Dry Eye Syndrome

Dry eyes are one of the most common problems seen by ophthalmologists. There are many reasons for dry eyes, including normal aging, medications, systemic conditions, environment, hormonal changes, contact lenses, and near work. Regardless of the cause, they all produce symptoms such as blurred vision, burning, itching, redness, and excessive tearing. These symptoms are exacerbated by conditions that require you to concentrate, such as computer use.

Tears are comprised of three layers. The outer layer consists of an oil layer to prevent evaporation. The middle layer, which is the largest layer, consists of aqueous. The inner layer consists of mucin. The aqueous is produced by the lacrimal gland, which is located under the outer orbital bone. The oil layer is produced by the meibomian glands, which are in the eyelids. The mucin layer comes from the goblet cells, which are found in the conjunctiva. The tears are spread across the cornea by each blink and excess tears drain out at the punctal openings near the nose in each upper and lower lid.

Treating dry eyes starts with using topical artificial tears. Natural tears with the fewest additives are usually the most soothing. Avoiding products with a decongestant will help because these products have a drying effect. Nutritionally, essential fatty acids (Omega-3 and Omega-6) have been linked to improving dry eyes. Restasis® (cyclosporine 0.05% emulsion) is the only prescription eye drop that increases the natural production of tears in cases of ocular inflammation. Restasis® was FDA-approved in 2003 and published reports suggest that it acts by reducing inflammatory cells and increasing mucin-producing goblet cells. Restasis® is not a cure for dry eyes, but it is an important adjunct. Punctal plugs are another treatment. They increase the tear pool by eliminating part of the tear draining.

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