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What is Dry Eye Syndrome?

The name "dry eye" can be a little confusing since one of the most common symptoms is excessive watering! It makes more sense, though, when you learn that 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're cutting onions, when you're around smoke, or when you accidentally scratch your eye. The reflex tears gush out in such large quantities that the tear drainage system can't 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.

vis'ion n: power of seeing.  

Did you Know?

Glaucoma is a leading cause of blindness in the United States, especially for the older population.  But loss of sight from glaucoma is often preventable. 

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Ophthalmologist

A doctor of medicine (M.D.) specializing in surgery and diseases of the eye.

Optometrist

A doctor of optometry who diagnoses and treats visual health problems.

Dry Eye Symptoms and Signs

  • 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

For more information call Florida Eye Center at 727-895-2020.

Causes of Dry Eye Syndrome

  • 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

  • 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 can 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.

For more information call Florida Eye Center at 727-895-2020.

Diagnosing Dry Eye

Your eye doctor can check for dry eye by examining your eyes with magnifying instruments, measuring your rate of tear production and checking the amount of time it takes for tears to evaporate between blinks. The doctor can also check for pinpoint scratches on the front surface of the eye caused by dryness using special, colored eyedrops call fluorescein or Rose Bengal.

For more information call Florida Eye Center at 727-895-2020.

Dry Eye Treatment

"Moisture Eyes" from Baush & Lomb
 
The most common treatment is use of artificial teardrops that help make up for the lack of natural lubricating tears. Artificial tear products come in liquid form, longer lasting gelform and long-lasting ointment form, which is most often recommended for nighttime use. Many different brands of artificial tears are available over-the-counter. Some contain preservatives and some do not. Unpreserved tears may be recommended for people whose eyes are sensitive to preservatives. Artificial tears can generally be used as often as needed, from a few times per day to every few minutes. You should follow the regimen your doctor recommends.
 
"Bion Tears" from Alcon
 
When infection, inflammation of the eyelids or clogged oil glands contribute to dry eye, special lid cleaning techniques or antibiotics may be recommended.

It may also help to avoid hot, dry or windy environments or to humidify the air in your home or office.

Research has confirmed the effectiveness of new ,safe anti-inflammatory medications and nutrients called fatty acids for treating dry eye. This research has lead to a new treatment options . This is called Restasis (cyclosporin).

Punctal occlusion is a medical treatment available at the Florida Eye Center for dry eye disease .This safe treatment may last forever and help your eyes save and better use of the few lubricating tears they do produce.

Punctal Occlusion

One way to reduce the hot, stinging, scratchy symptoms of dry eye disease is to help the eyes to keep the small amount of lubricating tears they do produce around longer. This is accomplished by closing off the small 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. This is like putting a stopper in the tub drain to fill the tub. The plugs can be placed into either of the two tear ducts, top or bottom, in both eyelids or only on one side/lid ducts. The punctum can also be permanently closed with a heat or laser procedure as another option.

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, your doctor may consider permanent punctal occlusion. 

Punctal occlusion is for those:

  • Who have been diagnosed with dry eye

  • Whose doctor has determined that punctal occlusion is the appropriate treatment for their condition

What to expect on procedure day:

Your treatment will be performed in an examination room. It does not require a surgery center. Once you have been checked in and settled comfortably, drops will be used to numb your eye; no injections or needles are used.

Your doctor will lift your eyelid up and ask you to look toward your ear, away from your nose. Using a forceps-like applicator, the plug will be placed into the drain in the corner of your eyelid, then released. The doctor will then gently push the plug into your natural punctal opening and you'll be asked to blink. Once the plugs get wet, they will expand to completely fill the opening. The entire procedure takes only a few minutes. Many patients report immediate relief from dry eye symptoms and resume normal activities immediately.

Realistic expectations:

Serious complications with punctal occlusion are extremely rare, but like any medical procedure, it does have some risks. If you experience side effects, your doctor can remove the plugs. Going to a specialist experienced in punctal occlusion can significantly minimize risks.

If you and your Florida Eye Center doctor decide that punctal occlusion is an option for you, you will be given additional information about the procedure that will allow you to make an informed decision about whether to proceed.

If you would like more information about this procedure you can make an appointment or contact the office for additional information

For more information call Florida Eye Center at 727-895-2020.

Ask The Doctor

Dr. Mark Sibley, MD, FACS - Florida Eye Center

Dr. Sibley has over 20 years of experience in the ever evolving field of ophthalmology.  He is a board-certified ophthalmologist, F.A.C.S., and he is highly trained to perform the advanced operations offered by the Florida Eye Center.  He is medical advisor to the Society to Prevent Blindness and to the American Diabetes Association, and is team ophthalmologist for the Devil Rays.

eMail:  AskTheDoctor@FloridaEyeCenter.com

For more information call Florida Eye Center at 727-895-2020.

Make YOUR eyes smile again ...

The information contained herein is intended to be educational and is not intended in any way as a substitute for medical advice and care from qualified vision care providers. Consult a vision care professional in matters relating to visual health and particularly with respect to any symptoms that may require diagnosis or medical attention.
   

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