Dry eye is not a single entity, but rather is the name for a group of conditions which affect the quality and quantity of tears, and how they coat the surface of the eye. The tear film coating the eye is the first surface that light hits when it enters our eye. Hence, dry eyes not only may cause discomfort but may also affect the quality of our vision. The tear film also is what a contact lens rests on, so dryness can affect the ability to wear lenses comfortably.
The production, quality, and stickiness of tears are all factors in dry eye, and a complex biologic system is involved, which is not completely understood.
Nevertheless, it is convenient to divide dry eye patients into mild, moderate, and severe. Mild cases are episodic, in certain situations where the eyes are stressed, but not most of the time. "Moderate" means that the condition occurs frequently and impacts the lifestyle. Severe is a constant, debilitating form which can be a severe handicap and reduce visual acuity as well.
There are many causes for dry eye. These include dysfunction of tear producing glands, excessive drainage, ocular surface infections, thyroid disease, autoimmune diseases, environmental stress, contact lens overwear, and just aging itself.
Artificial tear drops of various types are used for most dry eye patients either as the only treatment or as an adjunctive treatment. Some are just lubricants, some help tears adhere better to the eye, and some try and improve the ocular health.
Prescription drops: There are now several prescription drops available that target inflammatory causes of Dry Eye. Others are in the pipeline. These include RESTASIS, XIIDRA, and CEQUA. These are all designed to augment tear production by reducing ocular surface inflammation. They may be used as sole or adjunctive therapy and are most useful in moderate to severe cases. These substances often take weeks to months to cause noticeable benefits.
Tear Plugs: Plugs are tiny silicone or polymeric "stoppers" placed into the tiny holes in our eyelids that serve to drain tears away from the eyes. Placing these plugs is like putting a stopper in your sink. It is a brief, painless office procedure. The plug prevents tears from draining away from the eye, thus creating additional lubrication with your natural tears. Plugs come in two forms: dissolvable and non-dissolvable. Dissolvable plugs occasionally need to be replaced, but are incredibly comfortable and have no side effects. Usually, non-dissolvables do not need replacement, but on occasion, they may extrude or cause inflammation.
Omega-3 fatty acids (fish oils) help to stabilize the tear film. We can guide you to the best type to take for dry eye.
These include identifying any eyelid gland infections and causative systemic conditions and treating them, therapeutic heat, humidifiers, and reducing contact lens wear.
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