Causes
Studies show that 2.25 million people in the United States are affected by dry eye. Although it seems like there should be a simple fix, there are several factors that cause dry eye symptoms and treatment can vary based on the findings. In order to thoroughly understand what can be done to relieve dry eye, it is necessary for an eye doctor to fully evaluate and diagnose the condition.
The four most common causative factors leading to dry eye are lacrimal gland dysfunction, meibommian gland dysfunction, physical conditions and environmental conditions:
Lacrimal Gland Dysfunction: This condition is when the gland in the body that produces tears either does not produce enough tears and/or produces tears of a low quality. When a person has an autoimmune condition like Lupus, Rheumatoid Arthritis and Fibromyalgia, the body attacks the lacrimal gland decreasing tear production and deposits inflammatory factors in the tearfilm resulting in a low tear quality.
Meibommian Gland Dysfunction: This condition is when the oil glands along the eyelids that produce the oil component of the tearfilm do not secrete either enough oils or oils in the consistency that promotes stability of the tearfilm. The result is that the tears evaporate off of the surface of the eye too quickly leaving the eye exposed to the air and dries out the surface.
Physical Conditions: Age and gender play a large role in dry eye. Due to hormonal changes in women that decrease androgen production, the natural lubrication of the tears decreases. Men also can get dry eye but it is not as common. Usually with aging the eyelids can become loose and then the eyes to not close or blink completely resulting in surface dryness. A person may have medical conditions that require medications that also can be drying to the corneal surface.
Environmental Conditions: Certain conditions such working in a dry office environment, working in a hospital, flying in an airplane, being out in the wind, sleeping with a fan on at night, contact lens wear etc., will temporarily cause dryness of the surface of the eye.
Treatment
Dry eye treatment will depend on the causative factors for each person.
Lacrimal Gland Dysfunction: Restasis® ophthalmic emulsion (Allergan Pharmaceuticals) is the most common and most successful treatment for this type of dry eye condition. This prescription medication drop can also be supplemented with artificial tear and gel use. If necessary, punctal plugs can be inserted to prevent the tears from draining out of the tear ducts to keep the tears on the corneal surface longer.
Meibommian Gland Dysfunction: Topical antibiotic or antibiotic/steroid combinations can be used to help the oil glands function more fluidly. In certain instances, oral antibiotics can be used that also increase the function of the glands. Natural dietary Omega -3 supplements of fish oil, flaxseed oil or krill oil with appropriate amounts of DHA and EPA can be used either alone or in conjunction with other treatments to enhance effectiveness. In severe cases, medical procedures to clean out the oil glands may be necessary.
Physical Conditions: For those individuals who are affected by age and hormonal changes, dietary supplementation with Omega-3 fatty acids are the treatment of choice. If mediations are the contributing factor, the medications may be able to be discontinued or changed, otherwise, treatment of the symptoms with artificial tears, gels or ointments would be used. When eyelid conditions are a factor, often surgical intervention to correct the condition is necessary.
Environmental Conditions: Supplementing the corneal surface with artificial tears, gels or ointments are the treatment of choice for these conditions. Otherwise, removal from the environmental condition would be necessary to resolve the symptom.
Dry Eye can be treated successfully but it is important to assess and treat the condition appropriately. Once dry eye symptoms are successfully resolved, refractive surgery procedures like LASIK are highly successful.