The eye is an amazing camera, and few man-made cameras even begin to compare with the incredible human eye. Like the front surface of a photographic camera, the front surface of the eye also must have an exquisitely smooth, “polished” surface for crisp and clear images. The tear film is the critical front surface of the eye for high-quality images.
In addition to its optical function, the tear film serves an important nutrient role for maintaining the health of the cornea. While there are many other star players in the eye’s visual pathway (cornea, lens, retina, optic nerve, visual pathways in the brain), the tear film is an absolutely critical support player with a vital function often taken for granted… until it doesn’t function optimally. The tear film consists of three layers:
- an inner mucous layer which helps the tears to adhere to the surface of the eye
- a middle lubricating water layer secreted by the lacrimal gland
- an outer oil layer, secreted by oil glands on the lid margin, which stabilizes the tear film and slows evaporation
What Is Dry Eye?
Dry eye is the term used when the tear film is inadequate. Normally, the surface of the eye is constantly covered with a uniform layer of constantly produced tears replenished by normal and automatic frequent blinking. When the tear film dries, vision immediately becomes blurry as this is equivalent to roughing the normal smooth front surface of a camera lens.
Symptoms of Dry Eye
Patients with dry eye or ocular surface disease complain of:
- blurred vision
- inability to wear contacts comfortably
- general foreign body sensation
Often patients remark, “But my eyes are not dry. They run water all the time.” In fact, excess tearing, known as epiphora, is a common symptom of dry eye. When the corneal surface dries, the eye responds with reflex tearing to try and reestablish adequate lubrication. This is demonstrated by the tearing that sometimes results in daily activities when excess wind dries the cornea (for example, when walking out into a windy day, riding in a boat, driving with the windows down or with air vents blowing straight into one’s face, etc.) Unfortunately, this reflex tearing does not sufficiently compensate for a constantly inadequate tear film.
Causes of Dry Eye
Dry eye is more common with advancing age, but can occur at any age and in both sexes. Causes besides aging include hormonal change, auto-immune disease, medications, poor blinking and past ocular injuries among others.
How is dry eye diagnosed?
Dr. Groat will evaluate your tear film composition and tear production to determine the problem. You will be asked about health complications, medications, and past ocular injuries to determine if that is a cause.
Dry eye treatment
Treatments for dry eye may be specifically designed depending on which layers are primarily deficient. Treatments options are non-surgical or even surgical if eyelid malpositions are a factor.
Non-Surgical Dry Eye Treatment
Therapy usually begins with over-the-counter artificial tears, but may also include oral supplements (fish oil, omega-3s), prescription drops to increase tear production (Restasis), punctal plugs to slow drainage of the natural tears produced, antibiotics and/or hygiene regimens to treat lid margin/oil (Meibomian) gland dysfunction.
Surgical Dry Eye Treatment
If less invasive methods are unsuccessful, surgical treatments, which include the following, may be an option:
- Insertion of punctal plugs to limit tear drainage
- Punctal cautery to permanently close the drainage holes
- Treatment of an underlying disease
If an eyelid condition is causing dry eye, eyelid surgery may be recommended.
“Excellent physician! I feel very comfortable with him taking care of my eyes. He is a honest physician. Staff and office is wonderful! I would highly recommend him for all your eye needs!” – Debra
What happens if dry eye is left untreated?
If dry eye is left untreated, it can lead to complications that include pain, corneal ulcers/scars. There also is the potential to damage vision.
How Can i prevent getting dry eye?
There are steps that can be taken to prevent dry-eye symptoms. Simple lifestyle modifications such as wearing protective glasses on windy days, and giving the eyes a break during reading or other tasks that require intense focus, can effectively reduce the frequency and severity of symptoms