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"You'll 'See' - We Care."
Community Eye Care of Indiana
| DRY EYE: WHY IS IT A DISEASE AND NOT JUST A NUISANCE? Do you have dry eyes? Up to 12 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. |
| For more information about dry eye, go to any of the following websites: www.nei.nih.gov www.preventblindness.org www.eyemdlink.com Schepens Eye Research Institute |
| TREATMENT OPTIONS FOR DRY EYES Dry eye syndrome occurs when your eye doesn’t make enough tears to keep your eye moist and comfortable. Dry eye syndrome is more than just a nuisance. Your tears are important in keeping your eyes healthy. If you have dry eyes, many different treatments are available to maintain moist and healthy eyes, including: Environmental changes: Mild dry eyes can often be improved by making simple changes in your surroundings. One common cause of dry eye is air blowing in your face, which can evaporate your tears faster than your eye can make them. Don’t sit directly in front of a heating or air-conditioning vent at home or at work, and in the car, make sure these vents are not aimed directly into your face. Avoid using hair dryers, or at least shield your eyes when using one. If you smoke, you should seriously consider quitting, because smoking also aggravates dry eyes. Dietary changes: You are what you eat, and studies have shown that eating foods rich in omega-3 fatty acids can decrease dry symptoms. Fish such as tuna, salmon, and halibut, and various seed- and nut-derived oils such as flaxseed, walnut, soybean, and canola, are all good dietary sources of omega-3 fatty acids. Fish oil capsules are also commercially available at drug stores and health food stores. Tear replacement therapy: If the environmental changes alone don’t restore your eyes’ moisture level, many over-the-counter eye drops—called artificial tears—are available. These drops are highly effective in soothing dry eyes for most people, but they must be used regularly—often 4 times a day—in order to maintain constant moisture throughout the day. Artificial tears are available in multi-dose bottles and in single-dose vials. The bottles are easier to handle and contain preservatives so that the tears won’ t spoil before you use the whole bottle. Some people develop allergies to or irritation from the preservatives if they use the drops more than 4 times a day. The single-dose vials do not contain preservatives, and are recommended for anyone who needs to use the drops more than 4 times a day. These products can be purchased without a prescription in any supermarket or drug store. |
| WOMEN AND DRY EYE Dry eye syndrome is among the most common eye conditions in the United States. What is dry eye syndrome? In healthy eyes, a thin layer of tears coats the outside surface of the eye and keeps it moist. Dry eye syndrome occurs when the eye doesn’t make enough tears, or doesn’t make effective tears, or the tears that it does make evaporate too quickly and leave the eye dry and vulnerable. People with dry eyes often experience dryness, stickiness, and stinging or burning of their eyes. The eyes are often red and irritated. Sometimes the eyes water excessively in an effort to soothe the irritation, but these reflex tears are usually not adequate to fix the problem, and all they do is spill over the eyelid and run down the cheek. The cause of dry eye syndrome is unknown, but the disease affects approximately 77 million Americans. The disease becomes more common as we age, and is particularly common in women over the age of 35. Dry eye syndrome affects women two to three times more often than men. This is thought to be related to hormones. Male hormones (such as testosterone) seem to be good for the tear glands, and female hormones (particularly estrogen) seem to be bad for the tear glands. In a recent study, women who were on hormone replacement therapy after menopause had up to a 70% higher risk for developing dry eyes than women not using hormone replacement therapy. One particular form of dry eye syndrome occurs in patients with Sjögren’s syndrome. Patients with Sjögren’s syndrome suffer from dry eyes and dry mouth, because their bodies mistakenly produce small molecules that attack their moisture-producing glands, in addition to causing other problems, such as rheumatoid arthritis or lupus. Ninety percent of people with Sjögren’s syndrome are women. Dry eye syndrome is more than a nuisance. Left untreated, severe cases of dry eye syndrome can lead to problems such as inflammation, infection, and scarring of the eye surface, resulting in permanent loss of sight. Treatment options: If you have dry eye syndrome, there are numerous treatments available to help protect your eyes and your sight. For many dry eye sufferers, small changes in their daily habits can make the problem better, such as smoking cessation or making sure heating and air- conditioning ducts are aimed away from your face and eyes at home and at work. Diets high in omega-3 fatty acids—including fish, nuts, or supplements—can also improve dry eye symptoms. For others, tear replacement drops can help re-establish moisture to the eye or small plugs can be placed in the tear ducts to prevent tears from draining away too quickly. In addition, a new prescription medication called cyclosporin is now available. Marketed under the brand name Restasis®, cyclosporin helps your tear glands produce more of your own natural tears. |
| YOUR EYES SHOULD NOT ITCH AND BURN AS YOU AGE Aging is unavoidable, and as you age, your body undergoes many important changes. Your eyes are no exception. One of the most common problems associated with aging eyes is dry eye syndrome. If your eyes frequently burn or feel itchy or scratchy, you may have dry eye syndrome. As its name suggests, dry eye syndrome is caused by inadequate moisture to the eye. The front surface of the eye must be kept moist at all times in order to work properly. This is why your body produces tears—to keep the eye moist and healthy so that your vision will be crisp and clear. Tears have three main ingredients: a mucin layer that coats the outer surface of the eye, an aqueous or watery layer that provides moisture to the eye surface, and a lipid or oil layer on the outside to slow down evaporation so that your tears will last longer on your eye. Each of these three key ingredients is made by a different set of tear glands in your eyelid. If any of the three ingredients is missing, or if your tears evaporate too quickly, you will develop dry eye syndrome. The symptoms of dry eye syndrome include burning, itching or scratching, and a sensation of grittiness like sand in your eyes. Your vision may be blurred. Often these symptoms worsen throughout the day, becoming worse in the late afternoon or evening. Although this sounds backwards, some dry eyes water excessively. This is because a dry eye is often irritated, and eye irritation often triggers tearing to help soothe the eye. If your eye becomes dry and irritated because your tears are defective, then making lots more defective tears is no solution: instead you just end up with irritated, wet eyes. There are many causes of dry eyes, but the most common cause is simply getting older. As you age, your body produces less oil. This results in dry, irritated skin, and also dry eyes. The eyes get dry because the oil layer of your tears is deficient, and the water in your tears evaporates too fast. Women are particularly vulnerable to dry eyes as they age, because the hormonal changes that accompany aging often reduce tear production. Dry eye syndrome can be treated in a variety of ways. Environmental and lifestyle changes may be all that is needed. Perhaps you sit too close to a heating or air conditioning duct that is drying out your eyes, or perhaps cigarette smoke is irritating your eyes. Tear replacement therapy can effectively moisten your eyes. Placing small plugs in your tear ducts can reduce tear drainage, making your tears last longer. And new prescription medications can help stimulate your tear glands to produce more of your natural tears. Itching and burning is not a normal sign of aging. If your eyes itch and burn, tell your doctor. Your doctor will help you identify possible reasons for your dry eyes, and will design a treatment plan to relieve your symptoms. |
| WHAT CAN I DO FOR MY DRY EYES? Dry eye syndrome is a common condition that affects as many as 10 million people in the United States. Symptoms of dry eye syndrome include burning and an itchy or scratchy sensation, like having sand or grit in your eyes. Many people with dry eye syndrome have intermittent blurry vision that temporarily improves with rapid blinking. There are many causes of dry eye syndrome, but in general, the condition occurs because your tears are either abnormal or they are evaporating from your eye’s surface too quickly. Dry eye syndrome is often a nuisance, and in some cases, can lead to scaring of the eye’s surface with loss of vision. There are several treatments available. These range from simple lifestyle modifications to prescription medications, depending on the severity of the condition. can make tears evaporate too quickly. Most heating systems dry out your can make tears evaporate too quickly. Most heating systems dry out your home’s air even if you don’t sit too close to the vent; a humidifier can help put moisture back into the air. Cigarette smoke can irritate and dry out the eye surface as well, and quitting smoking often improves symptoms of dry eye syndrome. eye syndrome. If your eyes don’t produce enough tears or don’t produce healthy tears, there are tear replacements available. These artificial tears are sold over the counter in most drugstores and grocery stores. If your symptoms are mild to moderate, putting artificial tears into your eyes two to four times daily often helps relieve your symptoms. Artificial tears are available in multi-dose bottles and single-dose vials. The multi-dose bottles are less expensive but contain preservatives that some people cannot tolerate more than four times daily. The single-dose vials contain no preservatives, and can be used more than four times daily, but they are generally more expensive. If you require artificial tears more than four times daily, you may benefit from punctual plugs. The punctum is the opening in the lower eyelid through which your tears drain away. Plugging the punctum makes your tears—or artificial tears—stay on your eye surface longer, which improves your dry eye symptoms. Punctal plugs are quickly, easily, and painlessly inserted during an office visit, and provide significant relief for many dry eye sufferers. If for any reason you are unsatisfied with them, they can be removed as easily as they are inserted. Moderate to severe dry eye may require medical therapy. Prescription eye drops are available that stimulate your tear glands to produce more of your own natural tears. All medications have side effects, and prescription medications can be costly, so this solution may not be for everyone. If you have dry eye symptoms, talk to your eye doctor. Based on your lifestyle and the severity of your symptoms, your doctor will work with you to design a treatment plan to make your eyes comfortable. |
Dry Eye: Why is Dry Eye a Disease and Not Just a Nuisance? Dry Eye: Treatment Options for Dry Eye Dry Eye: Women and Dry Eye Dry Eye: Your Eyes Should Not Itch and Burn as You Age Dry Eye: What Can I Do for My Dry Eyes? |
| 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. Tears coat the eye in a smooth film made up of three separate layers. 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 that happens, the 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. For some people, the stinging and burning and redness and watering may seem like little more than a nuisance, but in fact, if left untreated, dry eye syndrome can lead to serious eye problems, including blindness. Dry eyes are inflamed eyes. Inflammation of the front surface of the eye increases the risk of some infections, and can also lead to scarring. Once scarring occurs, permanent loss of sight can occur. |
| Prescription medications: A new prescription medication called cyclosporine is now available. Marketed under the brand name Restasis®, cyclosporin helps your tear glands produce more of your own natural tears. Your natural tears help protect the surface of your eyes, improve the comfort of your eyes, and improve the quality of your vision. |