Dry Eye Disease
Your eyes constantly produce tears at a slow and steady rate so that they stay moist and comfortable. Some people are not able to produce enough tears or the appropriate quality of tears to keep their eyes healthy or comfortable. This condition is known as dry eye. Symptoms of dry eye include scratchiness, stinging, stringy mucus in or around the eyes, and blurry vision. Sometimes people with dry eye will experience excess tearing. This is the eye’s response to the discomfort from dry eye. When the eyes get irritated, the gland that makes tears releases a larger than usual volume of tears, which overwhelm the tear drainage system. These excess tears then overflow from your eyes. Dry eye often increases with age as tear production slows. For women, this is especially true after menopause. Dry eye can be associated with other problems like Sjögren’s syndrome, which can cause dry eyes along with dry mouth and arthritis. Your ophthalmologist (Eye M.D.) can usually diagnose dry eye by examining your eyes. Sometimes tests that measure tear production are necessary. The Schirmer tear test measures tear production by placing filter-paper strips between your eyeball and your lower lid. Your ophthalmologist might also test you for dry eye using diagnostic drops to check for patterns of dryness on the eye’s surface. Southwestern Pennsylvania Eye Center has acquired the TearLab Osmolarity system which is the latest technology in diagnosing dry eye disease. A patient with chronic dry eye suffers from a compromised tear film quality or quantity leading to increased rates of tear evaporation resulting in a more concentrated tear film or increased osmolarity. The TearLab Osmolarity system can measure your tear film osmolarity in 20 seconds. This gives the doctor a dry eye number and helps tailor a specific treatment plan for you. This is the first test to accurately quantify dry eyes. Chronic dryness on the surface of the eye leads to inflammation, a hallmark of dry eye disease. Left partially or completely unresolved, inflammatory dry eye can progress and lead to corneal damage and vision loss. Dry eye also increases the risk of poor outcomes and complications after surgery. InflammaDry® is the first and only, rapid, in-office test that detects MMP-9, an inflammatory marker that is consistently elevated in the tears of patients with dry eye disease. The test uses a sample of tears and takes less than 2 minutes to complete, with results available in 10 minutes. This also helps guide a treatment plan to be established with the patient during the initial office visit. Treatments for dry eye includes: Artificial tears: Artificial tears lubricate the eyes and help maintain moisture. Artificial tears are available without a prescription and can be used as often as necessary for relief.
Punctal Plugs: Near the inner corner of each eyelid are small openings, called punctae, responsible for tear drainage. A simple procedure known as punctal occlusion can help dryness by decreasing the normal drainage of tears to help build and maintain a large tear reservoir. This is a very simple office procedure and only takes a few minutes. Small plugs made of various materials are placed inside these openings to block drainage of tears. Just like a stopper that is put in the drain of a sink to keep the water from flowing down the drain, these plugs keep the tears that are made from flowing down the tear drainage system. Therefore, eyes stay moist and comfortable, even in those patients who produce fewer tears. These plugs are semi-permanent meaning they can easily be removed if necessary
Fish or Flax seed oil: Studies have shown that fish or flax seed oil can minimize the effects of dry eyes.
Nutraceuticals or dry eye vitamins: Certain vitamins have been shown to significantly help improve dry eyes.
Oasis Tears: New type of eye drop with a unique, viscoadaptive formual, optimized to provide longer lasting comfort.
Restasis: Restasis eye drops are the only FDA approved medical treatment for dry eyes. This drop taken twice a day helps to decrease inflammation on the surface of the eye and increases your natural tear production. Restasis is a safe and great option for many patients with dry eye disease.
Autologous Serum Drops: Autologous serum eyedrops and are made from a patient’s own blood. These eyedrops naturally contain ingredients that are known to speed up healing and increase lubrication of the surface of the eye. Eye drops made from a person’s own serum are superior to artificial tears for relieving signs and symptoms of severe dry eyes. The autologous serum contains essential components for maintaining eye surface health. None of the commercially available artificial tear preparations contain growth factors, vitamin A and other natural components, which have been shown to play an important role in maintaining eye health. The eyedrops are made using the clear part (serum) of your blood. The serum is diluted with saline and bottled into eyedropper bottles that need to be kept in the freezer until use. The drops contain no additives or preservatives, just your own serum diluted with saline.
Amniotic Membrane Grafting: The amniotic graft is a thin and semi transparent tissue. The amniotic membrane tissue has natural therapeutic actions that help damaged eye surfaces heal. It is a safe, effective treatment provided by a tissue bank regulated by the FDA. In severe cases of dry eye and ocular surface disease, the use of amniotic membranes tissue can be utilized to promote healing of the damaged ocular surface. The tissue has passed many quality control tests before it is provided to our facility.
On your own, you can take these steps to help improve your dry eye symptoms: Humidify the bedroom to at least 40% humidity when you are sleeping (when tear production is lowest). This can be measured with a humidity meter (hygrometer) on the nightstand. Humidity may be very low (less than 25%) during the winter when the heater is on, and this worsens the dry eye condition. You can take alpha omega fatty acids or fish oil or flaxseed oil orally (by mouth) to improve dry eye. Take frequent breaks when you are doing something that requires close concentration (such as using a computer or reading), and blink frequently. Use artificial tears frequently. Wear sunglasses when you are outside to protect your eyes from wind and sun.