July is Dry Eye Awareness Month.
We plan to improve awareness by publishing several articles this month focused on dry eye syndrome. Dry eye is extremely common, affecting 30 million Americans. The disease becomes more prevalent as we age, but dry eye can affect anyone and at any age.
Symptoms can range from a mere nuisance, to permanent loss of vision in severe cases.
What is Dry Eye?
Dry eye develops when the tears are insufficient to adequately coat, lubricate and protect the cornea. The cornea is the clear part of the eye and is what a contact lens covers.
The natural lubricant that is continually produced to keep your eyes moist is called the “tear film” and it is a complex mixture that is secreted from the meibomian glands, lacrimal glands, and from the cells of conjunctiva and cornea.
The tear film has three layers—a lipid (oil) layer, a water (aqueous) layer, and a mucin (mucus) layer. This tear film keeps your eyes healthy, nourished, and moist. The mucus layer allows the tears to spread evenly on the corneal surface. The center watery portion is the liquid tear itself which is covered by an oily lipid layer that controls evaporation.
Dry eye can be caused by either inadequate quantity of tears or, more commonly, poor quality of the components of the tear film. A poor quality tear film allows the tears to evaporate too rapidly. Often systemic disease may be associated with decrease production where the eye and it's surrounding structures simply to not make enough tears.
In patients with Meibomian Gland Dysfunction (MGD), the components of the tear film are of poor quality. More specifically, patients with MGD do not produce and adequate lipid/oily layer to delay evaporation. Treatments vary and are based upon the true cause of the dry eye.
Symptoms of Dry Eye
The symptoms of dry eye syndrome include, stinging, burning, or gritty feeling in your eyes, sensitivity to light, redness, tearing, eye fatigue, and blurred vision.
The tear film and the cornea are responsible for most of the focusing power of the eye (this is why laser vision correction procedures work). If the corneal surface does not remain lubricated and smooth, significant blurry vision can develop. The cornea is also very sensitive and the dryness causes the burning, scratchiness and redness.
Dry Eye Syndrome Treatments
Artificial tears are the mainstay of initial therapy. The trick is to supplement your own natural tears with the artificial drops. Remembering to take your drops, however, can be difficult. Warm compresses may improve meibomian gland function.
Prescription eye drops and oral supplements are available and may be the treatment of choice for those with dry eye due to certain conditions. Surgical treatments to be considered include punctal plugs which are placed in some or all of the 4 tear ducts. Punctal plugs are reversible.
There is also a pulsation system that has been cleared for clinical use by the FDA that messages the eyelids and applies heat to unblock Meibomian glands, thus improving the quality of the oily layer of the tear film.
In the next few weeks, expect additional articles related to Dry Eye Awareness Month.
We look forward to seeing you. If you have questions or want to make an appointment, please give us a call.