The symptoms of dry eyes can be a minor annoyance all the way up to a debilitating condition.  The common denominator is a poor quality tear film which evaporates too fast and thereby causes burning, further tearing and reduced vision. 

When an effected individual looks for a remedy for this condition, there are several avenues that require exploration.  Firstly, systemic medications can have a profound impact on the tear film.  Over the counter oral antihistamines can reduce tear production by 53%.  Some antidepressants as well as antihypertensive medication and antiemetics can cause ocular drying.  If you are taking a diuretic, you can expect a reduction in tear production as you become dehydrated.   While it may not be practical to discontinue any of these medications, having some knowledge of the cause of the problem is helpful.

You must also consider nutritional factors as a cause for dry eyes.  Omega-3 fatty acids, antioxidants, carotenoids and vitamin consumption all play a part in the stability of the tear film.  Even your state of hydration is important so if you have dry eyes one of the items to think about is drinking enough water to maintain good hydration.  Your level of omega-3 fatty acids can be increased by taking fish oil supplements, flaxseed oil and evening primrose oil.

Eyelid health can play a major part in the dry eye problem.  Chronic blepharitis and/or meibomian gland dysfunction are inflammatory conditions of the eyelid associated with low-grade infection.  They alter the tear film composition in a significant way.  At Miami Eye Center we will evaluate you for these problems and when present institute a regimen of antibiotics, lid scrubs and compresses to cure the condition.

A condition which often goes unrecognized is conjunctivochalasis which a loosening of the outer cover of the eye (conjunctiva) which impedes the proper spreading of tears over the surface of the eye.  This is seen in individuals who have had cosmetic eyelid surgery followed by dry eyes.  The tighter eyelids press against the eyeball and cause the conjunctiva to roll up on itself.  For those who develop dry eyes following cosmetic surgery, removal of the redundant conjunctiva and replacement with a tissue graft is often times quite helpful.

The treatment of this complex disease must take into account several approaches.  In relatively mild disease, the symptoms can often be managed by the proper selection of artificial tears.  Once again this remedy is made complicated by the array of teardrops on the drug store shelf; some are better than others.  If artificial tears are helpful but only for a short period of time then punctal plugs may be the next course of action.  These plugs are either temporary or permanent.  The plugs aim to reduce the volume of tears that is lost, leaving more tears in the eye at any given time. The plugs are usually made of silicone and their placement is a brief office procedure.

Cyclosporine 0.05% (Restasis) is a prescription eye drop that when instilled twice a day has been shown to effectively limit the progression of dry eye disease as well as alleviate the symptoms.  Many patients who do not get relief with artificial tears used 3 to 4 times a day have found Restasis to be quite helpful.

If you are looking for an opinion regarding your Dry Eye Syndrome as well as a thoughtful approach to its management, call for an appointment.

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