Dry Eye Syndrome
What Is Dry Eye Syndrome?
Dry eye syndrome is a chronic condition that is caused by an insufficient level of protective tear film. It is estimated that dry eye syndrome affects more than 10 million people in the United States.
Your eyes are covered with a continuous layer of tear film that forms a protective barrier. Tears have three layers: The inner mucus layer, which is the foundation of the tear film; the middle aqueous layer, which is mostly water plus salt and nutrients; and the outer lipid layer, the oily layer that prevents evaporation. Each layer is produced by a different part of the eye, and all three must work cohesively to protect it. Every time you blink, excess tears are drained into small ducts located in your eyelids, near your nose.
As you grow older, the production of tears from your lacrimal or tear glands may decrease. In addition, inflammation can also change the composition of your tears. Either of these factors can cause the tears to evaporate, and allow dry spots to form on the cornea, the protective outer layer of your eyes.
These changes on the surface of the eye can also impact the signals the eye send to the brain to make more tears. In some patients, the signal to the brain is disrupted, and it is not sending the message to create additional tears. However, other patients who suffer from dry eye syndrome may actually have watery or runny eyes. Although more tears are being secreted, these tears lack the proper composition for them to form tear film that remains on the eye.
Although dry eye syndrome can happen at any age, it is more common in people over age 40. In women, dry eyes often occur after menopause.
If you have dry eye, you may have the sensation that something is in your eye. This can cause irritation that may be worse at the end of the day, or your eyes may feel itchy or have a burning sensation. If you wear contact lenses, you may find it difficult to keep the lenses in for any length of time. You may also be more sensitive to light. As dry eye progresses, your eyes may also become inflamed.
Who Is at Risk for Dry Eye Syndrome?
We are all at risk for developing dry eye syndrome, particularly as we age. However, women are at greater risk, especially after menopause. Many factors can contribute to dry eye including:
- Certain medications including antihistamines, antidepressants, blood pressure medication and birth control pills
- Insufficient humidity in your home or office
- Living in a hot or dry climate
- Systemic diseases including lupus, rheumatoid arthritis, rosacea and Sjogren syndrome
- Insufficient blinking due to prolonged computer use or reading
- Long-term use of contact lenses
- Incomplete closure of the eyelids or eyelid disease
Dry eye syndrome can also be a side effect of LASIK or other refractive surgery. This may be a result of disruption to the nerves in the cornea that normally signal the brain to increase tear flow. This disruption to the corneal nerves may also cause you to blink less, disrupting the flow of tears over your eye. For most LASIK patients, dry eye resolves itself during the normal 6-month healing period.
How Is Dry Eye Syndrome Detected?
The diagnosis of dry eye syndrome begins with a full medical history, along with a comprehensive eye exam. Your doctor may utilize a test called a Schirmer tear test. In this test, a piece of blotting paper will be placed under your lower eyelid. After five (5) minutes, the doctor will measure the quantity of tears that has been absorbed. He will also put a special eyedrop in your eye to examine the condition of your cornea. This will allow him to see areas that are lacking lubrication.
Dry eye syndrome is a complex problem. More than one of the risk factors may contribute to your problems with dry eye. In addition to being uncomfortable, untreated dry eye syndrome can lead to damage to your cornea including corneal ulcers, risk of infection and loss of vision in severe cases. Therefore, if you have chronic symptoms of dry eye, you should see your doctor for diagnosis and treatment.
Treatment of Dry Eye Syndrome
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Primary Eye Care Specialists at Kadrmas Eye Care New England
Meet our ophthalmologists and optometrists who specialize in dry eye syndrome, primary eye care, and general eye health: