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A sufficient amount of lubrication is needed to keep moisture on the surface the eyes. When there is a chronic lack of this lubrication dry eye syndrome is experienced. The consequences of dry eye syndrome range from a subtly constant irritation, to the front anterior tissue of the eye, to a severe lack of moisture in the tear ducts.

The medical term for dry eye syndrome is keratitis sicca. This basically means that there is a decreased quantity and/or quality of tears. Dryness that affects the conjunctiva and cornea is referred to as keratoconjunctivitis sicca.


Symptoms of Dry Eye Syndrome

A burning sensation, scratchiness and a feeling of dryness that continues to persist are all symptoms of dry eye syndrome, and are sometimes enough for your optometrist to diagnose you with dry eyes.

Dry eye syndrome can cause the eyes to become irritated and red which causes the feeling of scratchiness. However, sometimes your doctor may wish to measure the volume of tears that are in your eyes. Filter paper, which is a thin strip of paper, is put under the lower lid of the eye to measure the production of tears. This is known as the Schirmer test.

Another dry eye syndrome symptom is the feeling of having something stuck in the eye. This is also known as the foreign body sensation because it feels as if there is something in the eye that should not be there and would normally not be there.

And finally, as strange as it may seem, dry eye syndrome can actually cause the eyes to become watery. This is due to the dryness being experienced on the surface of the eye causing an overstimulation of production. This takes place because tears are used as a mechanism of protection. When the eyes get overly dry, the tear ducts will double their effort in an attempt to "fix" the problem. However, this can just lead to further problems for the eyes.

Causes of Dry Eyes

In order to keep the eyes moist, and keep out dust and other debris, tears will bathe the eyes. Tears are full of enzymes that serve to neutralize the organisms and microorganisms that tend to colonize the eyes. Tears are a vital part of good eye health. When dry eye syndrome is present, one of two things can happen, the lacrimal glands don't create enough tears, or the chemical composition of the tears causes rapid evaporation.

There are several causes for dry eye syndrome. The following are some of the most common reasons:

  • Insufficient blinking
  • HVAC systems that produce too much air (hot or cold)
  • Medication side effects (birth control pills, Parkinson's medication, high blood pressure medication, antidepressants, antihistamines, etc.)
  • Menopause (hormonal changes)
  • Climate (dry, arid, dusty)

Dry eye syndrome can also be a symptom of certain systematic diseases such as:

  • Lupus
  • Ocular rosacea
  • Rheumatoid arthritis
  • Sjogren's syndrome

In addition, dry eyes can also be brought on due to contact lens wear. In fact, this is the most common complaint among people who wear contact lenses. Recent studies indicate that wearing contacts and experiencing dry eyes can be an extremely nasty cycle. When one has dry eye syndrome, wearing contacts lenses can be quite uncomfortable. As the moisture evaporates from the lenses, the symptoms of dry eye syndrome become even worse. Other causes of dry eye syndrome include disease of the eyelid and deficiencies of tear producing glands.

Tears are made up of three separate layers:

  • The inner layer known as the mucin or mucous layer
  • The middle layer which is watery and also known as the lacrimal layer
  • The outer layer which is oily and also known as the lipid layer

Each tear layer is produced by separate glands that are near the eyes. For example, the lacrimal gland, found above the eyes outer corner, makes up the lacrimal layer. So, if a problem occurs in any of these layers, dry eyes can be the result.

While both genders are at risk for dry eye syndrome, women tend to be the ones who experience it the most. This may be due to heavier hormonal changes during specific times in their lives. When it comes to dry eyes and men, research shows that the risk of this condition increases as they age. It has also been suggested by recent studies that smoking can also increase the risk of dry eye syndrome. This eye problem has also been connected to cosmetic eye surgery. If after the surgery the lids are not closed back up completely, dry eyes can occur.

Available Treatments

Dry eye syndrome is not always totally curable and can be an ongoing issue. The curability depends on the cause. However, even if it cannot be cured, the dryness, itchiness, burning and scratchiness can be managed. Your eye care professional may choose to give you a prescription of artificial tears. These will lubricate your eyes and may alleviate the bothersome and uncomfortable symptoms.

Restastis is a prescription eye drop that takes things a step further by helping to produce more tears through reducing the inflammation that is connected to dry eye syndrome. Another dry eye treatment option is Lacrisert. This is a small insert that is filled with hydroxpropyl cellulose which is an ingredient for lubrication. When placed in the lower lid, it works to continuously release lubrication for the eyes all day long.

People sometimes use eye drops that claim to "get the red out" in order to treat dry eyes. Though these kinds of drops can actually reduce or totally eliminate red eye on a temporary basis, they may (or may not) effectively lubricate the eyes. It all depends upon the formulation of the product. In addition to this, some of these drops can cause you to develop a tolerance to the whitening agents. This can cause the redness to increase more over time. There are other adverse reactions that can come from using redness reducing eye drops. This is especially true if they are used too often.

Those who wear contact lenses should be aware that certain eye drops, especially those labeled as artificial tears should not be used while the contacts are in the eyes. They must be taken out before the drops are used and at least 15 minutes should pass before they are reinserted. Check the eye drop label before proceeding. If the dry feeling is mild, it may be sufficient to simply use contact rewetting drops. Remember though that the relief from this will only be temporary. Check all labels before using any eye drops if you wear contacts. Even better, talk with your eye doctor before deciding to use any OTC formulas. They will know the best ones to try and those that will not work while using contacts.

When you are indoors, using an air filter can rid the environment of dust and other air particles that can bother your eyes. Humidifiers add moisture to the air when it is too dry to due to the heating and air system, so this is also a good idea to help your dry eyes.

If you find that your dry eyes are due to environmental factors, use sunglasses when you go outside to lower sun exposure. This will also protect your eyes from dust and wind that can make them even drier. The sunglasses with foam are best. Also look for glasses that wrap around your face well and are close fitting in order to get maximum protection. Research has suggested temperatures that are cold may also cause dry eyes. If the weather gets windy and cold where you reside, try using goggles when you go outdoors.

Permanent or temporary silicone plugs can be put in the tear drain ducts inside the eyelids to keep the tears on the eye from drying up too fast. They are called punctal plugs or lacrimal plugs. They are painless to put in and are generally not felt once they are properly inserted.

A new acrylic punctal plug has been designed. It is a smallish rod that gets soft and gel-like when it is exposed to body heat after being inserted. It was made to swell up in order to conform the tear draining canal size. The benefits of this plug are that there are no protrusions from the tear ducts that could possibly cause added irritation, and that one size fits all so there is no need for any measurements.

There is also another newly developed plug that consists of hydrogel. This plug is a pliable gel that is soft as it expands over the tear canal. It doesn't have a cap and if it needs to be taken out, an eye doctor simply has to flush it with some saline solution. For some people however, using punctal plugs do not provide an effective enough solution. If this occurs then the tear ducts may need to be surgically closed through a procedure known as punctal cautery.

Being mildly dehydrated can also cause dry eyes, so drinking more water may also be of help for dry eye symptoms. More water intake is especially important during dry, windy and humid weather. Just by drinking more water may noticeably reduce the symptoms of dry eyes. Experts have agreed that nearly 20% of the water you drink should come from foods that you eat. The rest should come from the fluid you drink. Water is the best beverage choice, but milk and 100% veggie and fruit juice is just as good in most cases.

Sometimes eye doctors will recommend using a special nutritional supplement to help with dry eye syndrome. Research has found supplements that contain omega 3 fatty acids may decrease the symptoms of dry eyes. Cold water fish like cod, salmon, herring and sardines are excellent sources of omega 3 fatty acids. Flax seed oil is sometimes recommended as well.

If the cause of dry eyes is medication, stopping the offending drug will usually resolve the dry eye issue. However, many cases show that taking the medication has a much higher benefit than not, which makes it impossible to discontinue use, even if it will clear up dry eyes. If there is a similar medication to use for a specific condition, your doctor can try switching you to that and it may help your dry eyes. However, you should never discontinue or switch medications without first consulting with your doctor.

Another way to help with dry eye syndrome is treating any underlying eyelid conditions such as blepharitis. If this is done than it may be necessary to use steroid eye drops or an antibiotic, along with frequent lid scrubs using antibacterial shampoo.

If the cause of discomfort is due to contact wear, your eye doctor may wish to try you on a different contact lens. Another option is just wearing your contact lenses for a couple hours each day. Depending on the severity of the condition, your doctor may recommend that you stop using contact lenses altogether until the dry eye problem is taken care of.

LASIK and dry eyes might not be the best combination. If you are considering having LASIK surgery, you should be aware that having dry eyes might disqualify you from having the procedure done. This does not mean LASIK is out of the question forever; just until the dry eye problems are taken care of completely. The reason for this is that if you have dry eyes, the healing after LASIK may be poor. This is why the majority of eye surgeons want to treat your dry eye syndrome before doing LASIK. This will ensure a much better outcome. This information goes for all kinds of surgical procedures for vision correction.

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