Dry Eye Syndrome has become one of the most common problems people have with their eyes. Dryness can be inherited; due to systemic disorders such as rheumatoid arthritis or lupus; or due to medications such as antihistamines, decongestants, beta blockers, diuretics, antidepressants, monoamine oxidase inhibitors, and others. Symptoms vary but may include itching, burning, matting, crusting, soreness, “red eye,” or a sensation of something in the eye. Paradoxically, tearing or watering is common, as the eye responds to irritation caused by dryness. Some eye drops designed to “get the red out” can make the condition worse, by decreasing tear production. Testing for this condition includes an examination of the eye, observation of tear break-up time (time before tears begin to bead up on the cornea), use of dyes to detect staining caused by dry or “sick” epithelial cells, measurement of tear production (Schirmer test), and sometimes more elaborate tests for tear components. Treatment usually begins with artificial tear or lubricant drops, nearly all of which are “over the counter.” These include thicker gel type drops, which are good at night but may blur vision during the day; preservative-free ones (more expensive and only needed if sensitive to the preservatives); and a large number of more “ordinary” ones. Each individual will find the one most effective and affordable for them. If these drops aren’t effective enough, other options include things such as Restasis (an anti-inflammatory agent), weaker steroids, omega-3 preparations, punctual plugs (partially block tears draining away from the eye), cautery of the punctual, tetracyclines, serum drops (prepared from your own blood), and special contact lenses which act as a tear reservoir. Sometimes the eye is so dry that the corneal surface breaks down and surgical intervention is required, by sewing the lids partially closed, placing an amniotic membrane over the cornea, or other procedures. Wrap-around eyeglasses or sunglasses (we have available) help to retain moisture. In many patients, there is an element of allergy contributing to symptoms – or exacerbated by allergy medications (many of which have a drying effect). Similar symptoms can, however, be due to allergy alone. Allergy eye drops frequently relive the itching, burning, tearing, soreness around the eyes, and other symptoms. As these may also make the eye dryer, additional lubricant drops may be required. As with many other things, what helps one problem may cause or aggravate another. Over-the-counter allergy drops may suffice. Zaditor was formerly prescription-required, but not for the past few years. Prescription drops such as Pataday, Lastacaft, and Beprieve may be tried. If these measures don’t help, weak steroids (less likely to cause side effects such as cataract or glaucoma) can be used. There is nothing that always works for everyone.
Posted on: Thu, 19 Jun 2014 00:12:27 +0000
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