Dry Eye 


Dry eye is a common condition that occurs when your tears aren't able to provide adequate lubrication for your eyes.

What is Dry Eye Disease?

Dry eye occurs when you do not produce enough tears or the composition of the tears is abnormal and cannot adequately cover the surface of the eye or are evaporated excessively.The tear film is an essential part for ensuring the overall health of the ocular surface.
It cleanses, lubricates and nourishes the surface of the eye as well as protecting it against infection. Both the quality and quantity of the tears must be maintained within certain levels to ensure a healthy and clear refractive surface essential for good vision.
Chronic dry eye can lead to damage of the eye’s surface, an increased risk of eye infections, and eventually the inability to produce tears. Left untreated, severe forms of dry eye can even damage your vision.

What are the symptoms?
Signs and symptoms, which usually affect both eyes, may include:
  • A stinging, burning or scratchy sensation in your eyes
  • Stringy mucus in or around your eyes
  • Sensitivity to light
  • Eye redness
  • Foreign body sensation
  • Difficulty wearing contact lenses
  • Difficulty with night time driving
  • Watery eyes, which is the body's response to the irritation of dry eyes
  • Blurred vision or eye fatigue
Why does Dry Eye Disease occur?
Dry eyes are caused by a lack of adequate tears. Your tears are a complex mixture of three basic layers – oil, water and mucus. This mixture helps make the surface of your eyes smooth and clear, and it helps protect your eyes from infection. Problems with any of these layers can cause dry eye syndrome.

Decreased tear production
Dry eyes can occur when you're unable to produce enough tears. The medical term for this condition is keratoconjunctivitis sicca . Common causes of decreased tear production include:
  • Aging
  • Certain medical conditions, including diabetes, rheumatoid arthritis, lupus, scleroderma, Sjogren's syndrome, thyroid disorders and vitamin A deficiency
  • Certain medications, including antihistamines, decongestants, hormone replacement therapy, antidepressants, 
  • Laser eye surgery
  • Tear gland damage from inflammation or radiation
Increased tear evaporation
Common causes of increased tear evaporation include:
  • Wind, smoke or dry air
  • Blinking less often, which tends to occur when you're concentrating, for example, while reading, driving or working at a computer
  • Eyelid problems, such as out-turning of the lids (ectropion) and in-turning of the lids (entropion)
Imbalance in tear composition
The tear film has three basic layers: oil, water and mucus. Problems with any of these layers can cause dry eyes. For example, the oil film produced by small glands on the edge of your eyelids (meibomian glands) might become clogged. Blocked meibomian glands are more common in people with inflammation along the edge of their eyelids (blepharitis), rosacea or other skin disorders.
 
How is Dry Eye Disease diagnosed?                   
Your ophthalmologist will begin with an eye exam. He or she will look at your eyelids and the surface of the eye. They will also check how you blink.There are many different tests that help diagnose dry eyes. Your ophthalmologist may do a test that measures the quality or the thickness of your tears. He or she may also measure how quickly you produce tears.


How Is Dry Eye Disease Treated?

Adding Tears

Your ophthalmologist might tell you to use artificial tears. These are eye drops that are like your own tears. You can use preservative free artificial tears as often as you need to. 

Saving Tears

Your ophthalmologist may suggest blocking your tear ducts. This makes your natural tears stay in your eyes longer. Tiny silicone or gel plugs (called punctal plugs) may be inserted in your tear ducts. These plugs can be removed later as needed. Your ophthalmologist could also recommend surgery that permanently closes your tear ducts.

Increasing Your Tears

Your ophthalmologist might have you use a prescription eye drop medication. This helps your eyes make more of their own tears.

Treating Dry Eye Culprits

Treating the underlying cause may require
  • prescription eye drops or ointments
  • warm compresses on the eyes
  • massaging your eyelids
  • certain eyelid cleaners


What must one do to prevent Dry Eye 
  • Avoid air blowing in your eyes. Don't direct hair dryers, car heaters, air conditioners or fans toward your eyes.
  • Add moisture to the air. In winter, a humidifier can add moisture to dry indoor air.
  • Consider wearing wraparound sunglasses or other protective eyewear. Safety shields can be added to the tops and sides of eyeglasses to block wind and dry air. 
  • Take eye breaks during long tasks. If you're reading or doing another task that requires visual concentration, take periodic eye breaks. Close your eyes for a few minutes. Or blink repeatedly for a few seconds to help spread your tears evenly over your eyes.
  • Be aware of your environment. The air at high altitudes, in desert areas and in airplanes can be extremely dry. When spending time in such an environment, it may be helpful to frequently close your eyes for a few minutes at a time to minimize evaporation of your tears.
  • Position your computer screen below eye level. If your computer screen is above eye level, you'll open your eyes wider to view the screen. Position your computer screen below eye level so that you won't open your eyes as wide. This may help slow the evaporation of your tears between eye blinks.
  • Stop smoking and avoid smoke. 
  • Use artificial tears regularly. If you have chronic dry eyes, use eyedrops even when your eyes feel fine to keep them well-lubricated.





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