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Dry Eye Treatment

Dry eye syndrome (DES) is a chronic condition that develops when your eyes do not produce and maintain enough tears to keep the eye’s surface lubricated resulting in multiple symptoms that range from person to person.

This can be due to a reduction in tear production or increased tear evaporation from a lack of lipid in the tears that stem from oil glands in the eyelids. The effects can range from minor dryness and discomfort to pain, blurred vision and frequent infections.

Signs and Symptoms of Dry Eye

The main function of tears is to maintain the health of the cornea of your eye by washing away foreign matter and ensuring that the surface of your eye remains moist, smooth and clear. Tears also rinse away dust particles from your eyes and contain enzymes that protect your eyes from bacteria that can cause infections.

Dry eyes is a condition that develops when the amount of tears produced is not sufficient to maintain the moisture balance in your eye. This can result in that scratchy sensation, a continuous feeling of dryness, stinging and a sensation of a foreign body in your eye. Ironically in an effort to fight off the condition, dry eyes can cause you to produce excessive tears, which is why some people experience watery eyes.

Environmental Causes

Hot, dry and/or windy climates, high altitudes, excessive sun exposure, central heating, air conditioning, hair dryers, cigarette smoke, air pollution, air travel.

Medications:(prescription or over the counter)

Allergy medications, esp. antihistamines, Antidepressants,(e.g. amitriptyline, diazepam), Some blood pressure medications, parkinson's medications, birth control pills, diuretics, beta blockers, sleeping pills, many pain medications, certain medications which regulate heart rhythm irregularities, decongestants

Contact Lens Wear

Two million individuals abandon soft contact lens wear altogether each year with nearly 50% of these contact lens "dropouts" attributing dryness or discomfort as the primary reason.

Diseases

Parkinson's disease, Sjögren's syndrome (an auto-immune disease), Rheumatoid arthritis, Lupus, Lacrimal gland deficiency, Diabetes, Sarcoidosis, Stevens-Johnson syndrome, Rosacea: Facial rosacea is commonly associated with ocular rosacea, which causes conditions such as blepharitis.

Refractive Eye Surgeries

Dry eye is the most common complaint or adverse event following LASIK.

Hormonal Deficiencies Or Changes

Thyroid conditions, Hormonal changes during menopause, Decreased production of androgen, Estrogen supplementation -(there are reports both of this improving dry eye conditions and worsening them).

Low Blink Rate

Blinking is critical in spreading tears over the surface of the eye and stimulating tear production. A chronic low blink rate is associated with dry eye symptoms. Computer use, reading, and watching TV are the three activities most commonly associated with a low blink rate.

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Causes of Dry Eye Disease

Dry eyes can occur naturally as a result of aging or hormonal changes, typically in women who are pregnant, taking oral contraceptives or going through menopause. In fact, women over 50 have a 50% greater risk of dry eye disease than men do of the same age.  

It can also result from taking certain medications that reduce tear production such as antihistamines, blood pressure medications, and antidepressants. Environmental factors can also play a role in drying out the eyes and dry eye disease is common in areas where the climate is dry, dusty and windy.

Home air conditioners or heating systems and excessive time spent staring at a computer or television screen can also dry out eyes and exacerbate symptoms due to the lack of blinking while staring at our screens.

Our Mississauga optometrists recommend following the 202020 rule for extended periods on the computer or phone. Every 20 minutes, take a 20-second break and look 20 feet away (6 meters). In addition to these breaks, wearing computer glasses and being more conscious of blinking can help.

Individuals that suffer from certain medical conditions such as diabetes, blepharitis, lupus, arthritis, and thyroid problems are more vulnerable to developing dry eyes disease. Other causes can be due to eye surgery including LASIK, certain conditions in which the eyelids don’t close properly or extended contact lens use.

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Diagnosis of Dry Eye Disease

Typically, dry eye disease can be diagnosed through a comprehensive eye exam and a description of your symptoms at our Mississauga Eye Care clinic.  On some occasions, our optometrist might decide to do a test that measures how quickly your tears evaporate from the surface of your eye.  

By instilling a simple dye called fluorescein (much like food coloring) the optometrist is able to watch and count how long it takes the tears to start to break up after they’ve asked you to hold your eyes open after a blink.  This is called TBUT or a Tear Break Up Time test.  

A low TBUT generally indicates a lipid (aka oil) deficiency in the tears resulting from oil glands in the eyelids not functioning properly. In another type of test, called a Schirmer test, a strip of filter paper is placed under the lid of the eye and you will be asked to close your eye for five minutes.  Following the test the amount of moisture on the strip will be measured. Schirmer tests are performed less frequently than a TBUT test.

Treatment for Dry Eye

Dry eye disease won’t have a permanent effect on your vision, but there is no reason to endure dry, itchy and uncomfortable eyes, especially since there are so many treatment options to increase moisture and comfort.

It’s also important to realize that this is a chronic disease that needs consistent treatment. Our Mississauga optometrist will work with you to create a long-term strategy to keep your eyes as comfortable as possible.

There are many treatment options for dry eyes which are highly dependent upon the cause and severity of the condition.

Treatment For Mild Cases

Many mild forms of DED can be alleviated using artificial tears or lubricant eye drops to make up for the lack of natural tears usually produced by your eyes. If over-the-counter drops don’t alleviate your symptoms, your doctor might prescribe prescription drops that actually stimulate tear production or steroids for short-term relief.

Treatment For Sever Cases

More severe cases of dry eyes might be treated with a punctal insert which is a tiny insert containing a slow-release lubricating substance that is placed inside the lower eyelid. Since dry eye disease is often related to eyelid inflammation known as blepharitis your doctor may prescribe a heated hot compress mask, specialty eyelid scrubs and sometimes an antibiotic ointment.  Finally, punctal plugs might be recommended for severe cases which would be inserted into the tear ducts to reduce the tear drainage in your eyes to keep them from drying out.

Treatment for external or environmental causes

If the cause of your dry eyes is something external or environmental, eliminating that cause may solve the problem and resolve the symptoms.  Avoid dry environments, hairdryers, heaters and fans, (particularly directed toward the eyes) and smoky environments and wear eye protection such as wraparound glasses or goggles when in dusty or windy areas.  

Use a humidifier to add moisture to dry indoor air.  If working on a computer or watching television, make sure to blink purposefully as our natural tendency is to reduce our blink rate when staring at a screen. Also, avoid rubbing your eyes as this can further irritate them. Staying hydrated by drinking at least 8 to 10 glasses of water per day can also help.

Switch Medication or Contact Lenses

In cases where discontinuation or switching to different medications is possible this can eradicate symptoms. Your optometrist may also recommend that you limit or refrain from contact lens use for a certain amount of time or switch to a different brand or type of contact lens which will reduce dehydration, such as daily disposables with silicone hydrogel. In fact, a recent survey on dry eyes and contact lens wearers showed that nearly 50% of contact lens wearers experience symptoms of dry eyes.

Eye doctor, woman suffering from eye allergies in Mississauga, ON

While a number of causes can be to blame, the two most common reasons for eye irritation are dry eye syndrome and eye allergies.

Optometrist, woman holding an orange over her eye in Mississauga, ON

You can develop dry eyes based on a variety of factors. Nutrition is one of those factors. Choose foods & supplements that will ensure less dryness.

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