PROCEDURE

Dry Eye Syndrome

What is Dry Eye Syndrome?

There are multiple causative factors involved in the etiology and progression of the inflammation of the eye, eye lids, and the tear-producing glands. This chronic, progressive, inflammatory process can decrease the eye’s ability to produce normal tears, mucus, and oils needed to protect the surface of the eye to keep it moist and lubricated. If the tears are not smoothly coating the cornea, the vision is blurry and may have excess tearing due to the dry eye feelings.

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Symptoms of Dry Eye Syndrome

  • Eyes that are tired and red-both the eye ball and eye lid margins
  • Eyes that are constantly tearing up
  • Eyes that feel gritty especially when awaking or after extensive reading or computer work
  • Eyes with variable vision associated with above symptoms
  • Eyes with variable sensitivity to light
  • Eyes sensitive to air conditioning and wind
  • Eyes where above symptoms are temporarily relieved by using artificial tears

Healthy Eye

healthy-eye

Dry Eye

dry-eye

Common causes of Dry Eye Syndrome include:

Hormonal changes such as menopause, hypothyroidism
Autoimmune diseases such as rheumatoid arthritis, Lupus, Rosacea, Sjogrens Syndrome
Medications (both prescriptions and non-prescriptions) especially diuretics, vasoconstricting drops such as Visine,
and Murine, antihistamines -both drops and pills, allergy medications, etc.—check the labels
Environmental factors such as prolonged computer usage, long hours of reading, smoke, and dust environments, air conditioning drafts and ceiling fans—especially while sleeping at night, dry environments such as airlines, kitchen cooking ovens
Pregnancy
Contact lens—especially if cleaning solutions are used daily or contacts are continuously worn. Using daily wear contacts are less likely to induce reaction. Using preservative free artificial tears and hydrogen peroxide cleaners frequently helps.
Poor or inadequate facial/lid/ocular hygiene, using “non-antibacterial soaps” such as Dove, Ivory, Neutrogena or “water only” on the face causing the meibomian glands that make the oil to be chronically infected, inflamed, and blocked.
Anatomical changes around the eye as a result of eye lid surgery, droopy or mal-positioned lids, inability to close eye or blink properly (either anatomical or neurologic etiology)

Treating Dry Eye Syndrome

Cross Eye Centers have two large studies that show 96% of dry eye patients with non-hormonal or anatomical etiologies use non antibacterial soaps on the face or 12% never ever use anything on face but water. This causes the meibomian glands to be chronically inflamed, infected and hence blocks the production of the oil and mucus needed to help prevent evaporation of the tear film. Treatment includes using antibacterial soaps (Dial, Safeguard, Irish Spring, Zest, Coast, and Lever 2000) three times a week on the face while showering. Commercial lids scrubs once a day, artificial tears especially preservative free and/or containing oil emulsions- especially if patient reads a lot or is a heavy computer user.

eye-drop

More treatments include:

  • Omega-3 either fish oil or Flax seed daily will help body make more and thinner oil for the eye. Generally, 2,000 mg a day is used for 4 to 6 months. Then the dose is 1000 or 1200 mg/day thereafter
  • Antibiotic drops with or without steroids helps quiet the eye lid inflammation and /or infections
  • Routine usage of new generation artificial tears with water, mucus and oil all together multiple times a day and beside the computer if that is your job is important
  • Application of ophthalmic ointment at bedtime, either prescribed or over the counter such as Refresh PM, is strongly recommended, especially if you use a C-Pap breathing machine or insist on sleeping with the ceiling fan on
  • Evaluate and possible change any drops put in eyes, especially those used for contacts and allergy
  • Consider surgical repair of abnormal lid structures/positions
  • Evaluations and laboratory testing by personal physician if auto immune causes are suspected. Also review with them all your medications to see if they are part of the problem and if they could be changed or modified
  • Low dose oral tetracycline (Doxycycline, Minocycline) for 2 to 6 months frequently helps decrease lid infections, decrease the oil viscosity, and also have anti-inflammatory effect.
  • Restasis (topical cyclosporine ophthalmic emulsion 0.05%)) twice a day blocks the body’s anti-inflammatory response and sometimes is the only drug to provide long term care. Patients will not notice much improvement for about 3 weeks