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Dry eyes

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Dry eye syndrome is a common cause of eye irritation. Tears reduce the risk of eye infection and, with each blink of the eyelids, help clear your eyes of any debris.




Effective treatment begins with a careful examination to determine which factors may be causing your symptoms. The goal of treatment is to keep your eyes moist. This can be done in a couple of ways:

  • Adding tears. You can usually treat a mild case of dry eyes with over-the-counter artificial tears. Your doctor or eye doctor can suggest what drops might be best for you. You can use the lubricating drops as often as you need, even several times an hour, to provide relief. Using drops proactively, before you begin an activity that tends to aggravate your symptoms, also helps. If you use drops frequently, preservative-free eyedrops might be the best choice to avoid an allergic or toxic reaction to preservatives. People with dry eyes are often more prone to irritation from the preservatives in eyedrops. You can also use ointments to ensure lubrication. These ointments can blur vision, so it's best to use them only at bedtime.

  • Conserving tears. Your eye doctor may also suggest methods to keep your natural tears around longer. This can be done by partially or completely closing your tear ducts, which normally serve to drain tears away. The tear ducts can be plugged with tiny silicone plugs. The closure conserves both your own tears and artificial tears you may have added. Silicone plugs can be removed or left in. A more permanent option is thermal cautery. In this procedure the doctor numbs the area with an anesthetic and then applies a hot wire that shrinks the tissues of the drainage area and causes scarring, which closes the tear duct.

People with mild dry eyes respond well to treatment with artificial tears. People with severe dry eyes require more aggressive treatment, such as the silicone plugs. If you have an eyelid condition such as an anatomic abnormality or an incomplete blink that aggravates your dry eyes, your doctor may refer you to a plastic surgeon who specializes in eyes (oculoplastic surgeon) for treatment. People with severe dry eyes may benefit from a special customized contact lens (Boston Scleral Lens). This lens rests on the white part of the eye (sclera), creating a fluid-filled layer over the cornea that keeps it from drying out.

Some people have persistent symptoms and don't respond to artificial tears alone even though their eyes appear fairly normal. This is because the sensory nerves in the cornea are densely packed, so that even small amounts of tear dysfunction can cause irritation.

It's possible that more than one variable may be contributing to your symptoms. Together with your doctor, you can devise a plan to address the factors that appear to be contributing to the problem. This process often takes time and requires patience and a trusting relationship with your doctor.

When dry eyes don't respond to artificial tears alone, some people may worry that they have an autoimmune disease such as Sjogren's syndrome. While many people with autoimmune disease have dry eyes, the large majority of people with dry eyes don't have autoimmune problems.

Dry eyes caused by problems with the meibomian glands and blepharitis generally respond to treatment with an antibiotic such as tetracycline (Sumycin).

The underlying cause of dry eyes may be an inflammation both in the lacrimal glands and on the surface of the eyes. When the eye is quite irritated from dry eyes, it can overstimulate the nerve fibers that travel from the eye to the lacrimal gland. That overstimulation causes lacrimal gland inflammation, which in turn reduces tear formation even further. Anti-inflammatory medication to the eye can dampen this cycle by reducing eye inflammation. When people experience intolerable irritation from dry eyes despite the frequent use of lubricating eyedrops, doctors may prescribe steroid drops.

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
In no event will The DrEddyClinic.com be liable for any decision made or action taken in reliance upon the information provided through this web site.



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