Learning more about Dry Eye Syndrome
Up to 14 million Americans suffer from a disease called dry eye syndrome. People with dry eyes frequently experience burning and stinging of their eyes, their eyes often feel sticky, and their eyes are often red. Some people with dry eyes also have periods when their eyes get so watery that tears spill over their eyelids and run down their cheeks. Your eyes normally make small amounts of tears all day long.
Tears play several important roles in keeping your eyes healthy and your vision clear. Tears lubricate the eye’s surface, wash away debris, provide a smooth surface to help keep your vision clear, and also contain natural antibiotics that keep your eyes safe from germs that might cause infections. The layer of tears closest to the front surface of the eye is called the mucin layer. Its job is to smooth out the uneven spots on the eye surface. Next, a layer of aqueous tears covers the mucin layer. The aqueous layer is watery, and makes up the majority of the tear film. Its job is to lubricate the eye and keep it moist. The final layer of the tear film is an oily layer called the lipid layer. This is the outermost layer, and its job is to cover the aqueous layer and prevent it from evaporating. Each layer of the tear film is made by a different part of the eye. The mucin layer is made by the eye surface itself. The aqueous layer is made by a tear gland tucked under the upper eyelid. And the lipid layer is made by small glands in the eyelids. For the tear film to do its job, all three layers have to be in their proper places in the correct amounts, like a recipe. If any layer is missing or abnormal—which can happen for a number of reasons—the tear film becomes disorganized and no longer soothes the eye like it should.
When symptoms of dry eye syndrome occur, the front surface of the eye gets dried out (causing stickiness) and gets inflamed (causing stinging and burning). Once it gets inflamed, the eye ignores the proper tear film recipe and starts making large quantities of the aqueous layer in an effort to soothe itself. These bad tears don’t soothe the eye at all—they just run down your face, washing away the mucin and lipid layers as well. This makes the eye even more irritated, so it makes even more bad tears, and the cycle continues. An ophthalmologist is usually able to diagnose dry eye by examining the eyes. Sometimes tests that measure tear production are necessary. One test, called the Schirmer tear test, involves placing filter-paper strips under the lower eyelids to measure the rate of tear production under various conditions. Another test uses a diagnostic drop (called fluorescein or rose bengal) to look for certain patterns of dryness on the surface of the eye.
Artificial tears are eyedrops similar to your own tears. They lubricate the eyes and help maintain moisture. Artificial tears are available without a prescription. There are many brands on the market, so you may want to try several to find the one you like best. Preservative-free eyedrops are available for people who are sensitive to the preservatives in artificial tears. If you need to use artificial tears more than every two hours, preservative-free brands may be better for you. You can use the artificial tears as often as several times an hour. Conserving your eyes’ own tears is another approach to keeping the eyes moist. Tears drain out of the eye through a small channel into the nose (which is why your nose runs when you cry). Your ophthalmologist may close these channels either temporarily or permanently. The closure conserves your own tears and makes artificial tears last longer.
In winter, when indoor heating is in use, a humidifier or a pan of water on the radiator adds moisture to dry air. Wrap-around glasses may reduce the drying effect of the wind, but you should note that they are illegal to wear while driving in some states. A person with dry eye should avoid anything that may cause dryness, such as an overly warm room, hair dryers, or wind. Smoking is expecially bothersome. Some people with dry eye complain of “scratchy eyes” when they wake up. This symptom can be treated by using an artificial tear ointment or thick eyedrops at bedtime. Use the smallest amount of ointment necessary for comfort, since the ointment can cause your vision to blur. Dry eye due to a lack of vitamin A in the diet is rare in the United States but is more common in poorer countries, expecially among children. Ointments containing vitamin A can help dry eye if it is caused by unusual conditions such as Stevens-Johnson syndrome or pemphigoid. Vitamin A supplements do not seem to help people with ordinary dry eye. If you have symptoms of dry eye syndrome, ask your Long Island doctor’s at North Shore Eye Care for a dry eye evaluation. Treatments are available to halt the disease.
In Long Island In Suffolk and Nassau county, we see patients from Stony brook, setauket, port jefferson, shoreham, wading river, miller place, mount sinai, rocky point, centereach, selden coram, middle island, riverhead, ridge, calverton, manorville, shirley, mastic, moriches, brookhaven, yaphank, patchogue, medford, jamesport, cutchogue, mattituck, southold, eastport, westhampton, east hampton, southampton, sag harbor, hampton bays, quogue, poquott, belle terre, sound beach, montauk, lake grove, Farmingville, farmingdale, new york city, queens, brooklyn, and many other towns.
