Dry Eye is a common condition in which there are insufficient tears to lubricate and nourish the eye. There are two main branches of dry eye syndrome. One form of dry eye is secondary to lower overall tear production. The other form of dry eye syndrome is secondary to a poor quality tear film. A poor quality tear film does not spread evenly across the cornea and will break down and evaporate off of the cornea at a faster rate. Either form of dry eye is typically chronic in nature.
Dr. Dold will take a thorough history and will perform a comprehensive assesment of the front surfaces of your eyes to diagnose dry eyes. Tear quality tests allow the doctor to evaluate staining patterns on your corneas and evaporation time. A comprehensive eye exam combined with additional tear tests give an eye doctor a clear understanding of the stability of your tear film.
An imbalance in the tear system as well as the inability to produce tears causes dry eyes. Varying factors affect the tear system and may affect the risk of development.
Environmental Factors: Allergies, excessive wind, dry air, car and heating vents, perfumes, and smoking can contribute to dry eye syndrome.
Age: Tear production often diminishes with age, especially in postmenopausal women.
Medical Conditions: Diabetes, rheumatoid arthritis and other auto-immune conditions, Sjogren's syndrome and collagen vascular diseases have been linked to limiting tear production.
Eye Specific Factors: Laser surgery, tear gland damage and difficulty blinking can decrease tear production or inhibit the tear system, causing dry eyes.
Medications: Some medications used to treat high blood pressure and depression as well as certain antihistamines, decongestants and birth control have been known to cause dry eyes.
Diet: Diets high in Omega-6 and fatty acids are pro-inflammatory and can contribute to dry eyes. Drinking too much caffeine and too little water will contribute to dry eye symptoms.
Excess tears, light sensitivity, burning, itching, redness and the feeling of sand or gravel in your eyes are all common symptoms of dry eyes. Additionally, if you have difficulty wearing contacts because of discomfort or if your vision blurs intermittently with contact lens wear, you may have dry eyes.
Dry eyes cannot be cured, but there are various treatments available.
Artificial Tears
Artificial tears and ointments are available over-the-counter. This is the primary treatment for dry eyes and there are many options available. Not all artificial tears are the same; different formulations work to stabilize different layers of the tear film. Dr. Miller will evaluate you for dry eye syndrome and will make recommendations for the most effective artificial tear formulation.
Temporary Punctal Occlusion
A removable or dissolvable plug can be inserted into the drain for your tears, impeding tear outflow and increasing tear volume. Temporary punctal occlusion is generally used to determine if permanent punctual occlusion will be effective.
Permanent Punctal Occlusion
A semi-permanent plug can be inserted if signs and symptoms of dry eye syndrome are resolved with temporary punctal occlusion. The semi-permanent plug can be removed, but many patients report improved comfort and a reduced need for artificial tears with the plug in place. Often, it does not need to be removed.
Restasis
A medicated eye drop that increases your eye's ability to product tears.
Contacts
Severe dry eyes can be treated with special contact lenses that protect the surface of your eyes while trapping moisture inside.
Surgery
Permanent, surgical closure of the tear drainage duct opening .
Omega-3 (Fish-Oil)
Fish oil balances the pro-inflammatory Omega-6 to reduce inflammation and stabilize the tear film.
Dr. Dold will consider underlying causes of dry eye syndrome when she considers a treatment plan. For example, if a medication may be causing your dry eyes, your doctor may suggest switching to a different medication that doesn't have dry eyes as a side effect. Or, if your underlying cause is an eyelid condition or a different medical condition, you may be directed to see a specialist who can treat that condition specifically, eliminating your dry eyes simultaneously.
Your medical history, test results, causes and symptoms will all be evaluated by Dr. Dold to determine the best course of treatment for your specific case of dry eyes.