The condition of “dry eyes,”or dry eye syndrome, is an extremely common ocular condition. I personally see numerous patients every day suffering from this condition. Those affected have many questions about their problem and a great deal of confusion, as suggested by the title, exists. In fact, intermittent tearing is one of the most common complaints of dry eye sufferers along with that of pain, foreign body sensation and fluctuating vision. Cosmetically, patients may complain of their eyes frequently appearing red or tired. The condition may be intermittent, or constant, and vary from mild to very severe.
Why does this happen to patients? There are many factors involved with age, genetics, environment and other medical conditions being among the most important. For instance, we know that the condition of dry eyes increases with age and is worse in lower humidity environments such as arid climates or during cold winter days. Medical conditions that affect the immune system, such as rheumatoid arthritis and oral medicines such as antihistamines (that dry secretions) may be factors.
In general, dry eye syndromes are the result of decreased tear production, poor quality of tears or rapid evaporation of the tears that are available. It is important for the doctor to recognize the cause so that the proper treatment can be initiated. How does the doctor make this diagnosis and determine the cause? The patient’s history is crucial and the examination is very important. The doctor will carefully examine the surface of the eyes and assess the amount, quality and sustainability of the tears. Some specialized tests may even be performed in the office.
Finally, the treatment plan is put into effect. Initial treatment typically begins with replacement of tears by artificial lubricants, gels or ointments. In addition, increased tear production may be stimulated with a topical prescription medicine called Restasis. For those with significant eye discomfort, topical anti-inflammatory drops may be prescribed. For those with a disturbance of the oil glands of the eyelid margins (known as meibomian glands), an antibiotic such as Azasite may be utilized. It is important to know that this condition is chronic and is not necessarily cured, but can be significantly improved with treatment. Excellent communication, compliance and follow-up all are important in promoting long term success.