Dry Eye Overview

Dry eye is a very common problem that millions of Americans suffer with each day.

Dry eye is a very common problem that millions of Americans suffer with each day.

There are two main causes for dry eye:

1. decreased secretion of tears by the lacrimal (tear-producing) glands
2. and loss of tears due to excess evaporation

Both of the above causes can lead to ocular surface discomfort that is often described as feelings of dryness, burning, a sandy/gritty sensation, or itchiness.  Other characteristics of dry eye include:

• visual fatigue
• sensitivity to light
• blurred vision

Tears that are normal and healthy contain a mixture of proteins and other components essential for ocular health and eye comfort.

Why are tears so important?

• They provide nutrients and support the health of cells in the cornea
• Tears lubricate the ocular surface
• They protect the exposed surface of the eye from infections
• Clear vision depends on an even distribution of tears over the ocular surface

Inflammation of tear-secreting glands reduces tear production that results in chronic dry eye which could also be indicative of Sjogren’s syndrome.

How can you know if you have dry eye or Sjogren’s syndrome?

• Examination by an eye doctor trained to diagnose and treat ocular diseases is essential for proper diagnosis.

Are there different treatments available for dry eye and the Sjorgren’s syndrome?

• The treatment options for dry eye symptoms depend on the causes and severity
• The doctor may use tests to assess tear production, tear stability and tear distribution
• A slit-lamp exam using dyes that temporarily stain unhealthy tissue will reveal any abnormality or damage to the ocular surface
• The tests usually cause little discomfort and are done in the doctor’s office

Treatment for dry eye disease may include:

• Artificial tears available over the counter that provides temporary relief from dry eye symptoms
• People who use drops frequently should choose a brand without preservatives or one with special non-irritating preservatives
• Artificial tears are used for mild forms of dry eye or to supplement other treatments
• Punctal occlusion: blocks the small openings in the eyelid that normally drains tears away from the eye.  This is usually done by inserting plugs made of silicone or other materials into the openings.  It is a simple procedure that helps retain the patient’s tears on the ocular surface for a longer time.  This treatment can improve symptoms and increase comfort for some people.
• Cyclosporine ophthalmic emulsion (Restasis®) treats an underlying cause of chronic dry eye by suppressing the inflammation that disrupts tear secretion.  Continued use usually results in increased tear production and comfort.
• Topically applied corticosteroids (cortisone):  To avoid potential complications of glaucoma and cataract, the frequency and duration of these medications should be limited.  The medicines are prescribed to treat acute episodes of inflammation in dry eye.

Other treatment options include:

• Cevimeline (Evoxac®) and pilocarpine (Salagen ®):  These are medications taken orally to increase salivation in Sjogren’s syndrome patients.  Studies have shown some improvement in dry eye symptoms.  The medications are approved for treating dry mouth.  Treatment for dry eye is considered an off-label use.

Treatment for excess evaporation of the tearfilm that can occur when there is irritation of the eyelids (known as blepharitis or meibomain eyelid gland dysfunction) includes:

• Maintaining eyelid hygiene by using warm compresses and eyelid massage
• Infections of the eyelid margin should be treated with appropriate antibiotics

Allergy and certain skin disorders like “rosacea” can aggravate dry eye and should be treated appropriately.

Accumulating evidence suggests that taking essential fatty acid supplements (Omega 3) by mouth may improve dry eye symptoms and signs.  Fatty acids such as flaxseed oil and fish oil supplements are available.

Ways of coping with dry eye include:

• Avoid environmental stress that worsen dry eye like low humidity, drafts from air conditioners or fans, smoke, dust, or excessive makeup
• When possible, you should avoid taking drugs that cause dryness as a side effect.  Drugs include those used for high blood pressure, antidepressants and antihistamines.  There are other drugs also that may decrease tear secretion and worsen dry eye.  Your ophthalmologist can help determine if any drugs you take are contributing to your dry eye condition.
• Blink on purpose or take short breaks with your eyes closed when reading or working at a computer.  These are activities in which most people tend to blink less, potentially aggravating dry eye.
• Use specially-formulated ophthalmic gels or ointments at bedtime especially to help keep eyes moist overnight.  Also, use artificial tears before bedtime and in the morning
• Apply warm compresses on the eyes after waking in the morning and periodically during the day
• Keep your eyes lubricated throughout the day, even if you don’t have dryness symptoms

Source:  Sjogren’s syndrome Foundation

Disclaimer:  These statements have not been evaluated by the Food and Drug Administration.  The information in this article is not intended to diagnose, treat, cure or prevent any disease.  All health concerns should be addressed by a qualified health care professional.

Author:  Connie Limon.  Visit http://smalldogs2.com/NutritionHealthHub  and sign up for a weekly nutrition and health tip.  The article collection is available as FREE reprints for your newsletters, websites or blog.  For a variety of FREE reprint articles on various topics rarely seen elsewhere visit http://www.camelotarticles.com

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