Probably one of the most common problems seen in the eye doctor's office is dry eye syndrome (DES). As we age, the protective tear film on the surface of the eye decreases. This leaves the delicate tissues of the eye exposed to the drying effects of air, wind, dust and sun. The eye still makes tears; in fact, many patients complain of wet eyes and tearing with this diagnosis. That's because the dryness produces a reflex tearing in an effort to keep the eye well lubricated.
In many people the dryness is worse in the afternoon and evening. Since we blink less frequently when we read, reading can also aggravate the symptoms of dry eyes. Sometimes environmental factors play a role as well. Dry weather, either in hot or cold temperatures, deplete the eye of needed lubricants. Cigarette smoke, fumes, dust and airborne particles are common irritants. In most patients, this condition is not associated with systemic disease, but some patients also have connective tissue diseases, such as rheumatoid arthritis, lupus, or Sjogren's syndrome.
Symptoms of DES include burning, stinging, aching, Itching, tearing, light sensitivity and a gritty or sandy sensation. These symptoms may come and go depending on many factors.
Treatment helps in most patients. This condition cannot be completely cured, so treatment must be ongoing. Usually artificial tears, available over-the-counter, soothe the eyes and give temporary relief. Some of the commonly used ones are Systane, Optive, Refresh, Theratears, Hypotears, Tears Naturale, and Genteal. However, there are many other brands available. If artificial tears must be used more than four times a day, then preservative-free tears are best for the eye.
The problem is that they only work for a short time and must be repeated at frequent intervals. Ointments last longer, but they usually will blur the vision and are most effective and convenient at night. Some of the eye lubricating ointments are Refresh PM, Genteal gel and Lacrilube.
Restasis (cyclosporine) eyedrops are a newer treatment for dry eyes. This drug must be used for about two to three months before it begins to improve the dry eye condition and its symptoms. It actually helps reverse the disease by reducing auto-immune inflammation that has damaged the eye's tear-producing glands. Once Restasis has improved DES, it must be continued, or the symptoms will worsen again.
In some patients with DES, very tiny soft silicone rubber punctum plugs are placed into the tear drainage system to "plug the drain" and keep more tears on the eye surface.