What is dry eye or aqueous tear deficiency?
Dry eye, or aqueous tear deficiency, occurs when the eye does not produce tears properly, or when the tears are not of the correct consistency and evaporate too quickly. In addition to being uncomfortable, dry eye can damage eye tissue, scar the cornea and impair vision. Permanent loss of vision from dry eye is uncommon.
Symptoms include irritated, scratchy, dry, uncomfortable or red eyes, a burning sensation, the feeling of something foreign in your eyes, stringy mucus in or around the eyes, excessive eye irritation from smoke or wind, excess tearing, discomfort when wearing contact lenses, or blurred vision.
Excess tearing from dry eye may sound illogical, but it can be understood as the eye's response to discomfort. If the tears responsible for maintaining lubrication do not keep the eye wet enough, the eye becomes irritated. Eye irritation prompts the gland that makes tears to release a large volume of tears, overwhelming the tear drainage system. These excess tears then overflow from your eye.
Who gets dry eye?
Older people frequently experience dryness of the eyes, but dry eye can occur at any age. Nearly five million Americans 50 years of age and older are estimated to have dry eye. Of these, more than three million are women and more than one and a half million are men. Tens of millions more have less severe symptoms. Dry eye is more common after menopause. Women who experience menopause prematurely are more likely to have eye surface damage from dry eye.
How is dry eye diagnosed?
Regular eye exams can detect dry eye early, before symptoms are noticeable.
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Dry Eye Treatment
What you can do: Use artificial tears, gels, gel inserts, and ointments - available over the counter as the first line of therapy. They offer temporary relief and provide an important replacement of naturally produced tears in patients with aqueous tear deficiency. Avoid artificial tears with preservatives, if you need to apply them more than four times a day, or preparations with chemicals that cause blood vessels to constrict. Over-the counter oral supplements may be helpful as well.
Wearing glasses or sunglasses that fit close to the face (wrap around shades) or that have side shields can help slow tear evaporation from the eye surfaces. Indoors, an air cleaner to filter dust and other particles helps prevent dry eyes. A humidifier also may help by adding moisture to the air.
Avoid dry conditions and allow your eyes to rest when performing activities that require you to use your eyes for long periods of time. Instill lubricating eye drops while performing these tasks.
How We Can Help
Dry eye can be managed as an ongoing condition. The first priority is to determine if a disease is the underlying cause of the dry eye. If it is, then the underlying disease needs to be treated.
Cyclosporine, an anti-inflammatory medication, is the only prescription drug available to treat dry eye. It decreases corneal damage, increases basic tear production, and reduces symptoms of dry eye. It may take three to six months of twice-a-day dosages for the medication to work. In some cases of severe dry eye, short-term use of corticosteroid eye drops that decrease inflammation is required. Collagen or silicone punctal plugs may inserted by your doctor in tear ducts to keep your tears on the ocular surface for longer periods of time. If effective, punctal cautery may provide a more permanent solution.