A B C D E F G H I J K L M N O P R S T U V W

DRY EYE

What is Dry Eye ?

The front surface of the eye is kept moist be a tear film made up of oil layers produced by the eyelids and a watery (aqueous) layer produced by the tear (lacrimal) glands. Disturbance of either component can result in symptoms of dry eye although the aqueous is much more commonly affected. Dryness of the eye surface causes irritation redness and if severe blurred vision due to drying of the cornea. This is a condition called keratoconjunctivitis sicca. Paradoxically in dry eye, the eye may occasionally water excessively due to the main tear (lacrimal) gland being stimulated by the surface irritation. Mild dry eye symptoms are not uncommon and particularly affect middle-aged and elderly women. Severe dry eye although uncommon can be very debilitating and distressing.

How does Dry Eye occur ?

The baseline tears are produced by the main lacrimal gland and by multiple small glands in the conjunctival lining. Chronic inflammation can affect these glands and in certain disorders (known as autoimmune) progressive destruction of the glands may occur. Sjorgrens syndrome is one of the conditions sufferers also have very dry mouth. Dry eye is a common problem for individuals with Rheumatoid arthritis. Chronic eyelid infection (Blepharitis ) commonly gives the same symptoms as Dry eye due to instability of the tear film. Dry eye symptoms can also occur in the absence of any tear film defect as a symptom of anxiety and mild depression.

Treatment Involved for Dry Eye

The diagnosis is made generally by examining the tear film under magnification. An orange dye (fluorosceine) is often applied to the eye surface to detect areas of dryness. Treatment is by application of artificial tear drops. These are used as frequently as necessary, in some individuals every hour or so. The ambient temperature and humidity will have an effect. An air-conditioned environment may be particularly dry. Lubricating ointment can be used at night. There are various kinds of artificial tear preparations and it is worth trying different ones to find the one which provides the best relief. These preparations can also be bought at a pharmacist without prescription. Special acetyl cysteine drops are given in more severe cases where the mucus foundation layer is affected. In people with significant problems with dryness it may be very helpful to "plug" up the normal exit tear ducts in the upper and lower eyelids. This allows the individuals own tears to be conserved. The procedure is relatively simple and generally not uncomfortable. Either temporary or permanent plugs can be used. Allergy or toxic effect of the preservative in the eyedrop preparation may occur. A preservative free tear substitute is then necessary. These are usually in single dose units. Treatment of an underlying autoimmune disorder may require treatment with immunosuppressive drugs.

After Treatment for Dry Eye

Artificial tear drops should improve the symptoms however if eyelid infection is present this will need to be treated .A number of people will become allergic or react adversely to the preservative in the eyedrop. Preservative free preparations are widely available but are more expensive. If artificial tears fail to control the symptoms "plugging" of the tear channels to conserve natural tears should be considered. The environment is important. Humidifiers may be helpful and open fires particularly gas fires make symptoms worse as does an air-conditioned environment.

Self Help Group Dry Eye Sufferers

British Sjorgrens Sufferers Association (BSSA) :01275 854215