Dry Eye Syndrome

Dry eye syndrome (DES) or Keratoconjunctivitis sicca (KCS) is an eye condition in which the eyes do not produce enough tears. Typical symptoms include burning and dryness which is often described as ‘sandy eye.’ The symptoms tend to worsen as the day progresses. Some sufferers feel that dirt or some other small particle is trapped in the eye. Others report itching or pain. Dry eye syndrome will eventually cause damage to the eye itself. This can cause additional discomfort and pain as well as photosensitivity. Other symptoms include a thin stringy or mucous discharge. Unfortunately, this discharge does not alleviate the symptoms, as it is not the typical ‘tear’ that lubricates the eye and prevents the symptoms of dry eye.

Many patients question whether they should see an ophthalmologist or an optometrist where surgery is concerned. And what is the difference between an ophthalmologist and an optometrist, anyway?

Some sufferers will notice a distinct worsening of their condition when they are engaging in activities that cause the eye to blink often. Watching television, driving, reading and using the computer all cause the eye to blink excessively. Other conditions such as dust, wind, smoke, low humidity, high altitudes and heat may cause the symptoms to worsen. Conversely, humidity and cooler temperatures may alleviate some symptoms.

 

It is crucial that diagnosis and treatment be made in a timely matter as prolonged untreated symptoms may lead to permanent eye damage. There are several tests that can be performed by an ophthalmologist to determine the extent of natural tear production. A Schirmer’s Test, in which paper strips are inserted in the eye, will measure tear production, while the slit lamp test, in which bright light is shined onto a thin section of eye, is used to determine if any damage is present. Other tests like the Tear Breakup Time, tear protein analysis and lactoferrin analysis can provide further information on the severity of the condition.

 

Once a diagnosis has been made, there are several treatment steps that can be taken. First, the patient should actively engage in environmental control. This means avoiding dry or drafty environments. Fans, air conditioners, heaters and hair dryers should be avoided. It may be helpful to wear glasses to protect the eye when these devices must be used. Patients are encouraged to use a humidifier to prevent exposure to dry indoor air.

 

Second, the patient must rehydrate the eye. This is done through the use of special eye drops called artificial tears. These are available over-the-counter and provide temporary relief to most dry eye symptoms if used throughout the day. For more serious cases, antilogous serum eye drops may be prescribed; these contain elements found in real tears like hepatocyte and epidermal growth factors as well as vitamin A and fibronectin. These elements can assist the eye with maintaining a healthy surface. Lubricating tear ointment, which contains mineral oil or petrolatum are used as an emollient and lubricant in the most sever of cases.

Finally, medication may be prescribed. Steroids or immunosuppressants have been shown to aid patients who suffer from dry eye syndrome.

 

In the most severe cases, or cases that do not respond to the above options, surgery or tear drainage blockage may be necessary in order to alleviate the symptoms and protect the eyes from further damage.