Do your eyes feel scratchy – as if sand is stuck under your eyelids? Do you blink or rub your eyes constantly? Along with redness and general irritation, these are typical symptoms of dry eye. The good news is that our Washington, DC, optometrist will treat your Dry Eye Syndrome in our convenient eye care clinic.
The first line of defense against dry eyes is to determine the specific cause. While many people share the same annoying symptoms, the culprit behind dry eyes is highly individual. Our eye doctor will perform a thorough eye exam to assess your personal condition and prescribe the most appropriate dry eye treatment.
Following your consultation with our Washington, DC, optometrist, we may recommend some of the following approaches:
Mild dry eye is often treated effectively with over-the-counter artificial tears. Preservative-free solutions are best, as they contain minimal additives that can irritate your eyes. Generally, you can apply artificial tears as frequently as needed.
Artificial tear inserts, similar to contact lenses, can be inserted into your eyes to improve your natural tear coating.
Conserving natural tears
If artificial tears are not enough to alleviate your discomfort, an alternate treatment involves blocking your tear ducts with tiny silicone plugs. This allows your natural tear film to stay in your eye and disperse across the surface of your eye. Called punctal plug insertion, our eye doctor will perform this minor procedure in the comfort of our Washington, DC, clinic. The plugs can be permanent or temporary (they dissolve over time).
If your dry eyes are due to sleeping with your eyelids slightly open, we may advise you to wear plastic eye shields or a special tape that holds eyelids closed while you doze.
Boosting production of natural tears
We can prescribe eye drops that increase the manufacture of quality tears. Adding a nutritional supplement with omega-3 fatty acids or fish oil to your daily diet may also help.
When blocked glands cause dry eye, a medical device called lipiflow can provide effective treatment. Using mild pressure and heat to unblock the oil-producing glands of your eyes, lipiflow can enhance tear quality with more lipids. As a result, your eyes are better lubricated and your tears evaporate more slowly.
Treating inflammation of the eye or eyelid
When there is swelling of your eyelid or ocular surface, it can interfere with proper tear production. Our optometrist may prescribe anti-inflammatory eye drops, medicinal ointments, or eyelid cleansers to reduce inflammation around your eyes. Warm compresses and eyelid massage can also be helpful.
More DIY strategies to treat dry eye
- Install a humidifier to raise the moisture level in your surroundings
- Use an air filter to remove dust and other irritants from the atmosphere
- Keep your eyes hydrated with artificial tears eye drops
- Apply hot compresses to help trigger tear production
- Drink a sufficient quantity water to restore fluids to your body
If you find that dry eyes are getting in the way of your clear and comfortable vision, call to schedule an appointment with our Washington, DC, optometrist. At Washington Eye Doctors, we are experienced and knowledgeable about dry eye treatment, and we look forward to helping you!
Dry Eyes Q&A with Dr. Rosenblatt
Question: What is Dry Eye?
Dr. Rosenblatt: In reality, dry eye is an old name for a very common problem. The new name is ocular surface disease. It is a very common disease. Anywhere between 10-60 million people are afflicted with it in the United States. In people suffering from dry eye, their natural tear is not properly and healthily bathing their eye. The result of which can be symptoms of discomfort, stinging, burning, sandy gritty feeling, and fluctuating vision throughout the day (part of the day they see clearly other parts blurry).
Question: Why did they change the name from dry eye to ocular surface disease?
Dr. Rosenblatt: We are seeing it's not just a tearing issue per se, but patients have problems with the surface of the eye as well. We added the word disease because we wanted the public to think more seriously about this condition. We wanted to move away from the term "dry eye" because patients would come in and have a tissue constantly in their hands to wipe their eyes due to excessive tearing and so when we say to them that they have dry eye, it doesn't make sense to them.
Question: What causes ocular surface disease/dry eye?
Dr. Rosenblatt: The causes of dry eye are varied. In most cases we see that it's a chronic inflammatory disease. This means that it won't go away. We look at it nowadays as any other chronic diseases, like high blood pressure or diabetes.
The inflammation is within the tear gland. There are different types of tear glands which produce parts of the components of the tears. The most common are the Meibomian glands. Our tears are made up of mucus, oil and water. It takes the proper amount of each of those components to have a good quality tear that does its job.
We have two types of tears. We have the everyday, what I like to call the "sprinkler system" tears which are low-grade and constantly on. This is the tear that we are talking about that is being affected by the clogged glands and inflammation.
The other type of tear we have is reflexive tearing. This is the fire hydrant of tears. The problem with the fire hydrant of tears is it is not the same quality of tear. The volume is only increased because the water component was increased.
If someone has dry hands and washes them in tap water, immediately under the water they look great, but when they dry again, they will be dryer than they were before you put them in the water. This is because the hands, or in our case the tear is missing the additional moisture component of the oil and mucus.
The Meibomian glands tend to be the number one source of inflammation. They produce the lipid component of the tears, which helps the tear spread evenly across the eye, and helps coat the outer layer of the tear whereas the tears don't evaporate as quickly. So, without proper lipid content we get a tear that doesn't spread well and evaporates too fast, leaving dry eyes.
Question: Are some people or demographics more prone to ocular surface disease/dry eye than others?
Dr. Rosenblatt: Sure. Women are the number one group suffering from ocular surface disease. As women age and become post-menopausal their eyes tend to get more dry. People taking medication for hypertension are also more susceptible to dry eyes. People who wear contact lenses are also more susceptible to dry eye.
One of the things we are seeing today is younger people, including many children, with dry eye. This seems to us to be environmental, due to the extensive amount of time on electronic devices and computers. We see that the more people are looking at these devices, they don't blink as often and the eyes dry out. You see, blinking is a pumping action. When we blink we help pump those glands. Therefore, without the normal pumping the glands get clogged. If they clog and are untreated, later in life the glands will even die off.
Question: How do you diagnose ocular surface disease/dry eye?
Dr. Rosenblatt: When someone comes in with the above symptoms, we look at, using various techniques, certain biologic dyes which we have in particular. The tears are clear, so in order to see them we have to change their color temporarily.
There are technologies available to image those glands and see the their condition and how significant the problem is, and how clogged are: can we express them with some gentle pressure, what's coming out of them when we do express them if anything.
Then we look at the tears: in terms of the volume of the tears, how quickly they evaporate which is called the break up time of the tears, and the dye we used will also allow us to look at the surface of the eye and where there are breaks in the surface. Again, think of dry hands, and you see the flaky skin, that's sort of what your eye does too.
Our eye has an epithelial layer that we shed all the time, but when there is dryness present, we can see areas which are broken, and that's where the dye shows up. Another dye we use that only shows up where there is cell death. This is an indication of a long-standing problem.
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