Dry Eye Los Angeles, Dry Eye Syndrome

If you suffer from symptoms of dry eye, the doctors of the East West Eye Institute can help. Dry Eye Syndrome, keratoconjunctivitis sicca, or simply dry eye, is a condition where there is a lack of tears, or a lack of the appropriate quality of tears to keep the eye healthy and comfortable.

The symptoms of dry eye may include:

• stinging or burning eyes;
• scratchiness;
• stringy mucus in or around the eyes;
• excessive eye irritation, especially from smoke or wind;
• difficulty wearing contact lenses;
• excess tearing.

Excess tearing from "dry eye" sounds illogical, but if the tears responsible for maintenance lubrication are not adequate to keep the eye comfortable, the eye becomes irritated. When eye irritation occurs, the lacrimal gland produces a large volume of tears to compensate for the deficiency. This sudden large volume of tears can overwhelm the tear drainage system. As a result, the excess tears can fill the space between the lids spilling over onto the cheeks, resulting in “tearing”.

It is important to understand that a healthy tear film is necessary to create a smooth and clear ocular surface. Without a healthy tear film, clear vision may not be possible.

The normal tear film consists of three layers.

• an oily layer;
• a watery layer;
• a layer of mucus.

A problem in any of these layers can lead to symptoms of dry eye.

The oily layer, produced by the meibomian glands in the eyelid margins, forms the outermost surface of the tear film. Its main purpose is to smooth the tear surface and reduce evaporation of tears. The middle watery layer makes up most of what we ordinarily think of as tears. This layer, produced by the lacrimal gland, cleanses the eye and washes away foreign particles or irritants. The inner layer consists of mucus produced by the conjunctiva. Mucus allows the watery layer to spread evenly over the surface of the eye and helps the eye remain moist. Without mucus, tears would not “stick” to the eye.

What Causes Dry Eye?

Tear production normally decreases as we age, and although dry eye can occur in both men and women at any age, women are most often affected. This is especially true after menopause. Dry eye also can be associated with various medical conditions such as lupus, rheumatoid arthritis, and Sjogren’s syndrome. A wide variety of common medications — prescription and over-the-counter — can cause dry eye by reducing tear secretion.

Common examples of medications that can lead to dry eye include:

• diuretics;
• beta-blockers;
• antihistamines;
• sleeping pills;
• medications for "nerves";

Some pain relievers:

Dry eye may be treated in several ways. Sometimes a combination of approaches is necessary to effectively treat dry eye.

Eyedrops called artificial tears can be used to lubricate the eyes. They work by supplementing one’s natural tears and are available without a prescription. Many different brands are available from which to choose, so it may be worthwhile to try several to find the one that works the best for you. Because preservatives in eyedrop preparations can themselves irritate the eyes, preservative-free eyedrops are available and are a good option if artificial tears are needed more than three or four times per day.

A new medication called Restasis® has been shown to effectively increase your natural ability to produce tears which may be reduced by inflammation due to chronic dry eye. Restasis® is available by prescription only and the doctors of East West Eye Institute can examine your eyes and determine if this medication is right for you.

Conserving your natural tears is another approach to keeping the eyes moist. Tears drain from the eye through a small channel into the nose (which is why your nose runs when you cry). Temporary closure of these tear drainage channels with special plugs is an effective means to treat dry eye. The closure conserves your own natural tears and makes artificial tears last longer.

Tears evaporate like any other liquid and steps can be taken to prevent evaporation. In winter, when indoor heat is on, a humidifier or a pan of water on the radiator adds moisture to dry air. Ordinary glasses may act as a barrier to reduce the drying effect of the wind. Environmental conditions that promote evaporation, such as an overly warm room, hair dryers or wind, can exacerbate dry eye and should be avoided. Smoking can be especially bothersome. Instillation of artificial tear ointments or gel drops at bedtime can be an effective means to combat dry eye that occurs in the morning.

Dry eye due to a lack of vitamin A in the diet is rare in the United States but is more common in developing countries, especially among children. Vitamin A supplements do not seem to help people with ordinary dry eye.

A thorough eye examination is necessary to determine if you suffer from dry eye. The doctors of the East West Eye Institute are here to help. If you have symptoms of dry eye, don’t suffer any longer. Feel free to schedule an appointment with us so we can help determine which treatment is right for you.

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