Dry eye is a common and often chronic problem, affecting most patients. Normally, each blink spreads tears on surface of the eye. These tears provide lubrication, reduce the risk of eye infection, wash away allergens, and keep vision clear. People with dry eyes may experience irritated, gritty, scratchy or burning eyes; a feeling of something in their eyes; excess watering; and blurred vision. Other symptoms include redness, light sensitivity, watery eyes, mucus near the eye, and blurry vision.

There are two classifications of dry eye:

• Inadequate tears. Tears are produced by several glands in the eyelids. Age, some medical conditions, and the side effects of some medicines (such as birth control) can decrease tear production.
• Poor quality of tears. Tears have three components, or layers: oil, water, and mucus. A smooth oil layer helps prevent evaporation of the water layer. This type of dry eye is very common and we offer in-office treatments to help maintain proper function of the oil glands

Factors that increase the risk of dry eye symptoms include:

• Age — The majority of people over age 65 have some symptoms of dry eyes.
• Gender — Women are more likely to develop dry eyes due to hormonal changes. These can be linked to pregnancy, oral contraceptives, and menopause.
• Medications — Antihistamines, decongestants, blood pressure medications, and antidepressants can all cause dry eye symptoms.
• Medical conditions — Rheumatoid arthritis, diabetes, and thyroid problems can cause patients to develop dry eyes, as can problems with inflammation of the eyelids (blepharitis), inflammation of the surfaces of the eye, or the inward or outward turning of eyelids.
• Environmental conditions — These causes include exposure to smoke, wind, and dry climates and the failure to blink regularly (common during computer or screen time).
• Other factors — Long-term use of contact lenses can be a factor in the development of dry eyes. In addition, refractive eye surgeries like LASIK can decrease tear production and contribute to dry eyes.

Dry eyes can be diagnosed through a comprehensive eye examination. Testing with emphasis on the evaluation of the quantity and quality of tears produced by the eyes may include:

• Patient history to determine the patient’s symptoms and to note any general health problems, medications, or environmental factors that may be contributing to the dry eye problem.
• External examination of the eye, including lid structure and blink dynamics.
• Evaluation of the eyelids and cornea using bright light and magnification.
• Measurement of the quantity and quality of tears for any abnormalities. Special dyes may be put in the eyes to better observe tear flow and to highlight any changes to the outer surface of the eye caused by insufficient tears.

Treatments for dry eyes aim to restore or maintain the normal amount of tears in the eye so that the patient can more comfortable. Dry eyes can be a chronic condition, and treatments may differ for each person. Treatments may include:

• Adding tears — These can be used as often as needed to supplement natural tear production. 
• Conserving tears — This can be done by blocking the tear ducts through which the tears normally drain.
• Increasing tear production — Your doctor can prescribe eye drops that increase tear production.
• In-office restorative treatment of the eyelids — Treatments in our dedicated “spa-like” treatment room last 30 to 40 minutes and include cleaning of the eyelids and stimulation and expression of the oil glands of your eyelids. These treatments are all done while you get a relaxing massage in our massage chair.  

• Anti-inflammatory drugs — These eye drops control inflammation on the surface of your eyes (the cornea) using the immune-suppressing medication cyclosporine (Restasis) or corticosteroids.

• Eye Inserts — If artificial tears don’t help, another option may be a tiny eye insert. Once a day, you place a hydroxypropyl cellulose (Lacrisert) insert between your lower eyelid and your eyeball. It dissolves slowly, releasing a substance to lubricate your eye.

• Tear-stimulating drugs — Available as pills, gel, or eye drops, these medications help to increase tear production.

• Autologous blood serum drops — For severe dry eye that fails to respond to other treatments, these eyedrops are made with a sample of your blood. The blood is processed to remove the red blood cells and then mixed with a salt solution.

Dry Eye Procedures

• Punctal Plugs — These tiny silicone plugs plug tear ducts to reduce tear loss. By partially or completely closing your tear ducts, it can keep your tears from leaving your eye too quickly.

• LipiFlow Thermal Pulsation — This treatment helps to unblock oil glands. The LipiFlow device is placed over your eye and delivers a gentle, warm massage to the lower eyelid for about 15 minutes.

• Intense-Pulsed Therapy — This utilizes pulses of light to liquefy and release hardened oils that have clogged glands in the eyelids.

You don’t have to suffer from the symptoms of dry eye. Talk to your optometrist about dry eye treatment options designed to address the underlying cause of your condition.