Appointments: 847-473-2568 or 847-473-2630 Walmart Vision Center 3900 Fountain Sq. Pl. Waukegan, IL 60085
Dry Eye Syndrome
Firstly, YOU ARE NOT ALONE! Millions of people have it. If your eyes do not itch dramatically, but water, feel irritated, or burn, it is most likely because of DRY EYE SYNDROME. Dry Eye Syndrome produces a collection of symptoms that result from insufficient quantity or quality of tears. Symptoms may include dry, red, irritated eyes. Often people suffering from dry eyes will feel a "gritty, sandy" sensation. In addition, the symptoms may become more apparent toward the end of the day, especially for contact lens wearers, and symptoms develop during computer use or excess near point reading. Dry eye patients may be more bothered by bright lights, ceiling fans, air conditioning or heat from one's car defrost blower. Even their vision can flucuate by the minute, and rubbing of the eyes sometimes clears the vision.
Patients often times have seemingly paradoxical watery eyes. This happens because as a reflex response to the dryness and irritation. The cause is usually due to either a decreased production of "normal" tears or increased evaporation of tears related to poor quality of the tear film. Take the DRY EYE QUESTIONNAIRE and bring it to the Doctor for discussion.
What Causes Dry Eye Syndrome? Several factors can contribute to dry eyes, including:
Blepharitis Often dry eye symptoms can result from inflammation of the eyelid margins, which may be caused by a bacterial infection (Staphylococci). This condition is called blepharitis and can compromise the quality of the tear film causing tears to evaporate more quickly. The bacteria produce waste material, which can cause a mild toxic reaction leading to chronic red, irritated eyes.
The first step in treating this condition is to initiate better lid hygiene. There are many ways in which to do this, but warm compresses and lid scrubs, are the key components. Dr. Wexler carefully studies the lids through a microscope to determine if you have active inflammation and its severity. When the inflammation is more severe or uncontrolled with lid hygiene only, antibiotic drops and/or ointments can be prescribed to control the infection.
Often another condition called meibomitis is also present. Meibomitis is an inflammation of the meibomian glands, which produce lipids that make up the outer layer of the tear film. This lipid layer is an oily layer, which helps retard evaporation of the tears. When the meibomian glands become inflamed or clogged, the tear film quality is poor. Systemic antibiotics such as tetracycline or doxycycline may be helpful in many cases. Omega 3 fish oils taken by mouth may improve the quality of the tear oil film and reduce inflammation of the glands, as well, and are recommended.
Computer Use Computer users tend to blink much less frequently (about 7 times per minute vs. a normal rate of around 22/minute). This leads to increased evaporation along with the fatigue and eyestrain associated with staring at a computer monitor.
Ideally, computer users should take short breaks about every 20 minutes to reduce this factor. In addition, adjusting the monitor so that it is below eye level will allow the upper lid to be positioned lower and cover more of the eye's surface, again to reduce evaporation. Trying to be more conscious of blink rate, air circulation, glare, and making a more ergonomic work area can help reduce dry eye symptoms while working at the computer.
Medications Some medications may also contribute to increased dry eye symptoms: Antihistamines, blood pressure medications, oral contraceptives, ulcer medications, over-the-counter vasoconstrictors (i.e. Visine), as well as antidepressants.
Diseases Diseases that may be associated with dry eyes include rheumatoid arthritis, diabetes, asthma, thyroid disease, lupus (SLE), and possibly glaucoma.
Age Tear volume decreases as much as 60% by age 65 from that at age 18. Dry Eye Syndrome affects 75% of people over age 65.
Hormonal Changes in Women Hormonal changes can cause decreased tear production brought on by pregnancy, lactation, menstruation, and menopause.
Dry Eye Treatment The first line of treatment should address the CAUSE of the dry eye, rather than simply treating the symptoms with eye lubricants, the most commonly prescribed treatment. Dr. Wexler takes a “ladder” approach in treating Dry Eye Syndrome, utilizing the most effective and cost-efficient method for the patient given the specific cause and severity. If the symptoms do not improve within two weeks, Dr. Wexler moves up the “ladder” with more involved treatment.
The general treatment approach involves full disclosure of the patient’s symptoms, medical and medication history. Much of the treatment involves what exacerbates or “triggers” the dry eye symptoms of watery eyes. So, as important is a treatment plan that may involve ocular (eye) medicine, oral medication, punctal plugs, which help slow down the tears through a natural biofeedback mechanism (Dr. Wexler can talk to you more about this common procedure), lid hygiene therapy, etc., it also may involve communication with one’s family doctor concerning a change in the patient’s systemic medications, altering a patient’s contact lens type or material, and/or altering their work environment.
Dr. Wexler’s gestalt approach maximizes the individual’s treatment and long-term maintenance of dry eye control. Please discuss your concerns with Dr. Wexler. Call 847-473-2568 for an appointment.
