What causes dry eye?
Tears are necessary for maintaining the health of the front surface of the eye, and for providing clear vision. Patients with dry eye either do not produce enough tears, or they produce tears of poor quality. With each blink of the eyelids, tears are spread across the front surface of the eye. Tears provide lubrication, reduce the risk of eye infection, wash away foreign matter, and keep the surface of the eyes smooth and clear. At Vista Eye Care in Thornton, Colorado, our eye doctors take a preventative approach to dry eye treatment.
What are the two main causes of dry eye?
- Inadequate production of tears – Tears are produced by several glands in and around the eyelids. When the normal amount of tear production decreases, or tears evaporate too quickly from the eyes, symptoms of dry eye may develop.
- Poor quality of tears – Tears are made of three integrated layers: oil, water, and mucus. Each component layer serves a function in protecting and nourishing the front surface of the eye. A smooth oil layer helps to prevent evaporation of the water layer, while the mucin layer functions in spreading the tears evenly over the surface of the eye. If the tears evaporate too quickly, or do not spread evenly over the ocular surface due to deficiencies with any of the tear layers, dry eye symptoms and inflammation may develop.
Who gets dry eye?
There are seven main risks for developing dry eye:
- Age – Dry eye is part of the aging process. The majority of patients over the age of 65 experience some dry eye symptoms.
- Gender – Women are more likely to develop dry eyes due to hormonal changes caused by pregnancy, oral contraceptives, and menopause.
- Medications – Antihistamines, decongestants, blood pressure medications, and antidepressants may reduce the amount of tears produced. Use of topical eye medications (such as anti-glaucoma drops) can result in higher occurences of dry eye.
- Medical conditions – Patients with rheumatoid arthritis, diabetes, and thyroid disease are more likely to have symptoms of dry eye. Meibomian gland dysfunction, inflammation of the eyelids (blepharitis), or the inward or outward turning of the eyelids can all contribute to dry eye.
- Environmental conditions – Exposure to smoke, wind, and dry climates (like we have here in Colorado!) can increase tear evaporation resulting in dry eye symptoms. Failure to blink regularly, such as when staring at a computer screen for long periods of time, can also contribute to dry eye. If you live in Thornton, Brighton, Westminster, or North Denver, you’re already predisposed to have dry eyes.
- Contact lens wear – Long term use of contact lenses can be a factor in the development of dry eye. Use of ultra-thin daily disposable lenses such as Bausch and Lomb’s BioTrue 1-Day and Acuvue’s Oasys 1-Day lenses can help reduce symptoms of contact lens-associated discomfort.
- Refractive surgery – Refractive corneal surgeries, such as PRK and LASIK, can cause decreased tear production and dry eye.
How does Vista Eye Care diagnose dry eye?
As part of our annual comprehensive eye and vision examination, we assess the health of the front surface of the eyes. We also offer a painless scan of the lower lids called “LipiScan” which allows us to determine the health of each patient’s Meibomian glands. For those patients with poor gland structure, or those patients with significant dry eye symptoms, we can have them return to our Dry Eye Clinic for an Ocular Surface Disease Evaluation, or OSDE. At that comprehensive dry eye exam, we will thoroughly evaluate the eyes and develop a customized treatment program. To learn more about our OSDE’s, please click here.
How are dry eyes treated?
There are five main ways to treat dry eye:
- Artificial tears – Mild cases of dry eye can often be managed using over-the-counter artificial tears. These can be used as often as needed to supplement natural tear production, or to increase the thickness of existing tears, allowing them to stick to the front of the eye between blinks. Use of eye drops that “get redness out” are not recommended as they introduce irritating chemicals into the eye. Our optometrists, Dr. Abert and Dr. Pedroza, recommend preservative-free artificial tear solutions because they contain fewer additives that frequently cause further irritation. Our favorite drop for patient’s with poor tear production is called Oasis non-preserved artificial tears.
- Punctal occlusion – The tear ducts can be blocked with tiny silicone or gel-like plugs that can be removed if needed. The goal of punctual occlusion is to keep available tears in the eye longer to reduce dryness-related issues.
- Increasing tear production – Restasis and Xiidra are prescription eye medications that can increase tear production. Omega-3 fatty acid nutritional supplements have also been shown to increase tear quality and production by reducing tear gland inflammation as well as improving tear quality.
- Addressing the Meibomian gland dysfunction – LipiFlow is the gold standard of treatment for MGD which is a chronic, progressive lid disease. This treatment liquifies the contents of the Meibomian glands with gentle heat application, and a pulsatile pressure then clears the glands of their clogged contents. This painless in-office procedure can help reduce symptoms for as long as three years after treatment.
- Treatment of the contributing eyelid or ocular surface inflammation – Prescription eye drops or ointments, warm compresses, lid massage, and eyelid cleaners may be recommended to help decrease inflammation around the surface of the eyes.
Please call our office today at (303) 450-2020 to schedule your annual comprehensive eye and vision examination or dry eye evaluation. If you prefer, you are welcomed to use the button below to schedule your exam online: