DRY
EYE
Excerpted
from Triad's Eye Care Notes
© 1989-2005 by Triad Publishing
Co.
Most
people have enough tears to keep their eyes properly moistened
and lubricated. "Keratitis sicca," the medical term for dry
eye (it actually means "dry cornea") is an annoying condition
in which there is not enough moisture in the eyes. Dry eye
is more common in women than in men, and in middle age and
the elderly than in younger people.
What
Causes Dry Eye?
The most likely cause of your dry eyes is that you do not
produce enough tears or that for some reason your eyelids
do not close well, especially when you sleep. Dry eye is often
related to other medical conditions, such as arthritis, or
Sjogren's (SHOW-grenz) syndrome, in which many of the body's
other normally moist membranes (such as those in the mouth
and nose) also lack moisture. Less commonly, it is associated
with severe inflammatory mucous membrane diseases (such as
pemphigoid).
Symptoms
and Diagnosis
The
dryness usually leads to a constant burning or foreign body
sensation. Your eyes may be sensitive to light, and red and
bloodshot a good deal of the time. These symptoms tend to
be worse in dry climates, in dry and windy weather, and late
in the day. Using a hair dryer may affect your eyes, as will
dryness in air-conditioned and heated rooms, especially if
you are in a draft or the direct flow of the vent, or the
dehumidified cabin of an airplane. You may also have dryness
of other mucus membranes, such as in the mouth and nose, or
have frequent eye and eyelid infections.
Many
patients complain of "watery" or tearing eyes and are surprised
to learn that their problem is really dryness. What happens
is that as the moisture decreases, the amount of mucus increases
and makes the eyes feel as if they are watering. The increased
mucus may also blur vision.
The diagnosis of dry eye is confirmed by a Schirmer Test,
in which a narrow strip of filter paper is placed in the corner
of each eye for a few minutes and then the amount of moisture
in the paper is measured.
Treatment
Because
there is no permanent cure, the goal of treatment is to add
sufficient moisture to your eyes to relieve the symptoms.
In most cases, this simply involves using artificial tears
eyedrops several times a day, or even every hour if necessary.
A lubricating ointment placed in your eyes at bedtime may
relieve the dryness usually felt upon awakening.If the dryness
is caused by poor closure of your eyelids when you sleep,
try using a small piece of tape (hypo-allergenic paper tape
is best) to hold them closed.
If symptoms persist, small "pellets" of concentrated artificial
tears may be tucked under the lower eyelid once a day. Soft
contact lenses can sometimes relieve the symptoms, possibly
because of their water-holding properties. But they do not
help everyone. In fact, some patients find that contacts seem
to make matters worse.
If
none of these measures helps, it may be necessary to close
the puncta (tiny openings in the eyelids that drain tears
into the tear ducts and nose), to prevent losing what little
moisture you have. The procedure may involve heat cautery,
plastic plugs, or suture. Afterward, you still may need to
continue using the eyedrops, ointments or pellets.
A
new special Vitamin A ointment seems promising for relieving
dryness, irritation and light sensitivity while enhancing
tear production and visual acuity. It is presently being evaluated.
Living
With Dry Eye
If
you have dry eye, try to avoid dry environments and use artificial
tears or other moisturizing eyedrops as often as you need
them. Always carry the drops with you. If, at any time, you
think your eye membranes have become infected (the symptoms
are increased redness and secretions), call your eye doctor
for an immediate appointment.
 Excerpted
from Triad's Eye Care Notes
© 1989-2005 by Triad
Publishing Co.
Patients: for more information about your eyes, see: Taking
Care of Your Eyes: A Collection of the Patient Education Handouts
Used by America's Leading Eye Doctors |
