Dry eyes watering: Punctal plugs – Mayo Clinic
Punctal plugs – Mayo Clinic
One approach to treating dry eyes is plugging the openings to the tear ducts with tiny silicone plugs (punctal plugs). These plugs close the tiny opening (punctum) that you have in the inner corner of your upper and lower eyelids. The closure conserves both your own tears and artificial tears you may have added.
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My Eyes Tear Up When I Read or Go Outside, But My Doctor Tells Me I Have Dry Eyes!: Eye Care of East Bay: Laser Eye Surgeons
As a cornea specialist, I see a large number of patients who suffer from dry eyes.
The symptoms of dry eyes can be quite variable amongst different individuals. Some common features include eye burning, sandy/gritty feeling in the eyes, itching, light sensitivity, tiredness of the eyes when reading or working on the computer, and excessive tearing.
Yes, you read that correctly. Some patients with dry eyes present with excessive tearing that sometimes occurs after being exposed to cold air, reading in bed, and windy conditions.
The reason for this is when we read for a period, we do not blink as much. This causes the eyes to get even drier and irritated. In response, the tear gland goes into overdrive, and excessive tearing happens. The same situation can occur when exposure to cold or hot air occurs.
Most of the patients who end up in my ophthalmology practice at Eye Care of East Bay have already had many of the usual treatments including artificial tears, gels, and eye ointment with limited response. Many are frustrated by lack of efficacy and the chronic nature of the condition. The symptoms of dry eyes are rarely severe but decrease the quality of life and have a negative impact on mood and mental health.
In this blog, I am going to give you a brief review of dry eyes and its standard treatment. In the next blog, I will review some of the less commonly used but very effective treatments for patients who do not respond to conventional therapies.
How Common is Dry Eyes?
It is difficult to know precisely how many patients suffer from dry eyes but it is estimated that at least 16 million people have chronic dry eye syndrome in the United States. On a typical day, I see at least 5-6 patients with dry eyes. Most of my dry eyes patients are older and more commonly women. This is partly because of hormonal changes – such as those that occur during pregnancy or menopause.
What Causes Dry Eyes?
Simply put, there are two general causes of dry eye. Either there is not sufficient tear production or too much tear evaporates from the eye.
Usually, the most common cause of dry eye is the age-associated decrease in tear production. As we get older, our tear glands do not produce as much tear as when we are younger. This is the most common type found in postmenopausal women.
Systemic disease such as Sjogren’s syndrome, rheumatoid arthritis, lupus, and others can also decrease tear production.
Finally, many medications such as sedatives, diuretics, antidepressants, blood pressure medications, oral contraceptives, antihistamines, nasal decongestants, and pain relievers can cause decrease tear production.
Dry Eyes can also be caused by rapid evaporation or premature destruction of the tears. In this condition, although there is sufficient tear production, the thin portion of the tears evaporates too quickly, leaving small amounts of salty liquid behind. This commonly happens when there is reduced blinking such as reading for an extended period or staring at the computer screen. Exposure to certain environmental conditions such as blowing fans, air-conditioning, pollen in the air, and others can cause more evaporation of tears.
Other factors such as long-term use of contact lenses and refractive surgeries, such as LASIK, can cause dry eyes.
What are the Treatments for Dry Eye?
Although there are many topical treatments for dry eyes, every patient is unique and will respond differently to available modalities of treatment. I usually sit down with my patients and together we come up with a step-wise treatment plan going from simple to more complex.
Step 1: Over the Counter Topical Artificial Tears, Gels, and Ointments
Frequent use of topical high-quality artificial tears can help many patients. There are many different over the counter artificial tears available. In general, the teardrops that are preservative free are gentler on the eye. The preservative containing drops can irritate with frequent use.
One general rule of thumb is that if the drops are used more than four times daily, preservative free tears should be used. The main problem with artificial tears is the short duration of effect. While they provide some relief, the result does not last a long time.
There are also many artificial eye gel and ointments that can provide much longer relief. The main problem with these is that they cause blurry vision. The gels or ointments are ideal for nighttime use right before sleeping.
I also advise my patients to use warm compresses twice daily. The use of warm compresses can help open up the glands at the eyelid margin. These glands secrete oily material that helps moisturize the eye and decrease tear evaporation.
Step 2: Prescription Topical Medications
There are currently two FDA approved topical drops for the treatment of dry eyes in the US:
One is Restasis. This is an anti-inflammatory eye drop that is used twice daily. The decrease in inflammation allows the tear gland to start producing more tears. So, it is not a teardrop but rather a tear producer. It is important to know that not everyone responds to the drops and it can take 3-4 months of use to have an effect. During that time, patients need to continue using their artificial tears. The medication does sting a bit when applied. I have had some pleased patients with Restasis but also some patients who did not respond to it.
Another recent eye drop that is new to the US market is Xiidra. It is also used twice daily, and it can help decrease symptoms of dry eyes.
Both of these medications are prescription, and although many insurance companies are paying for them, without insurance the cost can be quite high.
Some of dry eyes patients present to my office with very inflamed and red eyes. For some selected patients, a short course of topical steroid eye drops can be helpful. This should be done only for a short duration under the supervision of an ophthalmologist to monitor for side effects.
Step 3: Punctal Plugs
Each eyelid (upper and lower) has a small opening close to the nose called the punctum. The openings are connected to tear drainage ducts. The job of these ducts is to drain excess tears away from the eye. Dry eye patients do not have any excess tears to remove. In other words, they need to hold on to every bit of tear they have.
One way to do this is to close the lower tear drainage duct by placement of a tiny plastic plug in the opening. These devices are called punctal plugs, and they are generally about half the size of a grain of rice. When the drainage duct is closed, the patient has more tears and less dry eyes. This is similar to closing the drain in a sink.
The procedure is simple and can be performed in the office in a few seconds. Some possible side effects include irritation of the eye due to the plug or over-response to the treatment with excessive tearing. Depending on the type of plug, the procedure can be reversed by removal of the plug in many but not all cases.
We have covered some of the most common treatment of dry eyes. While many patients do respond to these treatments, there are patients with very severe dry eyes who continue to have symptoms despite these therapies. In my next blog, I will cover some non-common but very effective alternatives.
In summary, although treatment of dry eyes can be challenging for both the patient and the ophthalmologist, with appropriate evaluation and regular follow up, the condition can be successfully managed in most patients.
If you experience any of these symptoms, you can arrange for a consultation at my office at the Eye Care of East Bay in Walnut Creek.
Watery Eyes and Dry Eyes
While it may seem counterintuitive, watery and runny eyes can actually be a sign of dry eye disease. More specifically, they are an indication of an underlying condition known as Meibomian gland dysfunction, which is a factor that can worsen dry eye disease and affect ocular comfort. Meibomian gland dysfunction, or MGD, interferes with the eye’s natural tears and can cause the eyes to water in addition to feelings of grittiness, irritation, or foreign body sensation. Continue reading to learn more about Meibomian gland dysfunction and how this condition can cause watery eyes.
Understanding Your Tears
The tear film is responsible for protecting and nourishing the ocular surface. When the tear film is disrupted, we experience symptoms of dry eye disease. There are millions of small glands, called Meibomian glands, that line the eyelids and release an important oil, called meibum, into our tears. This meibum creates what is known as the “lipid layer” of the tears – it forms the outermost coating of the tear film and helps stabilize the ocular surface. When the Meibomian glands are not properly functioning, and the lipid layer is not properly distributed into the tear film, tears will quickly evaporate and leave corneal surface exposed. Because the cornea is highly sensitive, especially when it is unprotected, it makes reflex tears to attempt to cover the surface of the eye when the lipid layer is deficient. However, these reflex tears are poor quality tears that do not contain any meibum; instead of adequately coating the front surface of the eye to provide nourishment, they end up either immediately evaporating or running off the eye and down the cheeks. This is how watery and runny eyes can actually be indicative of underlying dry eye disease.
Treating MGD, Dry Eye and Watery Eyes
To treat watery runny eyes, you have to treat the underlying dry eye disease and promote proper Meibomian gland function. One common treatment approach to Meibomian gland dysfunction is warm compresses. This includes using a warm washcloth or commercially prepared heat-retaining mask and holding it over the eyelids for 10-15 minutes. The heat helps release any blocked or clogged Meibomian glands. Warm compresses can be followed by a soft lid massage to assure that the meibum is being properly released into the tear film. Nightly lid scrubs, either with a commercially prepared wet cloth or with warm water and soft soap, are also important for preventing any debris from clogging to the Meibomian glands. In moderate to severe cases of MGD, treatment with a short course of antibiotics can be employed to eliminate any possible bacterial colonization and associated inflammation along the eyelids that is contributing to the dysfunction of the glands. Your eye doctor may also perform in-office gland expression, where they will manually press on the Meibomian glands and force the lipid layer back into the tears. It is important to remember that, like treatment for dry eye disease, treatment for MGD is chronic and long-term. It may take time and consistency before a dramatic improvement in symptoms, like watery eyes, is noticed.
If you or a family member are interested in learning more about meibomiangland dysfunction (MGD) and dry eyes, ask your optometrist at Neal Eye Group about how we can help you improve your symptoms with different therapeutic options.
Call us at (610) 828-9701 or schedule your appointment online for an eye exam with the Neal Eye Group. We serve Conshohocken, Plymouth Meeting, Lafayette Hill, and Whitemarsh.
The 6 Most Common Signs Of Dry Eye
Posted in Uncategorized | March 23, 2020
With a name like dry eye syndrome, it would seem logical to assume that you would have dry eyes. But there’s a little bit more to this eye condition than that, and more common signs to watch out for. Keep reading to learn more about dry eye!
1. Dry eyes
Yes, one of the most common signs of dry eye syndrome is dry eyes. When your eyes are dry, it’s usually due to two things.
One, you aren’t producing enough tears, or two, the tears being produced are low-quality. In either case, it results in your eyes feeling drier than normal. But why are your eyes so dry?
Part of the problem could stem from the tear film in your eyes. In someone who doesn’t have dry eye syndrome, the tear film has three components: water, mucous, and oil.
When someone has dry eye syndrome, their tears are missing one or several of these vital components. If your tears don’t have enough oil or mucous, it can result in the frustrating symptoms of dry eye syndrome.
2. Irritation or gritty feeling
Another common sign of dry eye syndrome that goes along with having dry eyes is irritation. Generally, if your eyes are dry, they are also irritated.
They may also feel gritty, like something is in them, even if nothing is there. For most people with dry eye syndrome, the next logical step is to rub their eyes to alleviate the gritty feeling.
But this is actually the last thing you want to do! Rubbing your eyes in any capacity can cause an incredible amount of damage to them!
If your eyes feel irritated and you get the urge to rub them, resist and use artificial tears instead. When your eyes are too dry, using artificial tears or eye drops can help if your eyes start to bother you.
3. Watery eyes that won’t stop tearing up
When people hear the phrase “dry eye syndrome” the last sign they would expect is someone experiencing watery eyes that tear up. But watery eyes that won’t stop tearing up are another common sign that you may have dry eye syndrome.
Remember that some of the reasons people develop dry eye syndrome is because of tear production or because they produce low-quality tears. For people with dry eyes, they may have eyes that won’t stop watering because their tears aren’t high quality.
The tears may have too much or too little water in them, making them less beneficial for the eyes. Tears are a crucial component that keeps the eyes lubricated and moisturized.
4. Sensitivity to light
If you don’t have dry eyes, it can be difficult to understand what the condition feels like. If you’ve ever been to a movie theatre, think about how uncomfortable it feels when you make it outside into the sun.
After two hours in the dark, it can take your eyes a few minutes before they adjust to the sunlight again! Now imagine that’s how your eyes feel all the time, and you have a good idea of how someone with dry eye and light sensitivity might feel.
The problem with dry eye syndrome is if you leave it alone, it will only get worse over time. There’s nothing worse than having eyes that feel uncomfortable all the time!
5. Difficulty wearing contact lenses
When you have dry eyes, little tasks become a lot harder. For some people, this can mean that wearing contact lenses becomes difficult.
When most people put in their contacts, they wear them for eight hours a day. Contacts cover the surface of the eye and can soak up much of the eye’s fluids.
With dry eye syndrome, wearing contact lenses can become downright painful or impossible. Your eyes may become red, itchy, or even start hurting when you wear contact lenses.
Having dry eyes is one reason many contact lens wearers consider procedures like LASIK. After all, why wouldn’t you want to find a way to no longer need to touch your eyes multiple times a day if you could?
If someone with dry eye syndrome was thinking about LASIK, they would need to have their symptoms under control before getting the procedure. Undergoing something like LASIK with an active case of dry eye can lead to severe complications and worsening dry eye symptoms.
6. Itchy eyes
Although allergy season is right around the corner here in Griffin, experiencing itchy eyes all year isn’t an allergy symptom, it’s a sign of dry eyes. Having itchy eyes along with irritation, watery eyes, and grittiness is a sign that you should talk to your eye doctor about dry eye syndrome.
If you happen to have allergies and think you may have dry eyes as well, talk to your eye doctor sooner than later. Dry eye symptoms have a tendency to get worse during allergy season, not better.
It’s better to be prepared and know what you’re up against before pollen starts floating around and coating every surface around you!
What you can do to help your dry eyes now
If your dry eyes are bothering you right now, there are things you can do to find relief. Try some of the following tips:
Drink more water
If your eyes are dry, it can often be a sign that the rest of your body is also dehydrated. If you feel thirsty, you’re already showing signs that you aren’t drinking enough water!
Aim for at least 8 eight-ounce glasses of water every day. You’ll see benefits to your skin, eyes, and even your energy levels!
Eat more foods with Omega-3 fatty acids in them
If your eyes are dry, your diet could use some overhauling. Try eating more salmon, tuna, watermelon, walnuts, and chia seeds and see if you see any improvements.
Make some small lifestyle changes
They don’t have to be extreme but think about making some changes like buying humidifiers. Put them in the rooms that you’re in the most like your bedroom or living room.
Humidifiers are a great way to add moisture into the air, which your dry eyes will most certainly benefit from.
Get enough sleep at night
If you want to be healthy, inside and out, you need to make sure you’re getting enough sleep every night. Tired eyes are more likely to feel dry, so try to get at least seven to eight hours of sleep.
Do this every night, including on the weekends. Consistency is key if you want your eyes to feel better and to stay that way!
Tried these tips and not seeing any changes? It may be time to see an eye care professional for dry eye treatment.
Schedule an appointment to discuss your dry eye options at Takle Eye Group in Griffin, GA today!
Why Are My Eyes Watery?
Have you recently found your eyes watering unexpectedly? If so, don’t worry—you’re not alone. Watery eyes can affect people at any age, and numerous factors can cause them. It might sound strange, but watery eyes can even result from dry eye disease!
Visiting your eye doctor for an exam is the best way to determine why your eyes are watering, but we’ve provided some possible explanations below to help you get started. Read on to learn more about what causes watery eyes and inform yourself before reaching out to your optometrist.
Poor Drainage or Excessive Tearing? 2 Culprits Behind Watery Eyes
There are two main reasons that a person’s eyes might water: either their tear ducts are blocked, or their eyes are producing too many tears. However, either of these scenarios can result from various conditions, and some conditions (like dry eye disease) can cause both.
Blocked Tear Ducts
Blocked tear ducts are a commonly misunderstood reason for watery eyes. Many people assume that the tear ducts exist to produce tears, but that isn’t true. The tear ducts exist to drain tears into your nose through tiny holes called puncta. If the tear ducts are blocked, the eyes may water instead.
Newborn babies often experience watery eyes due to blocked tear ducts. Their eyes typically begin to produce tears after only two weeks, but their tear ducts may not open until they are seven or eight months old. Until the tear ducts can drain moisture properly, the infant’s eyes will likely water instead.
Adults may also experience blocked tear ducts since the puncta become narrower with age. Inflammation (a common cause of dry eye disease), injury, and certain medications or medical treatments can also create blockages in a person’s tear ducts.
There are many different reasons why a person’s eyes could produce too many tears. However, dry eye disease is one of the most common. Dry eye causes irritation that can provoke reflex tearing, causing a person to cry more frequently than usual.
Several other conditions can also cause a similar kind of irritation to that of dry eye disease. These include:
- Eyelid inflammation or blepharitis, which can also lead to dry eyes
- Conjunctivitis (either allergic, infectious, or chemical)
- Common cold complications
- Physical damage to the cornea (from a scratch or a foreign object lodged in the eye)
- A stye or ulcer
- Hay fever
- And more
Visiting an optometrist is the best way to find out why your eyes are producing too many tears. Your eye doctor will also be able to recommend a course of treatment for you, based on the reasons for your watery eyes.
Common Treatments for Individuals with Watery Eyes
Many patients come to us to learn more about why their eyes are watering. In many cases, we find that a patient’s watery eyes result from dry eye disease. However, other treatments are available for people whose eyes water for different reasons.
Treating Dry Eye Disease
We treat dry eye disease in numerous ways. Some of the most effective methods include:
- Blephex: this medical device allows an optometrist to remove debris from the eyelashes and eyelids. Cleaning these areas can reduce inflammation in patients whose dry eyes have been caused by blepharitis.
- Xiidra: these eye drops help your body regulate specific proteins that may cause dry eyes by disrupting the delicate balance of substances required for healthy tear production.
- Restasis: these prescription eye drops include cyclosporine, an anti-inflammatory that can help treat dry eye disease’s underlying causes.
- Punctal Plugs: sometimes, dry eye disease occurs when a person’s puncta drain their tears too quickly. In these cases, we insert tiny plugs into the puncta to prevent drainage so the eye can moisten adequately again.
Even people whose tears drain too quickly can experience watery eyes. The irritation associated with dry eye can provoke more reflex tearing than their tear ducts can drain. The result can be a person whose eyes are uncomfortably dry between bouts of frequent crying.
Treating Other Causes of Watery Eyes
Your optometrist may recommend other treatments for watery eyes caused by:
- Conjunctivitis: eyecare professionals may use antibiotics to reduce inflammation caused by conjunctivitis. However, they typically wait a week or so first to see if symptoms decrease naturally.
- Foreign objects: if an item is stuck in your eye and causing it to water, your eye doctor will take it out safely. Foreign objects may include ingrown eyelash hairs.
- Styes or ulcers: your optometrist can help drain a stye to reduce the discomfort it causes. Corneal ulcers can require medications or surgeries, depending on their severity.
Talk to Your Eye Doctor about Watery Eyes
Many different factors can lead to watery eyes, so it’s best to consult your optometrist instead of diagnosing the cause yourself. Qualified eye care professionals have the resources and experience necessary to tell you exactly why your eyes are watering and what to do about it.
Looking for dry eye relief
Speaking of Health
Individuals often take eye health for granted. However, for many people, dry eye disease is a very real condition that affects their daily lives. People with dry eye disease often produce poor quality tears, poor quantity of tears or both, which leads to chronic inflammation of the eye surface.
I have dry eyes, but my eyes are watery all the time. How can that be?
There are three kinds of tearing: basal (basic), emotional and reflex tears. In dry eye disease, it’s the basal tears that are of poor quality and quantity. Emotional tearing occurs when individuals are upset or moved by a sensitive situation. In this instance, there are plenty of tears; however, they’re typically poor quality. Reflex tearing occurs when something gets in your eye and the eye tries to flush it out. Again, this is a situation where there are excessive tears of poor quality. When your eyes get dry enough, they act as if there is something in them and try to flush it out, which leads to watery eyes. In fact, watery eyes are the No. 1 complaint of dry eye sufferers.
What factors contribute to dry eye?
- Normal aging changes your eyes, and they don’t function as well as when you’re younger.
- Changes in hormone levels associated with age, menopause, pregnancy or birth control pills affect the eyes.
- People who have acne rosacea (50 percent have dry eyes), diabetes, thyroid disease, autoimmune diseases and inflammatory diseases that include rheumatoid arthritis (often dry eye disease is a presenting symptom), lupus and Sjogren’s syndrome are more likely to develop dry eyes.
- Oral medications, including antihistamines, antidepressants and birth control pills, can increase the likelihood of dry eyes. Preservatives found in medicated eye drops that are used chronically, including glaucoma drops and in cheap artificial tears, can also worsen the symptoms of dry eye. Make sure to avoid drops that claim to get the red out. These can lead to rebound red eyes, which cause eyes to be even redder and more irritated than before.
- Irritation from secondary smoke, as well as the internal effects of smoking may lead to dry eyes.
- The standard American diet, which is high in omega-6 fatty acids and low in omega-3 fatty acids, is also a factor. Omega-6 fatty acids cause inflammation, a key component to dry eye disease. A heart-smart diet is an eye-smart diet, such as the Mediterranean diet.
- The health of your eyelid margins and eyelashes is important. Blepharitis (dandruff like debris called scurf) Meibomian, gland dysfunction (poor quality oil, atrophy of glands), ocular rosacea, irregular eye lid margins (scaring, notching), Demodex (mites living in eyelash follicles) can all play a role in dry eye disease.
- Wearing contacts disrupts the tear film, leading to dry eye symptoms and decreased contact comfort and wearing time. Existing dry eye disease can lead to poor successful contact lens wear.
- Dry, windy, dusty and smoky conditions can all be problematic. So is polluted air quality, including second-hand smoke and seasonal air quality.
- A poor blinking rate (normal rate 15 bpm, poor is 4-5 bpm) can affect your eyes. Incomplete blinking (60-70 percent when working on digital devices) can also lead to dry eyes.
- Many people are vitamin D deficient. This contributes to dry eyes, along with many other health issues.
Is there anything I can do to improve my dry eye disease?
Yes, but it takes time. Your dry eye disease didn’t occur overnight. It took many months or years to develop, and it’s not going to go away immediately. Start by seeing your eye doctor and discussing your symptoms. Many people fail to mention these issues to their eye doctor because they don’t see them as important.
How your eye doctor can help
Your doctor will work to evaluate your symptoms and the quality and quantity of your tears.
- First. The doctor will ask questions about your symptoms including when, where, how often and what you’re doing when they occur.
- Second. The doctor will ask questions about your general health and the medications you’re taking.
- Third. A quality evaluation is performed of your eyelashes, eyelid margins, Meibomian glands and the surface of the eyeball (the conjunctiva and cornea).
Once an evaluation is complete, your doctor will design a treatment plan in a stepwise format to improve the environment for your eyes and your dry eye disease. There’s no magic wand to make dry eye disease instantly better. However, if a treatment plan is followed and you learn and use new habits, your dry eye disease can be improved.
Treatment options may include the following:
- Address eyelash and eyelid appearance and inflammation — through hygiene, supplements and prescription drops.
- Monitor quality and quantity of the Meibomain gland oil — using supplements, hot compresses and other treatments.
- Quiet eye surface inflammation — with artificial tears, supplements and prescription drops.
- Increase quantity of tears — using artificial tears, prescription drops and tear duct (punctal) plugs.
- Control your environment — with a humidifier; no forced air across the face.
- Diet — supplements.
- Follow up visits with your eye doctor — to monitor treatment and make adjustments.
Robert Friese, O.D., is an optometrist at Mayo Clinic Health System in Fairmont.
For the safety of our patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was either recorded prior to COVID-19 or recorded in a non-patient care area where social distancing and other safety protocols were followed.
Dry Eye Symptoms and Treatment
We know what you’re thinking: it sounds counter-intuitive, but having watery eyes is actually a sign that you might have dry eye syndrome! Living with dry (yet watery) eyes can be difficult, but once you discover the specific cause, it may be easy to treat. We took some time to explore the watering that can accompany dry eye — its causes, symptoms, and treatments.
What is Dry Eye, Anyway?
With each blink of the eyelids, tears are spread across the cornea, the front surface of the eye. Tears have many important functions: they provide lubrication and moisture, keep the surface of the eyes smooth, wash away foreign debris, and help prevent eye infections. Dry eye syndrome — also called ocular surface disease — occurs when tears aren’t being produced in the quantity, or the quality, needed to perform all of these functions.
Symptoms of Dry Eye
While one of the main signs of dry eye is watery eyes, there are many other symptoms that can further indicate that you are suffering from dry eye syndrome, including:
What Causes Dry Eye?
Many factors can cause decreased tear production and quality, including your genetics, lifestyle, and environment.
When your eyes don’t produce enough tears, they can’t be properly moisturized, lubricated, and protected. Being exposed to wind or dry climates can cause tears to evaporate too quickly. Tear production can also diminish depending on your age, medical condition, lifestyle, and the medication you may be taking.
Why Are My Eyes Watering?
When your eyes become dry, the glands beside your eyes begin to produce tears in order to try to sooth the itchiness, burning, and irritation. The glands will over-compensate, producing so many tears that the eyes can’t drain away the tears fast enough, causing the feeling of constant wet and watery eyes.
It’s also possible that your dry eye is caused by tears not staying on your eye’s surface long enough to relieve the dryness. These tears either dry up too quickly or drain too quickly. This failure of the tears to actually improve your dry eye symptoms will just cause your glands to continue producing tears, leading to consistently watery eyes.
Blocked tear ducts are yet another cause for dry eye syndrome. When the tear ducts can’t drain tears from the eye (because they’re blocked due to a “foreign body” or eye injury), it can cause excessive watering in your eyes.
It’s Time to Reduce Watery Eyes and Relieve Dry Eye
Living with dry eye can affect your quality of life, especially when the pain of dry eye causes your eyes to excessively water. At Central Oregon Eyecare, we take special care to determine the specific cause of your dry eye, and provide you with the treatment you need to relieve your symptoms.
When you’re ready to find relief for your dry eye syndrome, schedule an appointment or call us at (541) 640-5242.
Dry eye syndrome: symptoms, causes, recommendations
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Check lungs easy
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Dry eye syndrome as a special case of dystrophic processes (AMD) and his friend – a computer
The number of diagnoses of dry eye syndrome in the world is growing along with the development of technology.The main factors: deterioration of atmospheric air, in particular, near industrial zones, conditioned air, side effects of many drugs, radiation of LEDs (especially super-bright ones in the blue part of the spectrum, including AMOLED screens and the like).
Signs of the disease: itching, redness, fatigue, dryness in the eyes and eyelids. The reason is a violation of tear production.
If the syndrome is detected at an early stage, when the usual clinic does not yet diagnose it, a whole sea of problems can be avoided.Let’s start with a quick spreadsheet to see if this concerns you or is worth passing by.
What to look for
Now we will talk about subjective assessment methods, that is, those that need to be confirmed by analyzes or other special tests. But, if you have a couple of these complaints, read on. No – just skip the post, you’re in luck.
- Burning or itching in the eyes.
- Sensation of dryness in the eyes.
- Redness of the eyes.
- Feeling of a foreign body in the eyes.
- Sensation of eye strain, especially when using a computer.
- Swelling and redness of the eyelids.
- Unstable, fluctuating vision.
- Spontaneous lacrimation.
- Hypersensitivity to tobacco smoke.
At the age of 45 and older, or with rheumatoid diseases, thyroid diseases, previous herpes, mononucleosis, trigeminal nerve surgery, eye injuries and eye surgeries, or with frequent use of beta-blockers, analgesics, anticholinergics, antidepressants, oral contraceptives, estrogens, anti-migraine drugs, the presence of injections of botulinum toxin for cosmetic purposes in the paraorbital area, wearing soft contact lenses, swimming in chlorinated water, the risk increases, and complaints should be monitored especially carefully.
But let’s move on to a slightly more scientific description of the syndrome.
– a subjective feeling of dryness (objectively, it may not be).
– an objective decrease in fluid secretion (subjectively it may not be felt).
– symptoms and signs (up to blepharospasm)
– a clinical picture in which the most important manifestation is the syndrome. Typical situations: menopause, autoimmune exocrinopathy, vitamin deficiency A.
In Ancient Greece, the term “xerophthalmia”, that is, “dry eye”, was first introduced. But then they were called corneal blindness, coupled with the complete drying of the surface of the eye. In the nineteenth century, the meaning of the term shifted to the professional designation of Sjogren’s syndrome and a number of keratitis. Only half a century ago, the term took on its current meaning: von Rött called quantitative criteria for the scarcity of tears. Now the diagnosis is divided into water deficiency, mucodeficiency and lipodeficiency, depending on which component of the tear is deficient.
Grades of dry eye syndrome
Degree is not the stage of development of the disease, but the level of severity and possible consequences. For example, as a result of injury or chemical exposure, you can start right away from a difficult stage and get to the terminal stage rather quickly. But it is better, of course, to avoid it.
- Subclinical degree – no vivid symptoms, the patient sometimes complains of a feeling of dryness when using a hair dryer, in dry air, in strong winds or when wearing contact lenses for a long time, or when working at a computer for a long time.
- Mild – the symptoms are pronounced, itching also appears, less often photophobia, even less often fogging, very rarely – a slight blepharospasm. Infectious or allergic conjunctivitis is often diagnosed.
- Medium – all symptoms + new signs (erosion, punctate keratopathy, filamentous keratopathy, conjunctival hyperemia). At a moderate degree, all changes are reversible.
- Severe – corneal ulcers, leucorrhoea, neovascularization of the cornea, adhesions and other changes that are already irreversible are added.
- Terminal – significant visual impairment is added due to blocking of the optical field (for example, an ulcer). The end of this stage is a complete loss of the ability to distinguish objects with the eye.
In any ophthalmological office, they can take a history from you, look at your eyes through a microscope and do tests for tear production. The latter are especially important in diagnosing early stages of DES and are therefore included in most regular eye examinations that are correct.
If the doctor has suspicions, he can also prescribe special diagnostic methods (vital staining with dyes; tear crystallography; cytocompression study; ultrasound examination of the lacrimal gland; laboratory studies of the SG), requiring a rather specific laboratory or diagnostic center technique.
As a rule, most of the cases of DES is diagnosed for impaired production of tears or related changes in the eye, in particular blepharitis.
Relationship with inflammation of the eyelids (blepharitis)
The peculiarity is that patients complain of a symptom, and usually there is a picture of the disease. But at the same time, in the diagnosis, signs are often not detected and therapy is not prescribed. There is even an anecdote about this in ophthalmology:
– What to do with a patient with blepharitis?
– Send it to a competitor!
So, dry eye syndrome and blepharitis are two related problems. If DES was not caused by blepharitis, then it can cause inflammation of the eyelid.If DES was caused by blepharitis, in any case, treatment of one requires treatment of the other. The main point is that you can replace a tear for as long as you like, trying to fight dry eye syndrome with supportive treatment, but this will not work. It is necessary to cure blepharitis as well (or to prevent it from developing in a scenario when it was not he who caused the launch of the DES). Plus, to solve a number of accompanying problems for the deterioration of trophism. If the doctor prescribes only a tear substitute or a similar remedy, at first the patient simply suffers, and then the development of the syndrome begins with concomitant irreversible organic disorders of the lacrimal apparatus and the surface structures of the eye, up to ulceration of the cornea.
Hence there are two rules:
- If your eyes are dry, you need to get diagnosed, and not wait until it passes.
- If you have been diagnosed with dry eye syndrome and prescribed only tear replacement, but did not indicate the exact reasons that caused it, you need to look for and treat them. And already start preventing problems that develop during DES.
Here’s a rough diagram of cause and effect.
Treatment is performed not only by protecting the eye from fluid loss, but also, most importantly, by removing the cause of the disease.More on this later. Be careful for now. It is better to be examined earlier (the test for tear production takes 10 minutes) than to join those for whom we are launching our bioreactors in the production of gel.
A little later I will tell you about the tear and how it is arranged and works.
Dry eye syndrome: 7 reasons and methods of treatment
Ophthalmologist, academician of AMTN, doctor of medical sciences. Chief physician of the Yasny Vzor network of eye clinics.
Modern ophthalmologists have identified who most often suffer from dry eye syndrome. These are those who spend a lot of time in front of the screens of gadgets.
Perhaps many are not even aware of their diagnosis. We will tell you the symptoms:
- feeling of sand and dust in the eyes;
- Unreasonable lacrimation;
- I often want to rub my eyes.
Doctors check dry eye in another way – Schirmer’s test. This is a test that shows the amount of tears. Special pieces of paper are pushed under the eyelids to absorb a tear. It is painless, takes a minute and gives an accurate result.
Before discussing directly the causes of dry eye, let’s figure out how it should be normal. Fully moisturized – a tear is responsible for this, which constantly washes the eye. And here there is an important nuance – the quality of the tear.
Yes, and tears are of high quality, but they are not very good. There are two components in a tear: water and fat (lipid). The balance of these components is a quality tear. If the balance is imbalanced, dry eyes occur.
Now let’s look at the reasons for this condition.
What Causes Dry Eye Syndrome
1. Gadget Screens
Screen means anything – a computer, tablet or phone. If you look at any screen for too long, your eye will dry out.The fact is that bright light makes us focus and peer more closely. We are too involved and our eyes simply “forget” to blink. The fact is that blinking is an unconditioned reflex, we don’t think about it. And this reflex slows down when our attention is overly focused on something.
2. Dry air
We have dry air everywhere. Batteries work in the office and at home in winter and air conditioner in summer. And on the street: just remember what it is like to walk in the heat – it dries up in the throat, not so much in the eyes.
Dry air dries out the tear, which should wash the eye. And it’s even more dangerous than a computer screen.
Few people know that our cornea (this is the transparent outer shell of the eye) does not have blood vessels, that is, it feeds on tears. For example, a tear is supposed to deliver oxygen to her. And how will she do this if she dries up under the influence of dry air? The less oxygen and nutrients the cornea receives, the worse its condition.
This is a purely female cause. During menopause, which can begin at a fairly early age, the amount of estrogen in a woman’s body decreases. These hormones affect fat metabolism. They also reduce the amount of the fatty component of the tear. This means that the consistency of the tear changes, it becomes more liquid, it cannot stay on the eye. In such cases, women may experience unreasonable lacrimation.
4. Contact lenses
Even if you remember to take off your lenses at night, if you change them every day and are sure of the sterility of your containers, you still cannot avoid dry eyes.
Long-term lens wear = dry eye syndrome. This is an axiom. Lenses break the layers of the tear, degrade its quality and dry out the eye.
Ideally, you should not wear your lenses every day, but only when necessary. Of course, for a person with poor eyesight, this is simply impossible. Replace your lenses with glasses? Again, this is inconvenient for many.
Therefore, with poor eyesight, there are two ways out:
- Ask your doctor to prescribe an artificial tear and constantly drip it into your eyes.
- Make laser vision correction, if you have no contraindications, and forget about lenses. However, the preparation for the operation must go through correctly – see the next paragraph.
5. Laser vision correction
Dry eye syndrome often worsens after laser vision correction. But this happens if the preparation for the correction was carried out incorrectly. Before the operation, the aforementioned Schirmer test, a dry eye test, should be done. And if necessary, treat this syndrome, but not with drops, but with more effective laser stimulation.If this technology is followed, then laser correction will take place without problems.
Some medicines cause dry eyes. These are usually antidepressants and oral contraceptives. The drugs affect the hormonal balance, which, in turn, affects the fatty component of tears. The tear film loses its stability and the eye dries up. In parallel with taking these drugs, it is better to use an artificial tear.
7. Chronic diseases: diabetes, conjunctivitis, blepharitis
Diabetes mellitus , in addition to many other unpleasant consequences, also causes dry eyes.But with the right compensatory therapy, this problem does not arise.
In the treatment of conjunctivitis antibiotics are used that interfere with the quality of the tear. Therefore, after treatment of this disease, it is imperative to be treated for dry eye syndrome.
Blepharitis is a chronic inflammation of the eyelids, which also impairs the quality of tears. Until it is cured, dry eyes will not go away.
How to treat dry eye syndrome
- Apply drops with artificial tears.However, the independent choice of drops, although it will not bring harm, but also benefit too: now there are drops with different compositions, so the doctor should choose the right ones for you.
- Receive laser treatment. Modern ophthalmologists treat dry eye syndrome not only with drops. Circulatory laser stimulation of the lacrimal glands is a type of physiotherapy that improves the production and composition of tears. Moreover, unlike drops, one course of treatment is enough for at least six months.
- Treat comorbidities leading to dry eye syndrome.
- Buy a humidifier.
- Set an alarm every 10 minutes when working at the computer. This will be a signal that it is time to blink properly.
- For those who wear contact lenses – do laser vision correction, if there are no contraindications.
And finally, let me remind you: anti-glare glasses for working at a computer, glasses with holes for relaxation are all a successful marketing ploy. They are absolutely useless to the eyes.
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Dry eye syndrome
3 February 2021
Eye fatigue towards the end of the day?
Sensation of “sand” in the eyes
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90,000 Sensations with dry eye syndrome
Trade name of a medical device: SYSTEIN ULTRA , lubricant eye drops, in a bottle of 10 ml. Area of application: Systain Ultra, eye drops-lubricant is a product that moisturizes the surface of the eyes and provides relief from the feeling of dry eyes, irritation, burning, cramps, the sensation of the presence of a foreign body and the effects of many adverse factors. Systane Ultra, lubricant eye drops can also be used to moisturize and lubricate silicone hydrogel and soft (hydrophilic) contact lenses by instilling over contact lenses as needed throughout the day. Systain Ultra lubricant eye drops also help remove particulate matter from the surface of the eyes that can cause eye irritation and / or discomfort. Directions for use: Shake the bottle well before use! Can be used as needed throughout the day.Place the solution in the eye and blink several times. Contraindications: Allergic reactions to any of the components of the drug. RK-IMN-5 No. 009759 dated 09/14/2017 without limitation of validity period.
Name of medical device: SYSTEIN BALANCE , lubricating eye drops, in a bottle of 10 ml. Application: Dry eye treatment for temporary relief of burning and irritation symptoms caused by dry eyes.Also used to treat dry eye caused by contact lens wear by instillation before inserting the contact lenses or after removing them from the eye. Directions for use: Shake the bottle well before use! Can be applied as needed throughout the day. Put a few drops in your eye and blink. Contraindications: Allergic reactions to any of the components of the drug. RK -IMN-5-No.010453 dated October 24, 2017, without limitation of the validity period.
Name of medical device: SYSTEIN® , lubricant eye drops, 10 ml in a bottle. Applications: Soothing solution that moisturizes the eye surface. Contraindications: Allergic reactions to any of the components of the drug. RK-IMN-5 No. 002841 dated 20.04.2016. Without limitation of validity period.
Address of the organization that receives claims from consumers on the quality of products on the territory of the Republic of Kazakhstan Representative office of Alkon Pharmaceuticals, Ltd.”Almaty, st. Luganskiy, 96 Tel .: +7 727 258 16 58 Email address: [email protected]
90,000 Eye dryness when wearing contact lenses
People, due to vision problems and who are embarrassed to wear glasses, often have to resort to using contact lenses. Failure to comply with the rules of use and regular wearing of lenses can cause conjunctivitis, an inflammatory process of an infectious nature, as well as dry eye syndrome. If you do not eliminate the cause due to which dry eyes have arisen and do not choose a strategy to deal with it, you can forget about the comfortable use of contact optics.
Causes of dry eyes
Drying of the mucous membrane occurs as a result of a lack of moisture on the surface of the cornea and conjunctiva. This is due to a violation of the production of tear fluid, which protects the eyes from drying out. Dry eye syndrome can appear from negative external factors, if you use a computer for a long time without interruption, watch TV for a long time, and also while wearing contact lenses.
Dry cornea from prolonged lens wear occurs for reasons such as:
- type of lenses that do not retain moisture well;
- poor-quality cleaning and care of contact optics;
- non-compliance with the wearing regime;
- an allergic reaction to any component of the lens solution;
- the optical product has been used longer than the recommended period.
Dry eye symptoms
With dry mucous membranes appear:
- swelling of the eyelids;
- redness, itching, burning;
- tingling, watery eyes;
- blurred vision, eye fatigue;
- intolerance to bright light and wind;
- feeling of grit in the eyes.
Means for eliminating dry eyes
Drops can be dripped without removing contact lenses, which is very convenient when traveling or at work.They moisturize the surface of the mucous membrane and prevent the evaporation of lacrimal fluid. They relieve manifestations of irritation, cramps, stimulate the process of cellular metabolism in the cornea.
They protect the eyes from adverse factors that lead to corneal dryness. They are made of special materials that attract moisture and retain it on the surface of contact optics.
Solutions for the care of contact lenses
To eliminate discomfort when wearing lenses, you must use special solutions as lens care.They create a protective film on the surface of the eyes and lenses, and also moisturize the optical product and the cornea of the eye.
They relieve unpleasant symptoms caused by drying out of the mucous membrane, but they cannot be used with moisturizing drops. The ointment can only be applied after removing the contact lenses.
The following guidelines can help protect your eyes from dryness caused by lens wear:
If your eyes persist with dryness and discomfort while wearing lenses, remove them from your eyes and consult an ophthalmologist.In the clinic, you will be prescribed the necessary tests and examinations, which will help to establish the exact cause of the drying out of the mucous membrane. Depending on the results of the study, the doctor will advise what needs to be done to eliminate the dryness of the corneal epithelium. Usually, in order for contact optics not to dry out the eyes, it is enough to adhere to such rules as:
Do not forget about the hygiene procedures required for optical products. Dry cornea is often caused by neglect of lens care.For people who do not want to deal with cleaning an optical product, the use of disposable models will be safe for the health of the mucous membrane. Since daily lenses do not need to be disinfected and cleaned, unlike contact lenses designed for long-term use.
To clean products for scheduled replacement, you need to use special solutions. They kill bacteria and viruses, and also moisturize and remove deposits and dirt from lenses. Well proven means that protect against evaporation of tear fluid and moisturizing lenses Biotrue, Unica Sensitive, Maxima, PureVision;
Terms of replacement of contact lenses
It should be remembered about the timing of replacement and the mode of use of contact lenses.If you do not take into account the time interval during which it is allowed to wear optical products without taking off, dryness of the mucous membrane will appear quite quickly. The same will happen if you wear contact correction means with a short service life for a long time.
Timely replacement of old optical devices with new ones is the prevention of the development of dryness and mucosal damage. The shelf life of these products depends on the processing methods of the material from which they are made and their characteristics.When wearing out-of-date vision correction means, their resistance to protein and fat deposits decreases and infectious inflammation of the mucous membrane may occur.
Apply eye moisturizers. If the means of vision correction are selected correctly, the rules of hygiene and the mode of wearing are observed, the lenses are not the cause of dryness of the cornea. A feeling of dryness in the eyes may appear due to lack of sleep, eye fatigue, after a long sitting at the computer.Effectively combating the discomfort caused by drying out of the mucous membrane, special eye drops, gels and emulsions.
They eliminate unpleasant symptoms, restore moisture to the surface of the eye. It is better to purchase moisturizing drops that are allowed to be used without removing the correction means. The means that restore the work of the lacrimal glands Adria Relax, Pro Active, VizoTeque Pure Crystal, Optimed Drops, Systain Ultra perfectly cope with the problem of dryness. When choosing drops, be sure to consult with an ophthalmologist, because only he can choose the right care products for you.
Use special contact lenses
Try to use lenses that are resistant to protein deposits. These means of vision correction restore the function of the tear film, which protects the mucous membrane from moisture loss. These optical products include: Acuvue Oasys hydrophilic lenses, 1-Day Acuvue TruEye, Dailies Total 1.
Dry eye syndrome occurs when the eyes produce too little tears, or they evaporate too quickly.Dryness can lead to inflammation. It occurs at any age, including people who are in good health. However, dry eye syndrome is more common in older people, when the amount of tear produced decreases. In addition, dry eyes are more common in women. More susceptible to the syndrome in areas where people are deficient in vitamin A.
Causes of dry eyes
The eyes produce tears all the time.Healthy eyes are covered with a tear film that persists between blinks. It helps prevent dryness and maintains clear vision. When the lacrimal glands produce less tears, the tear film becomes unstable. It “breaks down”, dry areas appear on its surface.
Tears are made up of water, grease, proteins, electrolytes, and bacteria-fighting substances. This combination helps to maintain a smooth and clean eye surface.Dryness can be caused by an imbalance in the composition of the tear, causing it to evaporate too quickly, or by insufficient tear production. Other reasons may be problems with the eyelids, taking certain medications and negative environmental factors.
Imbalance in tears
The tear film consists of three layers: lipid, water and mucin. The lipid layer consists of fats and covers the surface of the tear, slowing down the rate of its evaporation.The middle layer, which is composed of water and salt, cleanses the eyes and flushes out irritating particles and substances. The mucin layer is responsible for the distribution of tears over the surface of the eye. A problem with any of the layers can lead to dry symptoms.
Decreased tear production
At the age of 40, the amount of tear produced begins to decrease. When this amount reaches a certain level, the eyes become dry, irritated and reddened.More often women face this due to hormonal changes. Other causes may include autoimmune diseases, radiation therapy, diabetes, vitamin A deficiency, refractive eye surgery (LASIK).
Eyelid problems, medication, environmental factors
Each time you blink, the eyelids distribute a thin tear film over the surface of the eye. Most people blink about 5 times a minute. Eyelid problems can cause an uneven distribution of tears.Eyelid diseases such as ectropion, entropion and blepharitis can lead to dry eyes.
The following medications can cause dryness: some diuretics, antihistamines, decongestants, some sleeping pills, birth control pills, some antidepressants, acne medications, morphine, and other opiate pain relievers.
Environmental factors that contribute to dry eyes include dry climates, sun exposure, wind, and situations where air is directed towards the face.Cigarette smoke and contact lens wear can also be risk factors. Working at screens of electronic devices, reading, driving a car, as well as any increased concentration of vision can slow down the frequency of blinking, which contributes to dry eyes.
- sensation of dryness, burning in the eyes, soreness
- gritty eyes
- sensitivity of eyes to smoke or wind
- eye redness
- difficult to keep eyes open
- eye fatigue after reading, even for a short time
- blurred vision, especially towards the end of the day
- light sensitivity
- discomfort when wearing contact lenses
- double vision
- “sticking” of the eyelids on awakening
Some people experience pain with dry eyes.Complications can include even more significant redness, sensitivity to light, increased pain, and blurred vision.
To prescribe treatment, you need to contact an ophthalmologist who will conduct an examination, study the medical history, medications taken, and ask questions about the profession and lifestyle. Treatment focuses on keeping the eyes well hydrated, but the method will depend on the cause of the dryness. There are three ways to keep your eyes hydrated:
- maximum use of natural tears
- using artificial tears or eye drops
- reduced tear evaporation
If the source of the problem is a chronic eye disease or a general condition of the body, such as an eye infection or psoriasis, treatment for the underlying condition should be considered first.
For patients with chronic dry eyes, drops containing cyclosporine are prescribed, which reduces inflammation and stimulates increased tear production. This medication is not used for eye infections or a history of herpes.
The following actions will enhance the production of natural tears:
- wear glasses to protect your eyes from wind and hot air
- blink more often when looking at a computer or TV screen
- do not smoke and avoid places with high concentration of cigarette smoke
- Maintain an average room temperature of
- use a humidifier at home
Artificial tear and eye drops will help moisturize the eyes.The preservative-free eye drops can be used as often as needed. A moisturizing ointment is best used before bed as it can blur your vision a little.
Diet . Some studies suggest that omega-3 and omega-6 fatty acids can help reduce the risk and symptoms of dry eye. The source of acids is fatty fish, walnuts, flaxseed oil, flaxseeds, hemp and olive oil, pumpkin seeds.However, there is currently no evidence that omega-3 and omega-6 fatty acids can be used as primary treatments.
Most people with moderate dry eye syndrome do not experience long-term problems or any complications. However, significant manifestations can lead to inflammation, infection and damage to the surface of the cornea.
Article “What is Dry Eye and How Can I Get Rid of It”?
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