Dry eye syndrome, or keratoconjunctivitis sicca (KCS), refers to a group of disorders affecting the tear film resulting a decline in the quantity or the quality of tear production. Dry eye syndrome causes the eye to feel irritated, scratchy, burning, red and uncomfortable.
There are two types of tears produced by our eyes. Reflex tears are manufactured in large quantities in response to emotions (crying) or irritants (chemicals, foreign body). Reflex tears are very dilute, and contain mostly water. Moisture tears are produced throughout the day in small quantities to keep the surface of the eye from becoming dry. These tears contain a variety of substances that act as a barrier to infection, bring oxygen to the surface of the eye, and prevent rapid evaporation of the tear film.
Dry Eye Syndrome results from a deficiency of one ore more components of the Moisture tears. Causes include underlying diseases such as Rheumatoid Arthritis or Thyroid Disease, the natural aging process, menopause, and medications such as antihistamines. It can also occur after Laser Vision Correction (LASIK, PRK, etc.), but in this case the symptoms are usually temporary.
The most common symptoms are listed below.
Since many conditions may cause dry eyes, a complete eye examination is needed. There are also tests that can determine how quickly the tears break up and the quantity of tears being produced.
Proper treatment of Dry Eye Syndrome starts with the detection and treatment of any underlying conditions. Once this is accomplished, therapy is directed to the restoration of an adequate tear film. Treatment options include:
Artificial Tears: In many cases, the use of artificial tears eye drops provides adequate relief of symptoms. These drops are very gentle on the eye, and there is no limit on how many times a dry the drops can be used. Patients are instructed to use the artificial tears as often as is necessary to keep the eyes comfortable. The frequency of use will depend on the patient’s natural tear production, the temperature (moisture tears evaporate faster in hot, dry weather), and activity (eyes get drier with prolonged reading or computer use). Artificial tears are not a cure, and must be used indefinitely to control symptoms.
Nutritional Therapy: A combination of nutritional supplements (including vitamin A, Vitamin C, Cod Liver Oil, and alpha-omega free fatty acids) has been effective in stimulating increased Moisture tear production in about 80% of Dry Eye Syndrome patients. The supplements must be taken indefinitely, or the symptoms will recur.
Restasis: This is a relatively new eye drop medication that stimulates increased Moisture tear production. The drops are used two times a day, and also must be used indefinitely. It usually takes three to four months for the drops to take effect.
Punctal Plugs: On the inner corners of the upper and lower eyelids there are small holes that lead to the “drain pipes” that remove the tears from our eyes. It is possible to place small, flexible plugs in the holes, to block the normal flow of tears out of the eyes. This results in a thicker tear film. In many cases the plugs result in a “cure,” and patients achieve comfort without the use of eye drops or other medication. Insertion of the plugs is done in the examination room. The process is simple, painless and takes only about 60 seconds. The plugs can be left in place indefinitely. In the rare instance that the patient finds the plugs uncomfortable, they are easily removed.
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