What is Dry Eye?

Terms ‘dry eye syndrome, keratoconjunctivitis sicca (KCS), dysfunctional tear syndrome, lacrimal keratoconjunctivitis, evaporative tear deficiency, aqueous tear deficiency, and LASIK-induced neurotrophic epitheliopathy (LNE) ‘ all denote to the condition known as “Dry Eye”.

The eye relies on upon the stream of tears to give consistent moisture and lubrication to keep up vision and solace. Tears are a blend of water, oils, mucus and antibodies and uncommon proteins. At the point when there is unevenness in the tearing system, it may lead to dry eyes. Either eye does not produce tears properly, or when the tears are not of the correct consistency and evaporate too quickly.

Also, aggravation of the surface of the eye may happen alongside dry eye. If left untreated, this condition can prompt to agony, ulcers, or scars on the cornea, and some loss of vision, but still the occurrence of blindness is rare.
Dry eye can make it harder to keep your eyes open for an extended period of time as in reading a book or looking at a computer screen, and it can diminish resistance for dry environments.

Symptoms of ‘Dry Eye’

  • Stinging sensation ,burning sensation in the eyes
  • Feeling of dryness, grittiness and soreness in the eyes
  • Stringy mucus in or around the eyes
  • Eye sensitivity to smoke and wind (eyes water more in the wind)
  • Reddish eyes
  • Eye fatigue( even after reading for a relatively short period)
  • Photophobia – Eyes becoming sensitive to light
  • Wearing contact lenses is uncomfortable
  • Tearing
  • Blurred vision – usually worse towards the end of the day
  • Double vision
  • Eyelids stick together when waking up
  • Pain

What causes Dry Eye?

Dry eye can be mainly due to,

  1. Decreased tear production (keratoconjunctivitis sicca)
  2. Increased tear evaporation
  3. Imbalance in tear composition

Decreased tear production (keratoconjunctivitis sicca)

Aging (especially at menopause)

  • In medical conditions such as diabetes, rheumatoid arthritis, lupus, scleroderma, Sjogren’s syndrome, thyroid disorders and vitamin A deficiency
  • Use of some medications, including antihistamines, decongestants, hormone replacement therapy, antidepressants, and drugs for high blood pressure, acne, birth control and Parkinson’s disease
  • Laser eye surgery (only give temporary symptoms)
  • Tear gland damage from inflammation or radiation

Increased tear evaporation

  • Common causes of increased tear evaporation include:
  • Wind, smoke or dry air
  • Blinking less often
  • Eyelid problems, such as out-turning of the lids (ectropion) and in-turning of the lids (entropion)

Imbalances of tear composition

Sometimes lacrimal glands fail to produce the watery portion of tears in adequate amounts leading to dry eye.

Treatments for ‘Dry Eye’

Artificial tear drops and ointments. The use of artificial teardrops is the primary treatment for dry eye. Artificial teardrops are available over the counter.

  • Temporary punctal occlusion: Sometimes it is necessary to close the ducts that drain tears out of the eye. This may be done temporarily with a dissolving plug that is inserted into the tear drain of the lower eyelid to determine whether permanent plugs can provide an adequate supply of tears.
  • Non-dissolving punctal plugs and punctal occlusion by cautery (application of heat to tear exit duct): If temporary plugging of the tear drains works well, then longer-lasting plugs or cautery may be used or your doctor may decide to bypass the temporary plug and use a permanent plug.
  • Lipiflow: Lipiflow is a medical device that uses heat and pressure on the eyelids to unclog blocked glands. These glands produce oil as part of the tear film. The oil lubricates the eye and prevents the tears from evaporating.
  • Restasis: The FDA approved the prescription eye drop Restasis for the treatment of chronic dry eye. It helps your eyes increase their own tear production with continued use.
  • Xiidra: Approved in 2016, Xiidra is a new class of drug called lymphocyte function-associated antigen 1. Used for the signs and symptoms of dry eye. These eye drops are taken twice daily to stimulate tear production.

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