WHAT IS DRY EYE? HOW IS IT TREATED?
Normally, the eye produces a constant level of tears from the eye’s surface and lids. By doing this, the eye is continually bathed in fresh tears to keep the eye’s surface moist and comfortable.
WHAT ARE THE SYMPTOMS OF DRY EYE?
The usual symptoms include:
- Scratchiness, stinging, or burning eyes
- Stringy mucus in or around the eyes
- Early morning mattering and blurred vision
- Excessive eye irritation and tearing from wind or smoke
- Excessive tearing, especially while reading
- Discomfort while wearing contact lenses
Excess tearing from a “dry eye” may sound illogical, but can be understood as the eye’s response to discomfort. The eyes surface becomes rough and irritated, much like dry skin, prompting the lacrimal gland (responsible for the watery tears) to secrete an excessive amount of diluted tears onto the surface of the eye. The increased level of tears may overwhelm the eye’s tear drainage system resulting in an overflow of tears onto the cheek.
WHAT IS THE TEAR FILM?
The tear film consists of three layers that are all crucial for vision and comfort:
- An oily layer
- A watery layer
- A mucus layer
The oily layer is formed by the tear glands of the eyelids called meibomian glands. This is the outer most layer of the tear film, which responsible for preventing the evaporation and lubrication of ocular surfaces. The middle portion is a watery layer produced by the lacrimal and accessory tear glands. This layer represents the bulk of the tear film that is responsible for removing foreign particles and cleansing the eye. The inner most layer is the mucus layer produced by the skin of the eye. This layer allows the tears to coat surface of the eye uniformly and smoothly. Without the mucus layer the tear film would not adhere to the eye’s surface.
HOW IS DRY EYE TREATED?
Dry eye many times is a chronic condition, but with the appropriate lid hygiene and artificial lubrication it can be controlled or even reversed. The following treatment strategy has been customized for you and your needs. For the best results please follow the guide lines below.
- Warm compresses: Wet a clean washcloth with warm to hot water, wring it out, and place it over your closed eyelids for at least 5-10 minutes. This step may need to be repeated several times to complete the full 5-10 minutes period. (A better method is to create a rice sock. To create this, use a retired pair of pantyhose or a sock and fill it with 1-2 cups of rice. Tie the open end off and place the rice sock into the microwave to warm it up – 10 to20 seconds at first.) The warmth allows the scales and debris around your eyelashes to be loosened. Heat also helps to melt oily plugs blocking the nearby meibomian (oil) glands of the eye lids decreasing the risk of stye development. Once freed, the oily tears can now be released to lubricate and protect the eyes and lids.
Do this at least two times per day for both eyes for one month then once a day thereafter.
- Eyelid scrubs: Using a clean washcloth, cotton ball, finger, or lint-free pad soaked in a mixture of warm water and baby shampoo, gently scrub the base of your eyelashes (eyes closed) for about 5 – 10 seconds per side. Pre-moistened pads are also available.
Do this following every application of the warm compresses.
- Artificial lubrication ( drops ): It is important to maintain sufficient eye lubrication by using the appropriate artificial tears suggested by your ophthalmologist. It’s best to apply these tears multiple times a day to achieve the best results and sufficient eye protection. Non-preserved tears may be recommended.
- Artificial lubrication (gel or ointment ): It is also important to maintain sufficient eye lubrication at bedtime. This will allow the eyes to feel more refreshed in the morning. It may also be needed during the day as well for more severe dry eye cases.
- Steroid drops: You may also be advised to use a short course of a topical steroid eye drop to help reduce the amount of inflammation present. This may help speed up your recovery. The drop may be used in coordination with Restasis for a short period of time. Follow the instructions of the marked box only.
- Restasis: In some instances, dry eyes may be the result of an insufficient level of tear production necessitating the need this prescription medication. Restasis has been found to increase the eye’s natural ability to produce more tears. Some side effects include burning or itching. The best way to avoid the occasional burning is to chill the tears in the refrigerator. Though the affects of the drop begins during the first month, the full affect may not be achieved for as many as 6 months.
- Helpful supplements: It has been recently shown that flaxseed oil and other omega-3 fatty acids help to maintain a robust and stable tear film. These supplements have great anti-inflammatory and anti-oxidant properties. Vitamin A should be taken at the recommended levels separately or in a multivitamin.
*Flaxseed oil dose: 1000 mg AM and 1000 mg PM