Dry eye, also known as dry eye syndrome or keratoconjunctivitis sicca, is a chronic condition that can damage the cornea. It occurs when the eye’s meibomian glands stop working properly.
The fine layer of moisture on the surface of your eye protects sensitive tissues, lubricates eye movement and promotes clarity of vision. This layer is comprised of water, oil and mucus, and a deficiency in any of these three can lead to dry eye. The meibomian glands secrete oils that keep tears from evaporating quickly. When the function of these glands is interrupted, the result is evaporative dry eye. Because the watery surface is constantly dissipating, the eye often increases tear production in response.
Symptoms of dry eye may include pain or a burning sensation in the eyes, itchiness, redness, light sensitivity and blurred vision. Patients may have a feeling that there is a small particle in the eye. This feeling of grittiness or sandiness is usually caused by dry spots, although corneal injuries can also generate the sensation. Both causes are sometimes related: Severe dry eye can cause perforation of the cornea, known as ulceration desiccation of the corneal epithelium. For contact lens wearers, excessive dry eye can also increase the chance of infection.
Causes of Dry Eye
Dry eye syndrome can be triggered by a range of environmental causes, including air pollution, windy or dry climate, air conditioning, indoor heating and second-hand smoke. There also seems to be a correlation between dry eye and heavy use of eye makeup. Over time, cosmetics can clog the meibomian glands and suppress oil production.
At home, a dry eye sufferer should remove sources of airborne irritants. Outdoors, wear sunglasses to protect your eyes from the drying power of the sun. At home or the office, avoid excessive staring at computer screens. If that is unavoidable, try wearing protective lenses or using a special filter for the screen.
The chance of developing dry eye increases with age; after menopause, women are more likely to experience dry eye. The condition can also be caused or aggravated by blood pressure medications, birth control pills and certain other prescriptions.
Effective Dry Eye Treatment
Eye drops are the first line of defense against dry eyes. Applied two to four times a day, they can treat acute conditions. Some underlying causes require more permanent solutions, however.
Advanced treatments include eye drops with corticosteroids, which fight inflammation of the cornea. Antibiotics may be appropriate if tear-producing glands are compromised by infection or inflammation. Pilocarpine and related medications are sometimes used to stimulate tear flow. Dissolvable eye inserts that are strategically placed by pulling out the lower eyelid work in much the same way as eyedrops, but last longer.
If these less invasive approaches do not work, Dr. Schwartz may try inserting silicone plugs into the tear ducts. These punctal plugs are used to block the pathways that drain tears from your eyes. This can also be permanently achieved with a laser procedure.
In recent years many exciting new eyelid therapy solutions have been developed. Intense pulsed light treatment uses pulses of infrared and visible light to ease pressure on the glands by reducing eyelid inflammation. The LipiFlow thermal pulsation system and the iLux treatment system both use targeted heat to melt away waxy gland obstructions in as few as 8 minutes. iLux is a handheld device that combines light-generated heat and gentle expression technology to therapeutically restore functionality to the meibomian glands. iLux is also effective as a preventative treatment.
BlephEx treatment uses a rotating sponge to clear away debris that may be causing obstruction. TearCare uses adhesive heating patches that are applied to eyelids to unclog glands. After approximately 12 minutes, the doctor manually squeezes lids to put pressure on the glands and restore normal oil flow. The Bruder mask is a hot compress that a patient heats in a microwave at home and wears for 10 minutes at a time to warm the meibomian glands and clear blockages.
Ongoing Studies
Dr. Schwartz often participates in medical clinical trials, including tests of new treatments for dry eyes. If you would like to be involved in a clinical trial of a new dry eye treatment, we invite you to check with our office to see if there is an ongoing study that could potentially benefit you.
To schedule a personal consultation with skilled ophthalmologist Dr. Jay Schwartz at his Phoenix, Glendale or Scottsdale office, call or email Schwartz Laser Eye Center today.
