Dry eye syndrome

• 01 October 2016

WHAT IS THE DRY EYE SYNDROME?

The dry eye syndrome is an ensemble of symptoms caused by a decrease in quantity or quality of tear production. This problem bothers many people. In fact, it’s the most common ocular condition. You should know that, two types of tears are produced by the eyes.

1.       Reflex tears are produced in response to emotion, injury, irritation traumatism. They make tears more watery and there’s a reflex that produces an excess tearing in your eyes. Each eye has its own gland “outside the eye” in the upper part of it. Tear production or excess tearing generally quickly evacuate the irritant substances of the eye surface.

2.       Lubricating tears: keep the eye moist and fight infection. They are secreted by tiny glands inside your eyelids and the conjunctiva of the eye (white of the eye). With each blink, the eyelids spread tears over the eye, maintaining a tear film which keep the eye comfortable and moist.

A healthy tear film has three layers:

·         At the exterior of the eye, a layer of oil reduces the central evaporation layer.

·         The central layer is an aqueous layer (water). It represents 95% total density of tears.

·         The layer directly in contact with the eye is a mucus layer. It stabilizes the tear film, allowing the tears to spread evenly over the eye.

Some people don’t produce enough lubricating tears. Then, signs and symptoms appear: eye itching, burning, stinging or redness. They will be also affected by, eye irritation, discomfort, pain. Often they will feel like something is in their eye and have an over reaction to dust, smoke, and wind. Dry eye syndrome produces excess tearing.

Indeed, if there is a decrease in quantity or quality of lubricating tears, the lacrimal gland activates itself and produces an excess tearing caused by eye dryness and eye irritation. Generally, it doesn’t damage the eye, but it may cause blurred vision, redness of the eye which again cause a patient to be uncomfortable and as we already mentioned: cause excess tearing.

WHAT CAUSES: DRY EYE SYNDROME?

Advanced age is the most important risk factor for the dry eye syndrome. 75% of people over 65 are affected by dry eye syndrome, but it frequently begins to appear after the age of 30. This situation may be brought by a pregnancy, breastfeeding and menopause. Alcohol also has a negative effect. Other sicknesses are also associated to that syndrome as arthritis, ocular allergies and certain drugs, including oral antihistamines, oral contraceptives, diuretics, antidepressants, phenothiazine, pain drugs, sleeping pills and beta-blockers.

Exposure, at the house, the office or in the car, to an air conditioning, atmospheric pollution, sunny dry days with wind, allergen substances especially pollen, can unsettle the lachrymal film and lead to dry eye syndrome. Those who spend, a lot of time in front of the computer or read often, can also have: dry eye syndrome caused by decreasing eye blinking, during these activities. That’s why there are more and more young people with: dry eye syndrome.

DIAGNOSTIC AND TREATMENT

The severe cases of dry eye syndrome can eventually lead to serious eyes’ problems. A visual exam, is recommended if you think, you may suffer from: dry eye syndrome.

Your optometrist can examine your lacrimal film quality and the quantity of your tear production. He can also evaluate an eventual drainage on the surface of the eye and combined to your medical history and your symptoms, succeed in giving you a good diagnostic.

Treatments may include lubricating drops or artificial tears, in order to keep the surface of the eye moist. The lubricant may have the proprieties of a liquid, a gel or ointment. You can also create an environment which will help preserve your natural tears by using a humidifier in winter, by avoiding irritants, great winds, smoky atmospheres (cigarettes). If you must put artificial tears more than 4 times a day, it’s best to use preservative-free type. If artificial tears do not resolve the problem, your optometrist will daily recommend to combine artificial tears and 2000 mg/ of oral Omega-3 fatty acid supplements. Also, collagen implant to block the excess of tears which flow into 2 tiny drainage ducts, in the corner of the eye by the nose, may help you. The basic principle of these implants, is to preserve your tears on the surface of your eyes, instead of outside the eye. If these collagen implants which dissolve themselves in less than a week, seem to bring relief, then the ducts may be blocked permanently by inserting special silicone implants or thermos elastic material which will definitely obstruct the lachrymal duct. The ophthalmologist, only, can implant these permanent implants.

In extreme cases, where artificial tears or implants blocking the lachrymal ducts wouldn’t be sufficiently effective, a medicine called Restasis can be prescribed by your optometrist: one drop every 12 hours. This medicine increases tear production.

CONTACT LENSES AND DRY EYE SYNDROME

Those, who wear contact lenses, may also feel the effects of a dry eye. The flexible lenses, particularly need to be kept moist. An incompatibility, of the plastic of the lens with your eyes, an accumulation of protein deposits, calcium or any other substances coming from your body, can set onto the surface of your lenses and will lead to a dry contact lenses, consequently: a dry eye.

The development of new materials and new technology, in the making of contact lenses (disposable lenses), make in symptomatic cases, the wear of contact lenses much more, comfortable.

OCULAR ALLERGIES AND DRY EYE SYNDROME

Ocular allergies and dry eye syndrome are frequently associated to one another. It’s important to understand that a deficient tear film doesn’t accomplish one of its primary function which is to evacuate foreign substances outside the eye. This way, the allergens fix themselves on the eye and are not diluted in the tears and evacuated outside the eye. There is a large concentration of allergen at the ocular surface and, resulting from this: allergy symptoms.

Also, a patient that normally doesn’t have dry eye syndrome, the allergens, by their irritant property, can affect the stability of a lacrimal film and lead to an ocular dryness.

If you are subjected to ocular allergies or believe that you have ocular dryness, talk to your optometrist. He will advise you, on a suitable treatment.