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Dry Eye Therapy

Dry eye related problems are some of the most common eye conditions people come to us with.  One study showed that 48% of adults experience dry eye symptoms at least some of the time.  The surface of the eye must be kept moist and lubricated by a well-formed tear film.  If the protective ability of the tear film is compromised for any reason, dry eye symptoms may result.  You may have a dry eye problem if you experience some of the following symptoms:

  • Eyes feeling gritty or sandy, particularly when tired or after a long session in front of a computer
  • Feeling as if you have something in your eye (a "foreign body sensation")
  • Discomfort wearing your contact lenses as the day goes on
  • Eyes "burning"
  • Eyes red
  • Eyes watery - odd though it may sound, dry eye related irritation is a common cause of a watering eye.  This is because the dry eye irritation stimulates "reflex tearing" from the lacrimal gland

We use our expertise and range of products to provide relief from this irritating condition.

"For some time I had trouble with sore, irritated eyes, and was unable to get any relief.  At my eye examination with Cassidy Eyecare the condition of Meibomian Gland Dysfunction was diagnosed.  I started daily treatment applying a warm wheatbag and massaging my eyelids.  This helped my symptoms immediately.  I now see Troy every month for a treatment in his office which also makes a big difference.  The uncomfortable irritation has been greatly reduced, and I am grateful to have the condition greatly eased and under control.  A simple solution for a difficult problem" - Gillian, New Lynn.

 

Causes of Dry Eye

The tear film itself is made up of three primary components, which work together to provide a stable protective shield for the cornea.  Problems with any one of the three components can reduce the protective effectiveness of the tear film.

How tears work
  • The Mucin Layer provides the interface between the cornea and the tear film
  • The Aqueous Layer is produced by the lacrimal gland and comprises the watery bulk of the tear film
  • The Lipid Layer is produced by the meibomian glands along the eyelid margins and stabilises the tear film
 
Broadly speaking, dry eye problems are caused either by insufficient volume of tears (aqueous deficiency), or poor tear quality allowing excessive evaporation of tears (evaporative dry eye), or a combination of both. 

 

Evaporative Dry Eye

The most common cause of evaporative dry eye is dysfunction of the Meibomian glands, which are located along the eyelid margin.  If the quality of oil produced is poor the glands may become blocked, leading to an unstable tear film and eyelid irritation.  Bacteria may colonise the blocked glands, causing further irritation and often styes.  This condition is known as Meibomian Gland Dysfunction (MGD), or posterior Blepharitis.

Treatment is aimed at improving meibomian gland function with hot compresses to soften the stagnant oils within the glands, followed by eyelid massage to attempt to expel the thickened oil and a special eyelid wash to clean the lid margin.  Omega 3 dietary supplements can also be useful to improve meibomian oil quality.  At Cassidy Eyecare we offer an in-house treatment which is very effective at clearing the glands and returning your eyelids to normal function.

It's important to realise that maintenance treatment is often required to maintain a healthy tear film, and an ongoing routine may be necessary to prevent a return of symptoms.  Click here to download a PDF of instructions on treating MGD/blepharitis.

 

Aqueous Deficient Dry Eye

Aqueous tear deficiency is associated with a number of factors.  These include:

  • Increasing age
  • Female gender
  • Diabetes
  • Systemic medical conditions, such as Sjogrens Syndrome
  • Medications such as antihistamines, some anti-depressants, the contraceptive pill, beta-blockers and others

Treatment of aqueous deficient dry eye is by artificial tear supplements (dry eye drops), and management of dry-eye causing environmental factors.  Preservative-free drops dispensed in single-dose units are the most gentle on the eye, and are preferable to lubricants from a bottle, which need to contain a preserving agent.

 

Environmental Factors in Dry Eye

One of the primary ways to improve discomfort from dry eyes is to avoid situations that exacerbate the problem.  Of course, this is not always possible.  However you may want to consider avoiding these aggravating factors when it's practical to do so:

Air Conditioning

Air conditioning produces dry air which often aggravates dry eyes.  Some people find a benefit from using a humidifier at home to add moisture to the air.

Computers

Computer use is a very common contributor to dry eye symptoms.  A recent study found that 75% of women using a computer at work experienced dry eyes.  A number of studies have also demonstrated that people blink less when watching a computer screen, which increases tear evaporation.  Regular blinking, and a brief break from the screen every 20 minutes will help eye comfort.  Having an eye-drop lubricant handy and instilling a drop in a couple of times a day is also a good idea.

Excessive Airflow over Eyes

Windy conditions, or a fan in a car directed at the face will increase tear evaporation and worsen dry eye symptoms.  Wrap-around sunglasses for outdoor use can make a big difference.  For a really big difference, try sunglasses with a soft seal that manages airflow - these provide a tremendous improvement in dry eye protection (see example below).  These come in a reasonable range of styles, and are available through Cassidy Eyecare.

Nutrition

Firstly, keep yourself hydrated.  Even mild dehydration can worsen dry eye problems.  Secondly, consider increasing your Omega 3 intake.  There is good evidence that Omega 3 fatty acids improve tear film quality and reduce dry eye symptoms.  Good natural sources of Omega 3 include oily fish such as sardines and salmon.  One of the best supplements for dry eyes is the Theratears Nutrition Omega 3 which combines fish & flaxseed oil in a capsule.

 

Summary

Dry eye is a common problem that can usually be improved significantly by correct management.  A professional consultation with an optometrist experienced in dry eye management is the best way to diagnose the problem and begin the appropriate treatment.  Once again, it's important to understand that the goal of most dry eye treatments is to relieve symptoms and manage the condition.  It's rare to be able to cure dry eye completely & permanently with a single course of treatment.