Dry Eye Disease

If you ever have stinging, burning, gritty or sandy sensation, excessive tearing or itchy eyes, you may have symptoms of dry eye disease.

Dry eye disease is a condition where you don’t have enough tears or have poor quality tears to lubricate and nourish the eye. Tears maintain the health of the front surface of the eye and provide good vision. Dry eye disease is a common and often chronic problem, particularly in older adults. Advanced dry eyes may damage the front surface of the eye and impair vision.

The front surface of the eye is called the cornea. With each blink of the eyelids, tears are spread across the front surface of the eye. Tears are produced by several glands in and around the eyes. The tear film is composed of nutrients, electrolytes, proteins and lubricants. Tears provide lubrication, reduce the risk of eye infection, clear the eye of foreign matter, and keep the surface of the eyes intact and clear. Tears drain from the eyes into small drainage ducts called puncta in the corners of the eyelids, which drain in the back of the nose.

Courtesy of Clearly Ambiguous on Flickr

Courtesy of Clearly Ambiguous on Flickr

If there are any irregularities in the tear film, symptoms of dry eye may manifest. Dry eye disease may limit daily activities including reading, driving, working on the computer or wearing contact lenses.

Many different factors cause dry eye. These are some of the most common:

1) Hormones: Dry eye disease is more common in people 50 years old or older. Hormonal changes that are common in women experiencing menopause can cause dry eye.

2) Systemic diseases: Other systemic diseases including diabetes, glaucoma, Sjogren’s syndrome, lupus and rheumatoid arthritis can exacerbate the symptoms of dry eye.

3) Medications: Medications including antihistamines, hormonal replacement therapy and androgen therapy may contribute to dry eyes.

4) The environment: Environmental factors such as pollen or allergies, working on the computer or contact lens wear can make dry eyes worse.

Dry eye disease is diagnosed by patient history. In diagnosing dry eye disease, your doctor of optometry will evaluate the symptoms, general health problems, medications or environmental factors that contribute to dry eye disease. Your doctor will perform an external examination of the eyes including the eyelid structure and blink dynamics. Your doctor will evaluate the eyelids, cornea and conjunctiva is performed using bright light and magnification. Measurement of the quantity and quality of tears is assessed for any abnormalities. From this information, your doctor of optometry can determine if you have dry eyes and advise you on treatment options.

Treatments for dry eyes include:

  • over the counter artificial tears,
  • punctal plugs (small plastic pieces that close the ducts that drain tears out of the eyes),
  • eyelid hygiene,
  • dietary supplementation,
  • or a prescription eyedrop called Restasis (cyclosporine 0.05%).

If you experience any of theses symptoms, contact your doctor of optometry and ask for a dry eye evaluation.

~ Melissa Barnett, OD, FAAO

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