Dry Eye Syndrome

Understanding Dry Eye Syndrome

Are you suffering from dry eyes?

According to the (AAO), dry eye syndrome is a condition that affects as many as 12 million people in the United States. Many eye doctors have even been quick to refer to this as a modern day health care epidemic.

About Dry Eye Syndrome

Many people will tell you that they have no problem producing tears during a sad movie or when the get upset over a tragic event. A large percentage of our population are unable to create tears when they are not crying. These people that cannot produce tears suffer from a chronic condition called dry eye syndrome. If you have this problem or feel like there is an irritating thing in your eye you may suffer from dry eye syndrome. Up to 12 million Americans suffer from a disease called dry eye syndrome. People with dry eyes frequently experience burning and stinging of their eyes, their eyes often feel sticky, and their eyes are often red. Interestingly, some people with dry eyes actually have periods when their eyes get so watery that tears spill over their eyelids and run down their cheeks.

Chart Illustrating a Healthy Eye Compared to One With Dry Eye

Normal, healthy eyes, are continuously covered by a thin tear film. This film allows people to be able to see more clearly. Your eyes normally make small amounts of tears all day long. Tears play several important roles in keeping your eyes healthy and your vision clear. Tears lubricate the eye’s surface, wash away debris, and provide a smooth surface to help keep your vision clear. They also contain natural antibiotics that keep your eyes safe from germs that might cause infections.

Tears are made up of three layers:

  1. Lipid (oil) layer: lubricates and prevents evaporation
  2. Aqueous (water) layer: nourishes and protects the cornea
  3. Mucin layer: adheres tears to the eye

The eyelid glands called Meibomian glands create the lipid (oil) layer of the tear film.

Evaporative Dry Eye disease is most often caused by a blockage or obstruction in the eyelid glands, which can lead to a lipid deficiency in the tears.

Dry Eye Symptoms

Treatment of dry eyes aims to restore a more normal tear film to minimize your dryness, blurred vision and irritations. Persistent irritations to one or both of your eyes might be a cause of dry eye(s). A decreased tolerance to contact lenses is a common symptom as well. Symptoms do vary from patient to patient when it comes to dry eyes. Most patients say they suffer from the feeling that there is something in there eye that is unobtainable to get out. If you have any of the following symptoms listed, you may be suffering from dry eye.

Common Causes of Dry Eye Syndrome

  1. Aging Eyes – As people age, it is completely natural that the tears we produce have less oil in them. The aging population has specific dry eye related problems.
  2. Environmental factors – Environmental factors like windy climates or desert like climates cause dry eyes. Additionally, the use of air conditioning can cause this as well. You may wake up in the morning after being near and air conditioner and experience dry eye symptoms.
  3. Meibomian gland dysfunction – Patients with this dysfunction typically present with symptoms of burning, irritation, dryness, and decreased contact lens wearing time. The diagnosis is made by inspecting the glands and their secretions.
  4. Menopause – Females entering menopause are among the most prone to dry eye.
  5. Work environment – Some work environments that are dusty and windy may be harmful to patients more likely to develop dry eye syndrome.
  6. Medications – Antihistamines and decongestants may cause dry, eyes but other medications can cause dry eye as well (These medications include pain relievers, antihistamines, tranquilizers, oral contraceptives, beta blockers, diuretics, and antidepressants).
  7. Contact lens use – Wearing contact lenses can contribute to dry eye. Please consult your contact lens provider for specific questions about your particular type of contacts or schedule an appointment with one of our doctors to discuss this issue.
  8. Computer screen reading – Sitting in front of the computer for hours may cause you to blink less and also cause dry eyes. Many people are studying something called computer vision syndrome as well.
  9. Certain diseases – There are diseases linked to chronic dry eye. Has your eye doctor ever discussed these with you before? The most popular disease linked to dry eye is Sjogren’s syndrome, but other diseases that impact dry eyes are keratoconjuntivitis sicca, xerophthalmia, lupus erythematosus, Grave’s disease, diabetes, and scleroderma.
  10. Vitamin A deficiency – This uncommon vitamin deficiency exists with chronic failure to eat sufficient amounts of vitamin A or beta-carotene. This results in levels of blood-serum vitamin A that are below a defined range. Beta-carotene is a form of pre-vitamin A, which is readily converted to vitamin A in the body. Night blindness is the first symptom of vitamin A deficiency. Prolonged and severe vitamin A deficiency can produce total and irreversible blindness.

Dry Eye Diagnosis

BatraVision is  TearLab Center of Excellence

An objective and quantitative point-of-care diagnostic test that provides precise and predictive information.

The TearLab Osmolarity System* is intended to measure the osmolarity of human tears to aid in the diagnosis of dry eye disease in patients suspected of having dry eye disease, in conjunction with other methods of clinical evaluation.

Treatment options for Dry Eye Syndrome

Eye Drops

The use of artificial teardrops is a common treatment for dry eye but not always effective. Many over the counter eye drops are not worth anything but may give some temporary relief. No one drop works for everyone, so you might have to experiment to find the drop that works for you. If you have chronic dry eye, it is important to use the drops even when your eyes feel fine, to keep them lubricated.

Punctal Plugs

The dry eye specialists at our practice may also suggest punctal plugs for you. The term puncta refers to the opening of the tear ducts on the eyelid margin. The name may sounds strange but these tiny devices can do wonders for your dry eyes. The use of these plugs is typically useful in moderate to severe cases and often used in a specific eye that is not responsive to eye drops. These are actually little plugs placed in the corners of the eyes to reduce tear drainage. Tears will typically drain into your nose, but these plugs are inserted near the tear ducts to block the outflow.

Lipiflow for Evaporative Dry Eye

LipiFlow Logo

The new LipiFlow treatment addresses the root cause of evaporative dry eye by unblocking the meibomian glands that secrete oily lipids. 

In controlled clinical studies of patients who received a single LipiFlow treatment, the average meibomian gland score at 4 weeks increased by two to three times over the baseline condition, which reflects improvement in the number of glands secreting and secretion quality.   Additionally, at four weeks after the LipiFlow treatment, 79% of patients reported improvement in dry eye symptoms.


Bay area Patients with moderate to severe dry eye could have persistent damage to the corneal surface. If you are one of these patients you could likely benefit from treatment with a Prokera Amniotic Membrane. Donated amniotic tissue is held in place over the cornea with a small ring for several days. This tissue promotes corneal healing and can keep even severely dry eyes comfortable for months after removal.

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