To maintain optimal vision the eye must have a healthy tear film
layer. Without adequate tears, the eye dries out causing discomfort
and blurred vision. There are a number of conditions, both systemic
(total body) and ocular, that are
associated with the development of dry
eye. There are also a number of treatments available for
this potentially sight threatening condition.
The normal tear film is composed of three layers. A problem
with the production of any one of these layers will cause dry
eye symptoms. Before considering treatment options for dry eye,
we will review several of the more common
causes of dry eye.
Medications are a prime cause
of dry eye because they can affect your total body chemistry.
Antidepressants and allergy
medications may produce or worsen a dry eye condition.
If you develop the symptoms of dry eye, discuss your medications
and allergies with your physician. If they are a possible cause
and the symptoms are serious, together you might consider a change
in medications.
Dry eye can also be caused by systemic conditions like Sjogrens
Syndrome, Rheumatoid Arthritis
or Sarcoidosis. Women who have passed
through menopause are also susceptible
to dry eye problems as their tear production is known to decrease
with decreasing levels of estrogen. Improper closure of the eyelids
can contribute to dry eye by allowing more rapid evaporation of
the tear film. This can be a result of surgery on the lids or
trauma. Irritation of the eyelids, allergies,
certain home heating systems (forced hot air and wood stoves
are examples) and even air conditioners
can convert a mild dry eye into a symptomatic one.
Generally speaking, the first line of treatment for dry eye
involves the use of non-prescription (over-the-counter) artificial
tears. In some cases, non-preserved tears would be recommended
if, for instance, the patient had a sensitivity to preservatives
used in eye drops. These artificial tears come in a range of viscosity
(thickness). The thicker solutions last longer but tend to blur
the vision more and for longer time periods.
For patients in whom simple supplementation with artificial
tears is not enough to control the symptoms, blocking the tear
drainage system ("punctal occlusion") can be performed
by the eye doctor. This can be done with temporary, disolvable
plugs, removable silicon plugs that do not dissolve (but can fall
out) or permanently with surgical techniques.
Recently, a prescription strength drop to treat dry eye has
become available. Although not indicated for all cases of dry
eye (cost is a factor) it has shown great promise in the treatment
of moderate to severe dry eye sufferers. In addition to supplementing
the tear fluid, it acts as an anti-inflammatory agent, decreasing
irritation which causes drying and damage to the ocular surface.
Dry eye is a very common
condition with a wide range of severity. Contact lens use is particularly
dependent on a healthy and plentiful tear film layer. Dry eyes
can significantly complicate contact lens use and the clarity
of your vision with the lenses. Patients are encouraged to discuss
their dry eye concerns with their eye care professional.
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