Dry Eyes

Myths:

Dry eyes is just a condition of eyes.

Facts:

The eyes often reflect a larger problem that needs to be treated systemically. Certain nutrients such as vitamins A, C, D, E, & B6, Magnesium, GLA & DHA, Mucopolysaccharides & Tumeric may help ease chronic and severe dry eyes.

Read Customer Reviews of Products for Dry Eyes.

See Product Recommendations and Self Help Tips.

Overview:

Dry eyes, often referred to as Dry Eye Syndrome, is the complaint that eye doctors hear from patients. About 33 million Americans of both sexes of all ages of all racial backgrounds experience varying degrees of dry eye syndromes. Like most eye conditions, Dry Eye Syndrome is often related to health conditions in the rest of the body. It is commonly associated with dryness of other mucous membranes, interior body surfaces like the joints, as well as brittle nails. Dry eye can also be a sign of digestive imbalances or of more serious systemic autoimmune diseases, such as rheumatoid arthritis, Sjogren's syndrome or lupus erthematosus. The production of tears relies on the function of three interrelated layers:

• The Mucus Layer is the closest layer to the corneal epithelium. It is produced by the conjunctival goblet cells, and is absorbed by the corneal surface glycoproteins, creating a hydrophilic corneal surface.
• The Aqueous Layer lies between the Mucous and Lipid Layers, and comprises 90% of the tear film's thickness. It is secreted by the lacrimal gland and incorporates all water-soluble components of the tear film (slightly alkaline at pH of 7.4).
• The Lipid Layer is the most superficial layer. It is produced by the Meibomiam glands with minor contribution from glands of Zeis and Moll. The secretion is a sebaceous material that is fluid at body temperature. It works to retard the evaporation of the Aqueous Layer and lowers surface tension thereby allowing tear-film to mold itself to the eye's surface.
• Blinking renews the tear film by delivering material from the Aqueous and Lipid Layers and sweeping away debris. The normal blink interval is every 5 seconds. Tear film is typically stable for about 10 seconds.

Symptoms:

Typical symptoms include dryness, grittiness, irritation, difficulty reading for long periods of time, burning, and, even though it seems quite contradictory, excessive tearing or watering of the eyes.

Causes:

• Any disruption in the tear production process
• Blepharitis can often cause dry eye symptoms due to inflammation of the eye lid margins, which is caused by a bacterial infection (staphylococci). More on blepharitis
• Computer Users tend to blink much less frequently (about 7 times per minute verses the normal rate of around 22 times per minute). This lack of blinking leads to increased tear film evaporation along with the fatigue and eye strain associated with staring at a computer monitor. Ideally, computer users should take short breaks about every 20 minutes to reduce the risk of eye strain. Also, adjusting the monitor so that it is below eye level will allow the upper lid to be positioned lower and cover more of the eye's surface, again to reduce tear film evaporation. More on computer eyestrain.
• LASIK surgery temporarily disrupts the ocular surface/lacrimal gland unit. Also, during LASIK, roughly 60-70% of the superficial nerve fibers in the cornea are severed, which impacts sensation and affects acqueous tears. With compromised sensation, the blink rate can slow to the point where the tear film breaks up before the next blink can reconstitute it. This may result in mild to severe dry eye syndrome for many months after surgery. This condition usually clears up eventually.
• Other diseases that may be associated with dry eyes include Rheumatoid Arthritis, Diabetes (especially when the blood sugar is up), Asthma, Thyroid disease (lower lid does not move when blinking), Lupus, and possibly Glaucoma.
• Age: An average 65 year old only has 40% of the tear volume that he or she had at age 18. Dry Eye Syndrome affects 75% of people over age 65.
• Hormonal changes for women can cause decreased tear production brought on by pregnancy, lactation, menstruation, and post menopause.
• Other causes include too much coffee drinking, smoking, wearing contact lenses, time spent in air-conditioning or heat.

Drugs that can cause dry eye symptoms

(see "Drugs That Harm the Eyes" for a more complete list of harmful drugs:)

• Antibiotics
• Blood pressure medications
• Antidepressants
• Diuretics
• Over-the-counter vasoconstrictors (i.e. Visine)
• Antihistamines
• Birth control pills
• Appetite suppressants
• Ulcer medications

Conventional Treatment:

• Artificial Tears: Some form of over-the-counter artificial tears is usually recommended. Although they may provide temporary relief, they merely palliate the symptoms. In fact, the preservatives can aggravate the condition, and can even kill corneal cells. Tears that promise to "get the red out" will reduce circulation in the eye, decrease production of the tear film, and, worst of all, eventually make your eyes even drier.
• Punctal Occlusion: Punctal occlusion is a procedure used to help dry eye patients by closing the tear drainage canals with silicone plugs, which keep most of the fluid from the surface of the eye. This may provide long-term relief.

Dry Eye Tests

Since there are three different tear layers produced to make up the tear film, these tests, performed by an eye doctor, help determine where the dry eye problem may be coming from, and what treatment may be needed. Some common tests that may be performed:

• Rose Bengal staining pattern
• Tear film break-up time (<10 seconds)
• Schirmer tear test
• Tear Osmolarity
• Tear protein levels (lactorerrin and lysozyme)
• Evaluation of debris in tear film
• Conjunctival impression cytoloty
• Presence of corneal filaments