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Dry eye disease can be divided into two major categories:

  • Poor tear production
  • Evaporative dry eye

The tears of our eyes are a complex composition of oils, mucin, and liquids. In order for our tears to adequately lubricate the structures of our eyes they need to have the correct saltiness (osmolality), liquid, mucin, and oily component. If any of these are not in the correct proportion, we may experience symptoms of dry eye disease.

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Symptoms of Dry Eye

Symptoms of dry eyes include:

  • Dryness, grittiness or scratchiness
  • contact lens discomfort
  • redness
  • fluctuating vision
  • soreness or irritation
  • burning or watering
  • eye fatigue
  • light sensitivity

Poor Tear Production

Patients who have been diagnosed with poor tear production can be treated in a variety of ways. For patients with relatively mild dry eyes, the use of artificial tears can often relieve their symptoms. There are a variety of artificial tears that your doctor can prescribe, all of them are over-the-counter. These can be used as infrequently as once or twice a day to as frequently as every half-hour or more often. For patients who are allergic to the preservatives in some artificial tears and for those who will be using it frequently, your doctor may prescribe preservative free artificial tears.

In addition to over-the-counter treatments, your doctor may suggest occluding the tear drainage canals, punctum, in order to allow the tears you produce to linger on your eye longer instead of being drained away. There are several techniques used to occlude the punctum: some temporary, and some permanent—your doctor will discuss best treatments with each individual.

For those patients who have moderate to severe dry eyes associated with poor tear production there is medication that can be used, such as Restasis—which has been shown to help restore tear production. In addition, some patients have found relief in the use of autologous serum tears. Speak with your doctor about which treatment, or combination of treatments, is right for you.

Evaporative Dry Eye

Patients with evaporative dry eye disease often have adequate tear production; however, the layer of oil that sits atop of the liquid layer may be lacking or disrupted. It is this fine layer of oil that prevents the liquid component of your tears from evaporating. Several causes that may contribute to evaporative eye disease are an incomplete blink, and eyelid or eyelash infection, or meibomian gland dysfunction to name a few.

Your doctor may also suggest lid exercises that re-train your lids to close completely, allowing the oily layer of the tears to be distributed equally throughout your eye. If there is an infection, antibiotics and/or steroids, or anti-inflammatory medication may be prescribed. Often non ethyl ester formulated omega-3 supplements will be dispensed that can also offer relief.

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