Dry Eye Syndrome: More than an Annoyance

Dry Eye Syndrome
Eyes that are dry, burning, itchy and having excessive tearing or dryness – these are some of the symptoms of Dry Eye Syndrome (DES) and one of the most common problems we see in our office.  It’s estimated that 5 million Americans 50 years of age and older have significant dry eye symptoms.  Tens of millions more have less severe disease.  There has been an explosion in interest in how to treat dry eye syndrome.  While dry eye syndrome can be associated with rheumatoid arthritis, lupus, diabetes and other immune system disorders, it mainly occurs in people who are otherwise healthy and who do not have these conditions.
In healthy people, dry eyes can be caused by allergies, menopause, medications such as antihistamines, birth control pills, anti-depressants, certain blood pressure medications and inflammation of the surface of the eye (cornea).  If you wear contact lenses you are at higher risk for dry eye or it can be caused by an infection, exposure to irritants such as chemical fumes, tobacco smoke, or drafts from air conditioning or heating.
There is no question that dry eye syndrome can make you miserable and many people underestimate the consequences of it.  Dry eye sufferers find it hard to read, perform physical activities, use a computer or even spend a day outside.  At the extreme it can cause damage to the surface of the eye encouraging infection, decreased vision and even blindness.
Treatment Options
If you have the symptoms of dry eye such as burning, itching and irritation the first step is to see an eye doctor.  There are many causes of the sensation of dry eyes.  The cause must be determined in order to devise an effective treatment.  Depending on the cause of the Dry Eye Syndrome treatment may include the use of lubricants, antibiotic treatment, anti-inflammatory medications, Omega-3 fatty acids, changes in lifestyle and others. To be effective treatment must be tailored to the cause of the disease.
What You Can Do to Get Help
If your doctor determines that you do have dry eye syndrome, they may recommend over-the-counter drops for the first three to six months to access if your dry eye is a temporary condition.  Using artificial tears is the first line of therapy.  They offer temporary relief and provide important replacement of naturally produced tears in patients with dry eye syndrome.  However, some over-the-counter drops can make the symptoms worse.  Your eye doctor can provide advice as to which drops are helpful and which should be avoided.
Some studies also have concluded that taking Omega-3 fatty acids (especially DHA and EPA) may decrease symptoms of irritation.  Wearing sunglasses that fit close to the face with wrap around shades can help slow tear evaporation outdoors, keeping the surface of the eye moist longer between blinks.  Indoors, an air cleaner to filter dust can reduce irritation and a humidifier can add moisture.  Both may reduce dry eye symptoms.
When lubricant drops are not adequate anti-inflammatory medications may be prescribed.  These are prescription medications that must be taken regularly and often require months to become effective.
Another option is to plug the drainage holes at the inner corner of the eyelids (tear ducts) with Lacrimal plugs.  These can be inserted painlessly and the patient cannot feel them.  These plugs are made of silicone or collagen, are reversible, and are a temporary measure.  In severe cases, permanent plugs may be considered.  In some cases, a simple surgery, called punctual cautery, is recommended to permanently close the drainage holes.  However, closing the tear ducts can make some kinds of dry eye syndrome worse, and should not be done without careful evaluation, or before less invasive treatments have been tried.
Clinical Research Trials
The “Holy Grail” of dry eye is to find treatments that restore normal tear production.  Many medications have been developed and are being tested to this end.
The Taustine Eye Center conducts dry eye clinical research trials on an ongoing basis.  At the current time, Dr. Robert Williams the director of the Center for Clinical Research is seeking patients in clinical trials for four  medicines that may be new treatments for various forms of dry eye.  Qualified participants may receive study related examinations and treatments at no cost to themselves.  They may also be compensated for their time and travel.  Call 458-9004, Ext. 5 to set up an evaluation.
In Summary
There is no “best treatment” for dry eyes. There are many treatments for dry eye, but no single treatment that works for everyone. The most important thing that your eye care provider can do for you is to identify the underlying cause.  Then, you and your doctor can devise a plan to attack to cause of your symptoms.
The best advice about dry eyes is not to suffer every day and let it affect your quality of life.  There are treatment options available and most of them are simple and affordable or covered by insurance.  If you are experiencing dry eye symptoms see your eye doctor as soon as possible.

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