Dry Eye

Dry eye is a common problem and can be caused by a lack of tear production or rapid evaporation. In medical terms, Dry Eye is lovingly known as “KERATOCONJUNCTIVITIS SICCA”. Dry eye occurs whenever there is decreased production of tears or increased evaporation or break-up of the tear film. The tear film, which constantly covers the eye, consists of 3 layers: A superficial lipid (oily) outer layer which decreases evaporation, a middle watery layer which contributes 90% of the tear film, and the Mucous inner layer which facilitates spreading of the tears over the cornea.

Dry eye can be caused by environmental factors such as the wind, sun, pollution, smoke, heaters, and air conditioning. Certain medications and vitamin A can also contribute to dry eyes reducing tear secretion. Diseases that may be associated with Dry Eyes include Rheumatoid Arthritis, Diabetes (especially when the blood sugar is up), Asthma, Thyroid disease (lower lid does not move when blinking), Lupus, and possibly Glaucoma. LASIK surgery can also be a cause, because the surgery temporarily disrupts the ocular surface/lacrimal gland unit and can cause dryness. This condition usually eventually clears up. Age (tear volume decreases as much as 60% by age 65) and hormonal changes for women can cause decreased tear production.

How is dry eye detected?

People with Dry Eye have sandy-gritty irritation or burning in their eyes. Initially people may have symptoms only after particularly long days, or when driving, or with contact lens wear, or when exposed to extremely dry environments such as that seen in airplane cabins.

Eventually symptoms become more consistent, and if someone has sandy-gritty irritation or burning that gets worse as the day goes on, and if they have had these symptoms for more than a few days, Dry Eye should be ruled out by an eye doctor.

How do you treat Dry Eyes?

Treatment for KCS involves 3 essential components:

  • Stimulation of tear production. Tear production is best stimulated by the topical administration to the eyes. Usually 4-6 weeks (sometimes longer) is required for tear production to improve. Usually treatment must be continued for life to maintain tear production, but it is possible in some cases to reduce usage. This is especially true if KCS is detected early before severe drying is present.
  • Control of ocular inflammation and infection through the topical application of an antibiotic-steroid preparation. Occasionally antibiotics may be given orally.
  • Tear replacement until return of normal tear secretion.

Can Watery Eyes be a symptom of Dry Eyes?

Yes. As odd as it sounds, many Dry Eye sufferers experience ‘wet eyes’ due to the tear glands overproducing watery or reflex tears to compensate for a lack of a balanced tear film.

Can dry eye syndrome come and go?

Dry Eye syndrome does not truly come and go, but in the early stages of the condition, or with mild Dry Eye, you may only have symptoms after long days, or with environmental conditions that decrease your blink rate (i.e. computer use) or under conditions that increase evaporation from your tear film (i.e. wind, dry air, etc.). Some patients may notice discomfort only when they wear their contact lenses.


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