dry eye by keralaguest


									                       A FOCUS ON DRY EYE
DRY EYE AT A GLANCE                            Tears are made up of three layers: an
   ▪ Affects over 10 million Americans       inner mucous layer that allows tears to
   ▪ Most commonly caused by aging           stick to the eye; a middle watery layer
   ▪ Often only a disease of discomfort,     that provides the eye with oxygen; and
     but can lead to serious complica-       an outer oily layer that helps to keep
     tions if untreated                      tears from evaporating. Dry eye can be
                                             caused by an imbalance in this tear
DRY EYE DEFINED                              system, as tears with an improper
   Dry eye syndrome is broadly               make-up evaporate more quickly.
characterized as a disease of decreased          The lacrimal gland is a structure
tear production or increased tear            located above the eye that produces
evaporation.     Specifically, dry eye       tears throughout the day. If this gland
syndrome is defined as “dryness of the       is injured in any way, the amount of
cornea and conjunctiva,” structures          tears produced will decrease. Many
which make up the outermost layer of         times, people simply do not produce
the eye.                                     enough tears to keep the eyes moist,
                                             and the reasons for this are unknown.
SYMPTOMS OF DRY EYE                              Dry air is another major cause of dry
   ▪ Dryness           ▪ Itching             eye syndrome.        This is often seen
   ▪ Redness           ▪ Blurred vision      during long car or airplane rides, as
   ▪ Pain              ▪ Light sensitivity   well as in the winter months, when
   ▪ Feeling of        ▪ Feeling of          central heating systems are used to
     “grain of sand”    pressure behind      warm houses and buildings.
     in eye             eye                      Some diseases can lead to dry eye,
   ▪ Increased tears                         such as Sjögren’s syndrome (in which
                                             the body’s immune system attacks
   Why would dry eye cause increased         moisture-producing glands) and vitamin
tears? The body makes two types of           A deficiency.      Common medications
tears: lubricating (which moisturize the     that can cause dry eye include diuretics
eye) and reflex tears. Reflex tears do       (known as “fluid pills”), antihistamines
not moisturize the eye but are simply        (like Benadryl), and birth control pills.
the eye’s response to inflammation.              Finally, contact lenses are a chief
                                             cause of dry eye in many patients. In
                                             fact, nearly half of all contact lens
CAUSES OF DRY EYE                            wearers complain of dry eye! Soft
    Dry eye can result from the normal       contact lenses tend to absorb tears on
aging process. As our bodies get older,      the surface of the eye, while contact
the amount of oil they produce               lens solutions may contain additives
decreases. A 65-year-old produces 60%        that induce tear breakdown.
less oil than an 18-year old. Because
testosterone increases oil production,       DIAGNOSING DRY EYE
women tend to have drier skin than              For most patients, the diagnosis of
men. Women often see dry eye appear          dry eye is made by their doctor based
during menopause.                            upon their symptoms alone. However,
there are tests that may be performed       Artificial tears are the most common of
to evaluate the quantity and quality of     these treatment options, serving as a
tears.                                      protective barrier for eye surfaces and
   With Schirmer’s test, a small slip of    providing moisture to reduce irritation
paper is placed over the surface of the     and dry eye. Artificial tears should not
eye and used to measure the amount of       be used for more than three days
moisture produced by the eye in five        without a physician’s approval. Brands
minutes. The tear breakup time test         of artificial tears on the market today
uses fluorescent drops to gauge how         include GenTeal Lubricant Eye Drops®,
long it takes for tears to disintegrate.    Refresh Tears®, and Visine Tears®.
A third test, the tear protein analysis         Ocular emollients are another non-
test, analyzes the protein content of       prescription option for dry eye. These
tears to ensure the three layers that       products help to soften eye tissues.
make up the tears are in balance.           Because they can cause blurred vision,
                                            ocular emollients are typically only
TREATING DRY EYE                            used at night. Ocular emollients sold
    The first step in treating dry eye is   today include Bausch & Lomb Moisture
to make certain there exist no under-       Eyes PM® and Tears Naturale P.M.®
lying conditions that could be causing          Finally, patients with dry eye should
the dry eye. Only a doctor is qualified     be sure to take in enough omega-3 and
to provide the thorough physical            omega-6 fatty acids, as these can
evaluation needed to rule out any           improve dry eye symptoms.             It is
potential serious causative factors.        important that the recommended daily
    Once a physician has determined         allowance for these two supplements is
that a patient’s dry eye syndrome is        not exceeded (no more than 0.65 grams
not related to any other physical           for omega-3 fatty acids and no more
conditions, he may instruct the patient     than 4.44 grams of omega-6 fatty
to consider making changes to their         acids), as excessive doses may harm
environments that could alleviate their     the eye.
dry eye symptoms. The patient should            The only prescription option for
strive to avoid situations and causes       long-term treatment of chronic dry eye
that may exacerbate their condition,        is       Restasis®     (generic       name
such as staring at a television or          Cyclosporine.) Restasis suppresses eye
computer screen for too long. Wearing       inflammation caused by the body’s
sunglasses when outdoors reduces the        immune system. Patients using other
eyes’ exposure to dust, wind, and sun.      eye drops should wait ten minutes after
In addition, every patient with dry eye     using those eye drops before using
should drink plenty of water each day       Restasis; patients with contact lenses
to keep their bodies adequately             should wait fifteen minutes after
hydrated (though patients who have          instilling Restasis to put in their lenses.
been told to watch the amount of            Common side effects associated with
water they consume should discuss           Restasis include blurred vision, burning
increasing their water intake with their    and stinging of the eye, and excessive
doctor).                                    tearing. In most patients, Restasis is
    Several over-the-counter options        well tolerated, and these side effects
exist to help treat dry eye syndrome.       resolve within six to eight weeks.
   Prescription steroid eye drops can      contact your doctor for a thorough
be used on a short-term basis (i.e., for   physical evaluation if you suffer from
a matter of days) to help “jumpstart”      dry eye, as the condition may be the
the body’s natural ability to produce      result of some other disease or a
tears   and    reduce     inflammation.    medication you are taking. Remember,
Steroid eye drops are not approved for     dry eye is often successfully treated.
long-term treatment of dry eye             You can get relief!
   For patients who have tried the
above treatment options without
success, there are a few medical
procedures that may still be performed
to help with dry eye. “Punctal plugs”
serve to block the drainage of tears
from the eyes to the nasal cavity by
plugging the puncti—or tubes—that
connect the eyes to the nose.

    For the most severe and extreme
cases of dry eye, surgery may be
performed.      The puncti may be
permanently sealed, blocking the flow
of tears from the eyes to the nose. The
eyelids may also be partially sewn
together, decreasing the amount of
tears that evaporate. Again, both of
these options are reserved as last-line
treatments for dry eye syndrome.

    Most people with dry eye syndrome
will not experience any long-term
complications from the disease. In
certain    cases,      however, serious
problems may arise if the disease is not
adequately        treated.        These
complications include eye infection,
eye inflammation, scarring on the
surface of the eye, and, in the worst
cases, loss of vision.

   For most people, dry eye is a
benign—though    bothersome—disease.
Nevertheless, it is always wise to

To top