Ask Family Vision Center: What is Dry Eye Syndrome?
Dry eye syndrome is a very common condition that affects millions of Americans every year. Just like other eye health conditions, it can badly affect your day-to-day living. Family Vision Center, a trusted eye care practice that has offices in Crosby and Porter, has experienced doctors and advanced technology that can diagnose, treat and educate their patients with dry eyes.
The eyes are protected by three layers: oil (LIPID), water (AQUEOUS) and mucous (PROTEIN). Deficiencies in any of these layers produce different types of dry eye:
- Lipid Deficient (Evaporative) Dry Eye is caused by a deficiency in the glands along the eyelids that produce the oil layer called Meibomian Glands. When the amount of oil becomes insufficient, the water layer evaporates quickly and the eyes become dry. This may make the eyes feel as though there is grit or debris in them and can result in tearing. Other people may be desensitized to discomfort but may notice their vision fluctuates,doubles or gets fuzzy shortly after they blink causing increased blink rates. Even more commonly, people may notice watery eyes whenever there are vents, fans or wind blowing into their eyes which they may attribute to allergies. Redness of the eye or eyelids throughout the day and/or an uncomfortable feeling that is worse in the morning are also common symptoms of this type of dry eye. The dysfunction of these glands can also lead to soreness along the eyelid margins and frequent “Styes.” Unless managed regularly, most people have some level of oil (Meibomian) gland deficiency that worsens steadily with age. Family Vision Center provides a variety of preventative and acute therapies to manage this condition at every level of severity.
- Aqueous Deficient Dry Eye is caused by a lack of fluid released by the Lacrimal gland under the upper lids of both eyes. This gland constantly releases fluid into the eye that hydrates the surface of the eye, the mucous membranes and are spread across the eye by the eyelid as it blinks. This action is similar to a windshield wiper and relies on the smooth edge of the eyelid to distribute the fluid evenly. Non-prescription artificial tears can be helpful in treating this condition by supplementing the volume of tears in the eye. If supplementation is required more than 2 times per day, it may be more beneficial to employ an an anti-inflammatory eye drop such as Restasis or Xiidra that heals and repairs the lacrimal gland so that it may produce more tears and eventually correct the condition so that drops are no longer needed. Another treatment option for severe cases may include blocking the drainage of fluid out of the eye by using Punctal Plugs. Nutritional supplementation and management of environmental factors may also be necessary.
- Mucous Deficient Dry Eye can cause scarring and other long-term effects. It is worsened by the inflammation that is aggravated by Lipid and Aqueous deficiencies in the eye and can be effectively managed by balancing deficiencies in the other layers of the tear film, changing medications, treating systemic autoimmune conditions and using viscous tear replacement drops. Scar prevention can be achieved through stem cell/amniotic membrane therapy in severe cases
How is Family Vision Center’s approach different?
Due to chronic allergies as a child, Dr Szabo suffered from severe Dry Eye Syndrome (DES) at an unusually young age. It was not until she trained to become an Eye Doctor that she was diagnosed [Read more..]
5 Things you didn’t know about Dry Eye…
- Watery Eyes = Dry
Eyes Occasionally, a person may have watery eyes because the area where tears drain from the eyes is obstructed. This occurs commonly in newborns. The vast majority of people who suffer from watery eye do so because of evaporative dry eye. Evaporative dry eye often causes the moisture that protects your eyes from irritation to dissipate and causes your eyes to feel irritation–even if you don’t recognize the irritation as abnormal. This exposure is similar to getting a particle in your eye and makes the eyes reflexively release tears to wash away the irritant. Unfortunately, this added fluid is similar to running water over dry and irritated skin. It often leads to more irritation and can make the eyelids inflamed and raw.
- Using rewetting drops could be making your dry eyes worse
There are 3 different types of tear deficiencies that are treated differently. Adding rewetting drops that are primarily composed of water, may offer short lived relief but add to the wateriness of the eyes. The added wateriness can cause irritation and inflammation of the eyelids that release oils and may further impede the release of oils into the tear film. The use of eyedrops that “get the red out” do not address the reason that a person’s eyes are red. They use decongestant medicine to constrict or narrow the blood vessels of the eye making the eyes appear more white. When the medicine wears off, the narrowed vessels dilate, making the eyes appear even more red and requiring more frequent use of the “red-out” eye drops. Treating the underlying reason that your eyes are red will have long term benefits that these eye drops cannot provide. In addition to these reasons, using rewetting drops may relieve mild symptoms temporarily but they do not always impact the reason the eyes are dry, so the untreated dry eye disease continues to worsen with every passing day.
- You know those allergies that cause red, itchy, burning or watery eyes? They might not be allergies.
The most common type of dry eye is called Meibomian Gland Dysfunction or MGD. This condition results from blockage of the glands that line the eyelid margins. As these glands fill with trapped oils, they become distended and stretched. This occurs gradually and may not be visibly noticeable. The stretching of the microscopic gland often causes itchiness which gradually progresses to pain with pressure and ultimately pain without pressure. This occurs most commonly in the corners of the upper and lower eyelids because the glands in these areas are the most easily obstructed. Many people believe that they have allergies because their eyes water during times when they are spending time outdoor in the wind, using fans, air conditioners or heaters. This wateriness, in many cases, is the result of evaporation caused by moving air rather than allergy-causing antigens in the air. People who have allergies often have dry eyes at the same time. The swelling and inflammation that allergies cause in the eyelids cause the oil glands to narrow and close. Many medications commonly used to treat allergies can reduce the production of fluid released by the lacrimal glands and inhibit the release of mucous by the mucous membranes (goblet cells) affecting all or the layers of the tear film.
- Dry eyes ǂ old eyes; Old eyes ǂ Dry eyesWhile dry eye problems typically worsen over time if untreated, dry eye is a common problem for kids and young adults. Likewise, if preventative efforts are employed throughout life, old eyes do not have to be dry. While there are many factors that can cause eyes to be dry, the most common type of dry eye is completely preventable and treatable. Many people who are elderly can reverse their dry eye symptoms over time if they are treated appropriately and diligently. The physical changes that occur around the eyes with age may worsen dry eye syndrome but if eyelid therapy is maintained throughout life, some of these physical changes such as droopy lids, incomplete lid closure, irregular lid contour, eyelids turning in or out can be avoided resulting in more youthful looking eyes.
- Can’t win a staring contest? You probably have dry eyes.
The number of seconds that you can keep your eyes open without feeling the need to blink is directly related to the quality, volume and coverage of your tear film. Eye doctors frequently use a test called Tear Break-up Time (TBUT) to assess the tear stability, tear distribution and blink deficiency that a person has. When a person blinks, a small amount of oil is expressed from the eyelid margin. This oil mixes with the water and mucous in the tears and is spread by the eyelids evenly across the cornea. If the oils are not released, there is not enough tear volume, mucous does not blend the water and oil layers together or the protective tear film is not evenly distributed, dry spots develop exposing and irritating the sensitive cornea on the front of the eye. When this irritation occurs, you will feel the need to blink. A normal, healthy tear film with provide 10 or more seconds of stable protection for the cornea. If you cannot stare at something for 10 seconds or more without feeling the urge to blink, you may have one of the many forms of dry eye.
How do I know if my symptoms are from Dry Eye Syndrome?
Common symptoms of dry eye often include:
- Stinging or burning sensation in the eye
- A sandy or gritty feeling as if something is in the eye
- Excessively watery eyes often following very dry eye periods
- Stringy discharge from the eye
- Redness that may or may not be associated with pain
- Episodes of blurry vision
- Heavy eyelids
- Eye fatigue
What can I do to treat Dry Eye Syndrome?
Depending on the reason for the dry eye condition, Family Vision Center doctors employ a number of treatment options for patients with mild, moderate or severe DES. [Read more..]
- Lid cleansing
- Warm Compresses
- Lid Massage
- Oral medication (similar to medications prescribed for acne)
- Topical eye drops (prescription)
- Specialty re-wetting drops:
- Vitamin supplements
- Punctal plugs
- Prokera stem cell lenses
- Sleeping masks
Where can I learn more about dry eye syndrome?