Dry Eyes And Their Treatments

Dry Eyes and Their Treatments

Dry eyes are enormously common in the US, and it is believed to be the source of most complaints in eye doctor’s offices. While there are very few studies that have been conducted on this condition, many eye symptoms are thought to actually be based on a dry eye disorder. Symptoms may vary from mild to severe, and many patients may not even seek medical help. Most believe that the Over The Counter treatments are as good as it gets. Not so!! In addition, many doctors, and patients frequently concentrate on therapies that are totally unrelated to Dry Eye Syndrome.

Dry eye syndrome, also known as Dysfunctional Tear Syndrome is a combination of several events leading to the burning, sandy symptoms that make an individual unhappy. Left untreated, in some cases, serious corneal and scleral disorders can occur. The mechanism of dry eye syndrome is a culmination of inflammation of the tear, or Lacrimal gland, immune T-cell activation, Cytokine activation. This cascade of effects leads to tear poor tear coverage of the cornea and ocular surface damage.

Normal tear film includes 3 very important layers which include the Lipid, Aqueous, and Mucin layers. These layers must all be in careful balance. Disruption of any one of them results in poor corneal coverage, and symptomatic conditions. The most important of these layers is the Mucin layer. Many dry eye causes result because of a decrease in the mucin component. Soluble mucin is secreted by the Goblet cells, and many dry eye patients have damage to these Goblets which cause the dry eye. Refractive surgery is well documented to damage the Goblets and thus causing dry eyes post surgically.

Chronic dry eyes often have a decrease in tear proteins, growth factors, and soluble mucin. This results in an ocular surface compromise, discomfort and an eye doctor visit. Symptoms often include redness, burning, sandy feeling and ultimately decreased vision. This condition often increases with age as do most disorders, but may be made worse by underlying medical conditions such as high blood pressure and diabetes.

Testing for dry eyes frequently includes a Schirmer’s test, Tear Break up Time, Topography, Fluorescein clearance, Phenol Red Cotton Thread, Rose Bengal and/or Lissamine Green tests. Most doctors will not do all of these tests, but will employ at least several of them to make a proper diagnosis.

Treatment includes artificial tears, at first to replace the lost or poor quality tears. If that does not alleviate the symptoms, then a topical steroid like Lotemax is prescribed for at least 2-3 weeks. This medication reduces the swelling in the tear producing mechanism of the eye, and is an adjunct to artificial tears. In addition, most eye doctors will also suggest that the patient take an Omega III supplement to help increase the tear production. In severe situations Doxycycline, an antibiotic is employed to reduce lid inflammation and help increase tear production as well. Finally, Cyclosporine( Restasis) is prescribed to further increase the tear volume.

Some of the future possible treatments include Mucin stimulators, Hormonal therapy, and modified vitamin therapy. Dry eyes are a very common condition seen in eye doctors’ offices today. Proper care and therapy of these patients will eliminate future conditions, and will substantially reduce many of the pathological conditions that we often see in patients with long standing symptoms. See your eye doctor if you have any of these symptoms because early treatment is the best way to prevent future problems.

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