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Chronic Dry Eye Syndrome

Chronic dry eye is not only uncomfortable; over time it can actually damage your eyes and cause vision loss.

Chronic dry eye syndrome (keratoconjunctivitis sicca or KCS) is an inflammatory disease of the eye in which there are insufficient tears to lubricate and nourish the eye.  The most common form of dry eyes is due to an inadequate amount of the water layer of tears.

Tears are necessary for providing clear vision.  With each blink of the eyelids, tears are spread across the front surface of the eye, known as the cornea  Tears reduce the risk of eye infection, wash away foreign matter in the eye and keep the surface of the eyes smooth and clear.

Inadequate amount of tears:  Tears are produced by several glands in and around the eyelids.  Tear production tends to diminish with age, with various medical conditions or as a side effect of certain medicines.  Environmental conditions, such as wind and dry climates, can also affect tear volume by increasing tear evaporation.

Poor quality of tears:  Tears are made up of three layers:  oil, water and mucus.  Each component serves a function in protecting and nourishing the front surface of the eye.  A smooth oil layer helps to prevent evaporation of the water layer, while the mucin layer functions in spreading the tears evenly over the surface of the eye.

People with dry eyes may experience symptoms of irritated, gritty, scratchy or burning eyes, a feeling of something in their eye and, excess watering and blurred vision.  Advanced dry eyes may damage the front surface of the eye and impair vision.

Treatment

Treatments for dry eyes aim to restore or maintain the normal amount of tears in the eye to minimize dryness and related discomfort and to maintain eye health.

The development of dry eyes can have many causes.  They include:
•    Age – dry eye is a part of the natural aging process.  The majority of people over age 60 experience some symptoms of dry eyes.
•    Gender – women are more likely to develop dry eyes due to hormonal changes caused by pregnancy, the use of oral contraceptives and menopause.
•    Medications – certain medicine, including antihistamines, decongestants, blood pressure medications and antidepressants can reduce the amount of tears produced in the eyes.
•    Medical conditions – persons with rheumatoid arthritis, diabetes and thyroid problems are more likely to have symptoms of dry eyes.
•    Environmental conditions – exposure to smoke, wind and dry climates can result in dry eye symptoms.  Failure to blink regularly, such as when staring at a computer screen for long periods of time, can contribute to drying of the eyes.
•    Other factors – long term use of contact lenses can be a factor in the development of dry eyes.  Refractive eye surgeries such as LASIK, can cause decreased tear production and dry eyes.

Diagnoses

Dry eyes can be diagnosed through a comprehensive eye examination.  Testing, with special emphasis on the evaluation of the quantity and quality of tears produced by the eyes, may include:
•    Patient history to determine any symptoms the patient is experiencing and the presence of any general health problems, medications taken or environmental factors that may be contributing to the dry eye problem
•    External examination of the eye, including lid structure, blink dynamics and use of dyes to measure the quantity and quality of tears
Using the information obtained from testing, our doctors can determine if you have dry eyes and advise you on treatment options.
Treatment may include:
•    Adding tears using over-the-counter artificial tear solutions
•    Keeping natural tears in the eyes longer.  This can be done by blocking the tear ducts through which the tears normally drain.  A surgical procedure to permanently close tear ducts can also be used.
•    Prescription eye drops that help to increase production of tears can be recommended by our doctors, as well as Omega-3 fatty acid nutritional supplements
•    Prescription eye drops or ointment, warm compresses and lid massage or eyelid cleaners may be recommended to help decrease inflammation around the surface of the eyes

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