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Description of Dry Eye

There are two kinds of tears: those that lubricate the eye; and those that are produced in response to irritation or emotion. Excessive tears occur when a foreign body irritates the eye or when a person cries.
Tears that lubricate the eye are produced around the clock, and they have an important everyday function. A film of tears, spread over the eye by a blink, makes the surface of the eye smooth and optically clear. Without the tear film, good vision would not be possible.
The tear film consists of three layers: an outer oily layer, a watery layer, and a layer of mucus.

Some people do not produce enough lubricating tears to keep the eye wet and comfortable. Tear production normally decreases with age, or it can be due to a disease or medication.

Causes and Risk Factors of Dry Eye
Although dry eyes can occur in both men and women at any age, women are most often afflicted, especially after menopause
Dry eyes can also be associated with arthritis and accompanied by a dry mouth. People with dry eyes, dry mouth, and arthritis have Sjogren’s syndrome
Drugs and medications can also cause dry eyes by reducing tear secretion. Since these medications are often necessary, the dry eye condition may have to be tolerated or treated with "artificial tears."

Symptoms of Dry Eye
Stinging, burning, scratchiness, stringy mucus, and excess irritation from smoke are the usual symptoms.
Surprisingly, increased tearing may be a symptom of dry eyes. If the basic tear secretion is below normal, excess tears are produced by the lacrimal gland in response to irritation. Even though the eye is basically dry, overflow tearing can occur, masking the dryness that caused the tears in the first place.

Treatment of Dry Eye
Replacing natural tears with artificial tears is the basis of treatment. Artificial tears are available without prescription and are used as eye drops to lubricate the eyes and replace the missing moisture. There are many brands of artificial tears on the market, and many people try several different brands to find one that suits them best.
The tears may be used as often as necessary - only once or twice a day, or as often as several times an hour. Solid inserts that gradually release lubricants during the day are also beneficial to some people.
Conserving the naturally produced tears is another approach to keeping the eyes moist. After bathing the eye's surface, tears enter a small opening in each lid, the punctum, and drain through a small canal, the canaliculus, into the lacrimal sac and down the naso-lacrimal duct into the nose. These channels may be closed temporarily, or permanently, by Dr. Earle. The closure creates a reservoir of tears which allows the eyes to stay moist for longer periods of time.

Medicated prescription eye drops such as Restasis and Lotemax can be employed to reduce the inflammatory symptoms associated with chronic dry eye. Bandage contacts that are highly oxygen permeable can act as a band-aid. They can protect the heavily enervated cornea from the irritating affect of blinking across an exposed cornea without lubrication.
Other methods of coping include using a humidifier in winter, and avoiding anything that adds dryness to the air, such an overly warm room, hair dryers, or being outside on windy days. Anything that adds an irritant to the air will also make a person with dry eyes more uncomfortable. Smoking is especially bothersome.

Some people complain of "scratchy eyes" upon awakening. Using an ointment at bedtime can treat this symptom. Use the smallest amount of ointment necessary for comfort, since the ointment can cause temporary blurring of vision.
Although ointments containing vitamin A seem to be of benefit to people with severe dry eye due to scarring from Stevens-Johnson syndrome or pemphigoid, vitamin A does not seem to help people with ordinary dry eye.