DRY EYE SYNDROME
Tears are essential for healthy eyes and vision.
What is Dry Eye Syndrome?
Dry Eye Syndrome, or DES, is a condition caused by a lack of naturally producing tears. Tears are an essential aspect of eye health because they lubricate the surface of the eyes, keeping them moist and comfortable. When the body is unable to produce an adequate amount of tears, the eyes can begin to dry out, leading to itchy, red, and painful eyes.
At Lifetime Eyecare Associates, we are leaders in treatments for Dry Eye Syndrome patients in The Woodlands, Texas . If you or a loved one suffers from DES, speak with our eye doctors and schedule a consultation to learn how we can help.
Tears are more than just fluid in the eye; they have a chemical makeup comprised of water, enzymes, proteins, metabolites, lipids, and mucins.
Tears are important because they keep your eyes well-lubricated and protect them from foreign bodies or dust particles, which can cause irritation. When an insufficient amount of tears is produced in the tear ducts, Dry Eye Syndrome occurs.
Enzymes are proteins that cause a chemical reaction inside the body
Proteins are molecules containing amino acids that are found in tissues in the body
Metabolites are small molecules that are related to metabolism
Lipids are molecules with an oily substance which contain healthy fats
Mucins are glycoproteins that helps cells stick together
The most frequent types of Dry Eye symptoms include:
- Blurry vision
- Burning sensation
- Gritty feeling
- Itchy eyes
- Watery eyes
It may seem ironic, but one symptom of DES is watery eyes. This occurs when the body attempts to self-soothe the dryness by producing excessive tears, a condition known as Keratoconjunctivitis Sicca (KCS). The tears lack a sufficient amount of water, so although these tears may provide temporary relief, the excessiveness of the tear production isn’t healthy.
Who Is at Risk for Developing Dry Eye Syndrome?
Like other diseases and eye conditions, there are some people who are more susceptible to developing DES. Age, gender, medical conditions, even the environment can contribute to sensitivity to dry eyes.
Certain medical conditions can make Dry Eye more prevalent. Patients with any of the following diseases may notice signs of DES symptoms:
- Arthritis, an inflammation of the joints
- Blepharitis, an inflammation of the eyelid, usually caused by skin conditions such as dandruff or rosacea
- Diabetes, a condition causing high blood glucose levels
- Glaucoma, a disease of the optic nerve, which causes vision loss
- Hypertension, high blood pressure in the arteries
- Lupus, a chronic autoimmune disease that causes damage to healthy tissue
- Thyroid Disorder, when the tissues that surround the eyes become swollen or inflamed
- Vitamin A Deficiency, when there is an insufficient amount of Vitamin A, which normally helps protect the cornea
People who live in areas with heavy winds or with dusty or dry air may find that their eyes often feel dry. Being around smoke or hair dryers can cause the same reaction. Being in direct aim of a heater or air conditioning unit can also dry out the eyes.
Women are more prone to DES because of hormonal changes due to pregnancy, birth control, and menopause. Women over age 50 have a 50% greater risk of developing Dry Eye than men of the same age. Additionally, women tend to visit their doctor more often than men and at earlier stages of discomfort, so diagnosing the condition in women is more common.
According to the National Eye Institute, the risk of experiencing DES goes up with age. That’s because the natural tears of the eye decrease over time, which is a natural part of aging. As the patient’s tear production diminishes, signs of Dry Eye increase.
Treatment for Dry Eye Syndrome
Our eye doctors treat patients from all over The Woodlands who have Dry Eye. Our staff has the experience and knowledge needed to help give you relief from DES symptoms and improve your quality of life.
Depending on your specific case, we may recommend artificial tears or lubricant eye drops to produce tears to moisten and make your eyes feel more comfortable. Prescription drops can help stimulate tear production and, in some cases, steroids can provide significant short-term relief.
For patients with more severe DES, the doctor may suggest the use of punctal plugs. These tiny devices are placed inside the tear duct to block tears from draining. As the natural moisture is prevented from leaking out, it remains in the eye and coats it properly, keeping it lubricated and comfortable.
Scleral lenses can provide effective relief, as well. These are custom-designed rigid contact lenses with a large diameter that cover the entire sclera (the white part of the eye) without touching the cornea. Scleral lenses contain a tiny pool of water, providing constant moisture to dry eyes.
Lipiflow could be your first step to relief. Studies show 79% of patient report improvement of their overall dry eye symptoms with four weeks of treatment with Lipiflow.
If your eyes feel scratchy, gritty and dry, you may have a chronic condition known as Evaporative Dry Eye, which is caused by blocked Meibomian glands.
Lipiflow is a fast and virtually painless procedure that opens and clears the blocked glands. Learn more about Lipiflow here.
Medications and Dry Eye
All medications include warnings of possible side effects which some patients may experience. There are certain categories of medications that are known to decrease natural tear production, such as:
- Anxiety medications
- Birth control pills
- Blood pressure medication
If you are taking any of these medications and feeling any signs of Dry Eye, speak with our eye doctors about some alternative medications or treatments to alleviate your symptoms
Many symptoms of Dry Eye Syndrome last for the short term, meaning, they can fade with proper treatment or sometimes, on their own. Blurry vision, itchy or red eyes, and stinging can be treated effectively and perhaps eventually disappear.
Some symptoms of Dry Eye Syndrome have long-term effects, which means that they can last for months or even years. These may include:
- Corneal abrasions or ulcers
- Long-term inflammation
- Vision impairment
Corneal abrasions can become serious if left untreated. They often heal on their own, but in more severe cases, prescription creams or bandage contact lenses may be needed for more efficient treatment. In cases of vision impairment from Dry Eye Syndrome, we can help.
These long-term effects of Dry Eye can negatively impact your life. Sensitivity to light and difficulty driving are 2 primary examples of everyday tasks that can become restricted with severe Dry Eye Syndrome. This leads to a lower quality of life.
If you suffer from Dry Eye and are ready for a solution to your painful symptoms, contact our eye doctors and the staff at Lifetime Eyecare Associates. We are here to help you experience better vision today.
Dry Eye Q&A’s with Dr. Lagunas
Dr. Claudio Lagunas answers the most frequent questions he receives about Dry Eyes.
Typically, for mild symptoms, it’s ok to try over-the-counter solutions such as lubricating eye drops, but if that is not solving the patient’s problems or they see their symptoms are not improving, then they definitely should come in and see their optometrist for testing, and or a dry eye examination. This way we can find out the true cause of their symptoms and give them a proper treatment plan.
False. At least not in the Houston area. Here we see Dry Eye symptoms are the same year-round and don’t find the symptoms worse in the winter than the summer. There are also a lot of other factors involved besides just the temperature that can cause Dry Eye symptoms.
Yes. There are some patients who are more prone for Dry Eye, for example age is a big factor, and age-related issues cause the quality of our tears decreases over time. Patients who take certain medications or who suffer from certain medical conditions suffer more from Dry Eyes. Also, women are more prone to Dry Eyes. In general, though, Dry Eye can affect just about anyone.
Watery eyes are definitely a symptom of Dry Eye, and it could also be caused by something else. For instance, allergy related issues. Both of which we can treat. If someone tears a lot without any other cause, or emotional component, then it is very likely Dry Eye. It is the eyes natural response to try and protect the eye. Especially if the eye is dry and the quality of the tears is not enough to protect their eyes.
There are very specific tests we conduct to determine if a patient has Dry Eye. We actually screen every single patient who comes in to see if we see any Dry Eye symptoms. If they specifically know they may already have Dry Eye, then we will do:
1) a tear break-up time test, LipiView (part of the LipiFlow technology), which lets us look at the glands to see if there is any obstruction of the glands,
2) we will run some functional tests to see how many of the patient’s glands are producing the oil,
3) we will do a blink assessment to see if the patient is a partial blinker or not,
4) and We will conduct an ocular surface disease assessment test.
LipiFlow is a treatment for meibomian gland dysfunction (MGD). If we see that a patient has an obstruction of their glands…each person has about 25-35 glands in the upper and lower lid. If those glands are blocked for any reason, then the production of oil in the tear is decreased. If enough of those glands get blocked, then this can cause some serious problems.
Some of the new research shows that about 86% of patients with Dry Eye symptoms actually have MGD. Again, once we have diagnosed the glands are blocked, then we will use LipiFlow, the only FDA approved treatment for unblocking the glands. So far we have had some fantastic results from patients who have undergone the LipiFlow procedure.
Once we have diagnosed the true cause of the Dry Eye symptoms, we will put the patient on the appropriate drop for them. There are a number of different drops. Whether it be a lipid-based drop for patients who need more oil in their tears, or water-based drops because they need more water in their tears.
There are also masks we use very effectively, to heat up the glands, so if they are not completely obstructed, and there is a little bit of blockage, then the heat will open up those pores, release the blockages, and allow those glands to work better.
There is omega-3 and vitamins that have been proven to increase production of tears. There are some medications like Restasis that have been proven to increase tear production.
As you see, there are a number of ways to treat Dry Eye, we first need to find the root cause of the problem so we can best address the situation and find a solution to their symptoms. Each patient is different. Some patients require a lot of the above treatments, some patients only one or two of them.
It can also include warm compresses of the eyelids, discussing environmental factors like water intake, Omega 3 supplementation, limiting fans and AC. Depending on the type of dry eye, as well as the severity, it could include a variety of treatments.
Number 1 is early diagnosis. Since Dry Eye and MGD are progressive disorders, so the earlier we catch it, the longer we can preserve the glands from damage. Eventually, if not treated, the glands will atrophy and just die out. The key is getting tested early and often, and then following your optometrist’s treatment plan.
I want each patient to know that we are the fifth office in Houston to offer have the LipiView, which is part of the new LipiFlow technology. LipiFlow is the treatment, but we are actually using the LipiView as a screening for every patient who comes in, and this lets us view the glands and see if there is a problem.
Many patients don’t require the full-blown treatment with LipiFlow, they may only require specific drops, or the heat mask. We really want to make sure Dry Eye or MGD is detected as early as possible and LipiView helps us do that for every patient.
We want everyone suffering from Dry Eye symptoms to know they can come in and get the proper diagnosis and treatment. Relief is possible.