Article on dry eyes

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Dry eye syndrome has several causes. It occurs as a part of the

natural aging process, especially during menopause; as a side effect

of many medications, such as antihistamines, antidepressants, certain

blood pressure medicines, Parkinson's medications and birth control

pills; or because you live in a dry, dusty or windy climate. If your

home or office has air conditioning or a dry heating system, that too

can dry out your eyes. Another cause is insufficient blinking, such

as when you're staring at a computer screen all day.

Dry eyes can become red and irritated, causing a feeling of

scratchiness.

Dry eyes are also a symptom of systemic diseases such as lupus,

rheumatoid arthritis, rosacea or Sjogren's syndrome (a triad of dry

eyes, dry mouth, and rheumatoid arthritis or lupus).

Long-term contact lens wear is another cause; in fact, dry eyes are

the most common complaint among contact lens wearers. Recent research

indicates that contact lens wear and dry eyes can be a vicious cycle.

Dry eye syndrome makes contact lenses feel uncomfortable, and the

rubbing of the lenses against the conjunctiva seems to be a cause of

dry eyes.

Incomplete closure of the eyelids, eyelid disease and a deficiency of

the tear-producing glands are other causes. Tears are composed of

three layers: the outer, oily, lipid layer; the middle, watery,

lacrimal layer; and the inner, mucous or mucin layer. Each layer is

produced by a different part of the eye (the lacrimal gland produces

the lacrimal layer, for example), so a problem with any of those

sources can result in dry eyes.

Panoptx sunglasses can help with dry eyes because they keep out wind,

pollen and dust with their Orbital Seal; 99 percent of wearers in a

study reported a decrease in overall dry eye symptoms.

Artificial tears help dry eyes feel better. Don't confuse artificial

tears with formulas that just " get the red out. "

Salmon is a good source of omega-3 fatty acids, which may reduce your

risk for dry eyes. Sardine, herring and cod liver oils are even

better, or try a supplement.

Dry eye syndrome is more common in women, possibly due to hormone

fluctuations. Recent research suggests that smoking, too, can

increase your risk of dry eye syndrome. With increased popularity of

eyelid surgery (blepharoplasty) for improved appearance, dry eye

complaints now occasionally are associated with incomplete closure of

eyelids following a procedure.

Treatment for Dry Eyes

Dry eye syndrome is an ongoing condition that may not be cured

(depends on the cause), but the accompanying dryness, scratchiness

and burning can be managed. Your eyecare practitioner may prescribe

artificial tears, which are lubricating eyedrops that may alleviate

the dry, scratching feeling.

Restasis eyedrops (cyclosporine in a castor oil base) go one step

further: they help your eyes to increase tear production. Restasis

treatment is the first of its kind.

Sometimes people use the eye drops that " get the red out " to treat

their dry eyes. This won't work unless the eye drops also contain

artificial tears, and the original " get-the-red-out " formulation

doesn't. These drops can reduce or eliminate the redness temporarily,

but they don't treat the cause of the redness, whether it's dryness,

environmental irritation or some other problem.

Not only that, but the vasoconstrictors in those formulas that reduce

redness by contracting the eye's blood vessels are addictive, in the

sense that over time, more and more is needed to achieve the same

effect. And with frequent use, the effect diminishes after a while,

anyway — the blood vessels simply won't constrict as much as they did

when you first used the drops.

If you wear contact lenses, be aware that many eye drops, especially

artificial tears, cannot be used while your contacts are in your

eyes. You'll need to remove them before using drops and wait 15

minutes or even longer (check the label) before reinserting the

lenses. If your eye dryness is mild, then contact lens rewetting

drops may be sufficient to make your eyes feel better, but the effect

is usually only temporary.

Check the label, but better yet, check with your optometrist or

ophthalmologist before buying any over-the-counter eye drops. It will

probably save you a lot of money, because he or she will know which

formulas are effective and long-lasting and which ones are not, as

well as which eye drops will work with your contact lenses.

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The patented electrolyte balance of TheraTears precisely matches the

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Tears Again Hydrate gels contain omega-3 fatty acids to treat dry eyes

Your eyelids may be causing your dry, scratchy and irritated eyes.

Learn more

If the problem is environmental, you should always wear sunglasses

when outdoors, to reduce exposure to sun, wind and dust. You may want

to try the kind that has a foam or other seal at the sides, to keep

wind and dust from getting to your eyes at the top, bottom and sides

(see photo on this page). Indoors, an air cleaner can filter out dust

and other particles from the air, while a humidifier adds moisture to

air that's too dry because of air conditioning or heating.

REDBANK, N.J., June 2006 — The National Women's Health Resource

Center has named the top 100 dry eye hot spots in the United States

based on information compiled from the National Oceanic and

Atmospheric Administration's Climatic Data Center and the

Environmental Protection Agency.

Factors used in the selection process included temperatures,

humidity, wind, altitude, pollutants and ocular allergens.

The top 20 U.S. cities named as dry eye hot spots are:

1. Las Vegas, Nevada

2.* Lubbock, Texas

2.* El Paso, Texas

4. Midland/Odessa, Texas

5. Dallas/Fort Worth, Texas

6. Atlanta, Georgia

7. Salt Lake City, Utah

8. Phoenix, Arizona

9. Amarillo, Texas

10. Honolulu, Hawaii

11. Oklahoma City, Oklahoma

12. Albuquerque, New Mexico

13. Tucson, Arizona

14. Norfolk, Virginia

15. Newark, New Jersey

16. Boston, Massachusetts

17. Denver, Colorado

18. Pittsburgh, Pennsylvania

19.* Bakersfield, California

19.* Wichita, Kansas

*Cities were tied for these spots.

Temporary or permanent silicone plugs in the lacrimal (tear) ducts

keep tears in your eye from draining away as quickly. Called lacrimal

plugs or punctal plugs, they can be inserted painlessly while you're

in the eye doctor's office and are normally not felt once inserted.

Punctal plugs help retain moisture on the eye by keeping tears from

draining away too quickly. Tiny meibomian glands in the inner eyelids

secrete lubrication that helps keep the eye moist.

A new type of punctal plug made of acrylic is a small rod that

becomes a soft gel when exposed to your body heat after insertion. It

is designed to accommodate to the size of any punctum canal.

Advantages of this type of plug are that one size fits all, so

measurement is unnecessary, and nothing protrudes from the tear duct

that could potentially cause irritation.

Another new kind is made of a hydrogel that expands into a soft,

pliable gel in the punctum canal. It has no cap, and should it need

to be removed, the eyecare practitioner can simply flush it out with

saline solution.

With some people, however, punctal plugs aren't effective enough, so

their tear ducts need to be closed surgically.

Doctors sometimes recommend special nutritional supplements for dry

eyes. Studies have found that supplements containing certain

essential fatty acids (linoleic and gamma-linolenic) can decrease dry

eye symptoms. You could also eat more cold-water fish, such as

sardines, cod, herring and salmon, which contain omega-3 fatty acids.

Read more about nutrition and the eyes, as well as the use of

flaxseed oil to relieve dry eye.

Drinking more water can help, too (see sidebar).

Mild dehydration may make dry eye problems worse. This is especially

true during hot, dry and windy weather. But the symptoms of dry eye

syndrome may be improved by simply drinking more water.

The Institute of Medicine recommends that each day, women need 91

ounces of water and men need about 125 ounces. Experts agree that

about 20 percent of the water your body needs comes from the food you

eat, while the rest originates from the fluids you drink. The best

choices for beverages are water, 100 percent fruit and vegetable

juices and milk. — S.J.

If medications are the cause of dry eyes, discontinuing the drug

generally resolves the problem. But in this case, the benefits of the

drug must be weighed against the side effect of dry eyes. Sometimes

switching to a different type of medication alleviates the dry eye

symptoms while keeping the needed treatment. In any case, never

switch or discontinue your medications without consulting with your

doctor first!

Treating any underlying eyelid disease, such as blepharitis, helps as

well. This may call for antibiotic or steroid drops plus frequent

eyelid scrubs with an antibacterial shampoo.

Quite a few products are in testing for possible dry eye treatment.

For example, trehalose (a carbohydrate) improved dry eye symptoms in

small studies, but further testing is needed.

If contact lens wear is the cause of your dry eyes, your eyecare

practitioner may want to switch you to a different lens or have you

wear your lenses for fewer hours each day. In a few cases, it is

recommended that contact lens wear be discontinued altogether until

the dry eye problem is cleared up. Read our related article on what

can be done about contact lens discomfort.

If you are considering LASIK, be aware that dry eyes may disqualify

you for the surgery, at least until the problem is resolved. Dry eyes

increase your risk for poor healing after LASIK, so most surgeons

will want to treat the dry eyes first, to ensure a good LASIK

outcome. This goes for other types of vision correction surgery, as

well.

Guide to Dry Eyes | Ask the Dry Eye Doctor Your Question | Dry Eye

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[Page updated May 2007]