One of the most common problems seen in the eye doctor’s office is dry eye syndrome. Symptoms include burning, stinging or a gritty sensation. The eyes may become red and irritated. Decreased tolerance of contact lens wear is common. Excessive tearing is common in dry eye. How can this be? This is because a person has two types of tearing. The main form of tearing is “baseline” tearing. This occurs naturally and continuously. A second form of tearing is called “reflex” tearing. Reflex tearing occurs during such events as cutting an onion, watching a sad movie or sustaining physical trauma. Irritation of the ocular surface caused by dry eye syndrome can lead to an increase in reflex tearing which cause the eyes to water!
There are many causes of dry eye syndrome. Medication such as antidepressants, antihistamines (for seasonal allergies) and cold medications can induce dry eye syndrome. Dry eye syndrome is also associated with systemic conditions such as arthritis and collagen-vascular diseases. Contact lens wear can exacerbate dry eyes. Also, dry eye syndrome is worse in the winter when many buildings are heated by forced hot air heat. Long periods of reading or staring at a computer screen can aggravate the symptoms of dry eyes due to decreased blink rate. For many people, the dryness is worse in the afternoon and the evenings. Environmental factors play a role as well. Cigarette smoke, fumes, dust and airborne particles are common irritants.
Treatment can improve symptoms in most patients. Dry eye syndrome cannot be cured but with proper diagnosis and treatment, the majority of patients can be helped.
Artificial tears which are available over-the-counter soothe the eyes and give temporary relief. The best tear drops seem to be Refresh®, Systane®, TheraTears® and Soothe®. These drops last roughly one hour per application and must be repeated at frequent intervals. Thicker formulations such as Refresh Celluvisc®, Refresh Liquigel®, Systane Gel Drops® or ointments last longer but they may blur vision. Ointments are most effective at night. The best ointments are Genteal Gel®, Systane Gel® or Refresh PM®. Preservative free preparations are gentler on the ocular surface and are preferred.
Omega-3 nutritional supplements dosed at 2000 mg daily can improve symptoms of dry eye syndrome and are highly recommended. We recommend Nordic Naturals Pro Omega 2000® taken orally. Nordic Naturals Algae Omega® is an alternative formulation ideal for vegans or those with fish allergies. These supplements are available for purchase at our front desk at a very competitive price. We also offer a $3 rebate for each empty bottle returned.
Punctal occlusion This involves blocking the opening of the tear duct drainage system with silicone or collagen “punctal plugs”. This drainage system normally carries tears away from the eye into the nose. Blocking this drainage of tears increases the tears available to the eye thus relieving most dry eye symptoms. This quick and painless procedure is performed in the eye doctor’s office.
Restasis® and Xiidra® are prescription drops approved by the FDA to treat dry eye syndrome. They may help increase the production of natural baseline tears but can take weeks to months to take effect.
In severe cases of dry eye syndrome, an amniotic membrane is extremely effective in repairing the surface of the affected eye(s). The amniotic membrane is placed on the affected eye in a simple, painless manner and covered by a bandage contact lens to promote healing. Amniotic membranes are made from human amniotic membrane that is donated by healthy, consenting mothers giving birth through scheduled C-sections. Donors are rigorously screened for various viral and infectious diseases. The amniotic membrane is obtained and processed according to standards and/or regulations established by the American Association of Tissue Banks (AATB) and U.S. Food and Drug Administration (FDA).
The TearCare® System uses application of localized heat therapy in adult patients with dry eye disease due to meibomian gland dysfunction (MGD) to aid in clearing the blocked glands. TearCare® is the world’s first and only wearable therapeutic eyelid technology providing a personalized open eye experience. This treatment allows the patient’s eyes to remain open and blinking during the procedure. Soft, flexible thermal devices are placed on the outer surface of the eyelids to deliver a therapeutic level of warmth for a specific period of time in order to liquefy meibum, an oily coating which prevents tear film from evaporating. Once the blockage is softened it can then be expressed by the doctor allowing the glands to function properly again.