the-counter artificial tears. There are many OTC tears, both preserved and preservative free, and of various consistencies. They can be used as often as necessary — once a day or as often as several times an hour. Moderate to severe DES usually needs more attention, and there are antibiotic and/or steroidal/non-steroidal anti-inflammatory medications that may be prescribed.
Another successful approach to DES is conserving the body’s own tears through the use of punctal plugs. Normally the tears drain out of the eye through a canal into the nose. Your eye doctor can plug these holes with temporary or long-term plugs to keep the tears on the eye longer, thus keeping the eyes moister. The procedure is non-invasive and can be done quickly and easily during the eye exam.
Dr. Michael Grossman, comprehensive ophthalmologist and cataract surgeon at Illinois Retina & Eye Associates, presents an eye health seminar on Thursday, April 16, or Tuesday, April 28th, 5-6:30 p.m., titled, “Is Cataract Surgery Right for Me?” Engage in this lively discussion to learn the ins and outs of cataracts; why we get them and treatment options. Refreshments provided. A short video of LIVE cataract surgery will be narrated and a FREE eye scan for attendees is available. This event is free, however, seating is limited. Please register by calling 309-589-1880.
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