Dry eye syndrome is a common disease in which the eye under-produces or poorly produces tears, or tears leave the eye too quickly. The tear film consists of three different layers: a lipid layer, an aqueous layer and a mucous layer. A normal functioning eye constantly produces this tri-layer tear film, which acts as moisturizer and lubricant. For someone with dry eye, the resulting lack of moisture and lubrication can cause a variety of problems.
Dry eye symptoms may include:
- A burning, stinging, or scratchy sensation in the eyes
- Eye redness
- Stringy mucus in or around the eyes
- Difficulty with contact lens wear
- Blurred vision or eye fatigue
- Watery eyes, which is the body’s response to the irritation of dry eyes
Dry eye syndrome can occur for many reasons. A common cause can be the use of over-the-counter and prescription medications such as antihistamines, beta-blockers, sleeping pills, pain relievers and many others. Overuse of diuretics can also play a role in developing dry eye. For this reason, it is very important to inform your ophthalmologist about any medications you are taking, which can help diagnose the disease. Certain systemic diseases may also contribute to the development of dry eyes as well as conditions affecting the ocular surface or the eyelids. In addition, tear production often slows down as people get older. This is particularly common for women after menopause. Sometimes the cause is unknown.
Treatments for dry eye:
- Controlling one’s environment — Patients should avoid situations in which tears evaporate quickly; for example, by using a humidifier in a dry house, wearing wrap-around glasses in the wind, and not smoking.
- Artificial tears — Mild to moderate cases of dry eye syndrome may be treated by applying artificial tear eye drops as little or as often as necessary. There are a wide range of products available without a prescription that the doctor can recommend.
- Eyedrops to control corneal inflammation — Certain prescription eyedrops that contain immune-suppressing medications, such as cyclosporine and lifitegrast can help increase tear production for those with chronic dry eye by targeting inflammation in the eye. Topical corticosteroids may also be used to decrease corneal inflammation, but are not ideal for long-term use due to possible side effects, such as increased intraocular pressure or cataracts.
- Supplements — Several studies have shown that Omega-3 fatty acids are beneficial in treating dry eye. Gamma Linolenic acid (GLA) contained in evening primrose oil, blackcurrant seed oil, borage seed oil, has similarly been shown to help patients suffering from dry eye.
Technology to treat dry eye: There are several procedures available for the treatment of dry eyes. Dry eyes caused by blocked oil glands may be helped with a treatment called LipiFlow thermal pulsation, which delivers a gentle warm massage to the eyelids. In more advanced cases, a technique called intense-pulsed light therapy (IPL), followed by massage of the eyelids can be performed.
Conserving tears: An effective way to make better use of the tears in the eye is surgery to close the tear ducts, thus preventing existing tears from leaving the eye as quickly. This may be done temporarily, with punctal plugs made of collagen, or more permanently with silicone plugs or by cauterizing the tear ducts closed.
Intense Pulsed light therapy (IPL): IPL can be very beneficial in patients experiencing dry eye from inflammatory conditions such as rosacea. This treatment is being done to help get some symptom relief and is usually done once a month for four months best results. Improvement can usually last from 6 up to 12 months. A single maintenance treatment can be done as needed afterwards. During a treatment which lasts about 10 minutes, the patient’s eyes are shielded and gel is applied to the treatment area on the patient’s cheekbone from ear to ear (under the eyes and across the nose). The IPL handpiece is placed on the skin and activated with a short flash of light. Patient may feel a momentary warming and slight discomfort to the skin. The tip of the IPL is cooled making the procedure more comfortable. There is no downtime. For some patients, the skin could be slightly red immediately post treatment. Any redness will usually dissipate within an hour or less.
After the treatment, the patient will have their meibomian glands (oil glands lining the lids) expressed at the slit lamp. For this the eye is numbed and pressure is applied to both sides of the lid. You can resume normal activity immediately. Moisturizer, sun block, mascara, etc. can be applied post treatment.
