Dry Eye Center of Excellence
The name “dry eye“ can be a little confusing since one of the most common symptoms is excessive watering! However, the eye makes two different types of tears. The first type, called lubricating tears, is produced slowly and steadily throughout the day. Lubricating tears contain a precise balance of mucous, water, oil, nutrient proteins, and antibodies that nourish and protect the front surface of the eye. The second type of tear, called a reflex tear, does not have much lubricating value. Reflex tears serve as a kind of emergency response to flood the eye when it is suddenly irritated or injured. Reflex tears might occur when you get something in your eye, when you are cutting onions, when you are around smoke, or when you accidentally scratch your eye. The reflex tears gush out in such large quantities that the tear drainage system can not handle them all and they spill out onto your cheek. Still another cause of reflex tearing is irritation of the eye from lack of lubricating tears. If your eye is not producing enough lubricating tears, you have Dry Eye.
- Watery eyes
- The feeling that there’s sand in your eyes
- Eyes that itch and burn
- Vision that becomes blurred after periods of reading, watching TV, or using a computer
- Red, irritated eyes that produce a mucus discharge
- Age: As we get older, glands in the eyelid produce less oil. Oil keeps tears from evaporating off the eye. Decreased oil production allows tears to evaporate too quickly, leaving the eye too dry.
- Diseases including diabetes, Sjogren’s and Parkinson’s Disease
- Hormonal changes, especially after menopause
- Prescription medications: These include some high blood pressure medications, antihistamines, diuretics, antidepressants, anti-anxiety pills, sleeping pills and pain medications. Over-the-counter medications including some cold and allergy products, motion sickness remedies, and sleep aids can also cause dry eye.
- Hot, dry or windy conditions: High altitude, air-conditioning and smoke can also cause dry eye.
- Reading, using a computer or watching TV
- Contact lenses
- Eye surgery: Some types of eye surgery, including LASIK may aggravate dry eye.
- Inflammation: Recent research suggests that dry eye may be caused by inflammation due to an imbalance of “good” fats and “bad” fats.
One way to alleviate dry eye is to help the eyes to make better and longer use of the small amount of lubricating tears they do produce. This is accomplished by closing off the small funnel-like drain hole found in the inner corner of the upper and lower eyelids. These drain holes, called punctums can be closed with tiny plugs called punctal plugs. The plugs can be placed in the two tear ducts, top and bottom, in both eyes or in only the lower ducts. The punctum can also be permanently closed with a heat or laser procedure. Punctal plugs can be temporary or permanent. Temporary plugs dissolve a few days after insertion. If your dry eye symptoms disappear when the temporary plugs are inserted, our doctors may consider permanent punctal occlusion.
