Dry Eye

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Dry Eye     (Tear Film Dysfunction)

 

Dry eye is a common problem caused by reduced production of the tear film.

 

The eye and eyelids are lined by the tear film which is fine and almost invisible and made up of three layers.  Its function is to lubricate the eye, preventing damage and inhibiting the growth of bacteria.  A healthy tear film is essential to the eye, providing oxygen and nourishment.  

(click to enlarge)

The tear film is produced by the lacrimal gland which is located behind the eye, the meibomian glands in the eyelids and numerous cells on the eye surface.

The tear film is constantly being renewed and when we blink this helps it to spread it around the eye surface.  It then discharges into the tear ducts.

Deficiency in any one of the three layers will lead to dry eyes. Symptoms include discomfort, redness, burning, grittiness of the eye and foreign body sensation.  Often the eye is completely normal to look at.  Patients often complain of tired eyes or even pain and may experience intermittent blurriness of vision.   Reading or watching TV may make symptoms worse.  This is because patients blink less during these types of activities.  Air conditioning, central heating and smoky environments may also have an effect on eye dryness.

Causes

Age-related  - tear film production often decreases as we grow older. 

An autoimmune condition, Sjögren's syndrome, can be another cause. This is a common problem, mostly affecting women.  The body is attacked by its own immune system, damaging the lacrimal gland and so reducing tear film production.

Treatment

Occasional use of tear supplements may be all that is required to reduce the symptoms of dry eye to a level which is acceptable to the patient.

These tear supplements, available as artificial tears,  may need to be used frequently throughout the day.

Viscous gels are thicker so are used less frequently.  However, care must be taken not to apply too much at a time, otherwise patients may find these cause temporary blurring of vision after application.

The drops are used to relieve the symptoms and are not a cure for the condition so you will probably always need to use them.

Another solution for dry eye is to conserve the eye's natural production by reducing the drainage of tears.  This is done by blocking the tear drainage ducts with tiny plugs called 'punctal plugs'.  These can de dissolvable plugs which last for a few days and are used for diagnostic purposes.  Alternatively they can be non-dissolvable for permanent reduction in tear flow unless removed. 

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Page last updated on Saturday, 25 June 2005 12:36:23

 

Highgate Ophthalmic Practice     

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