Dry Eye

Dry Eye Disease is one of the most common reasons for patients to visit an eye doctor. A 2012 Gallup poll showed that over 26 million Americans suffer from Dry Eye. Another poll has found that over 45% of the population over the age of 18 in the United States regularly experience Dry Eye symptoms. Dry Eye is characterized by a breakdown in the stability of the tear film.

The tear film is critical in maintaining the health of the front surface of the eye. It is also important in providing clear vision. The cornea, which is the window into the eye, plays the largest focusing role in the eye. Wetting of the cornea by the tear film is critical to maximizing the quality of the images we see.

The tear film consists of two layers. There is an oil layer that coats a mucous/water layer. The oil layer is derived from glands that line the upper and lower lids and plays a role in preventing the evaporation and breakup of the tear film. The mucous/water component of the tear film is derived from goblet cells on the surface of the eye and the lacrimal gland, which is located above the eye.

Symptoms of Dry Eye include the following:

• Blurred vision
• Burning sensation
• Fluctuating vision
• Foreign body sensation (feeling like there is something in the eye)
• Gritty sensation
• “Tired” or “Heavy” eyes
• Watery eyes
• Aching or sore eyes
• Dryness sensation
• Red eyes
• Light sensitivity
• Itchy eyes

Looking through this list of symptoms, it may seem odd that “watery eyes” are a common symptom of Dry Eye. This is a result of the fact that dryness of the ocular surface will often over-stimulate the production of the watery component of tears as a protective mechanism. “Reflex tearing” like this does not stay on the eye for an adequate amount of time to correct the underlying problem of a dry surface. This often results in tearing from the corners of the eye.

There are numerous factors that contribute to the development of Dry Eye. Some are included in the list below:

• Computer, tablet and smartphone use
• Contact lens wear
• Aging
• Menopause
• Home and office heating and cooling systems (heating, air conditioning and ceiling fans can all decrease the indoor humidity)
• Dry and windy outdoor environments
• Smoking
• Certain medical conditions such as diabetes, thyroid disease, lupus, rheumatoid arthritis and Sjogren’s syndrome
• Prescription and over-the-counter medications such as antihistamines, decongestants, antidepressants, some blood pressure medications and birth control pills
• Eyelid problems that result in incomplete closure when blinking or sleeping
• Certain eye surgeries like LASIK can cause Dry Eye that is typically temporary

 Dry Eye is a chronic and often progressive condition. You and your eye doctor will determine a treatment regimen that will help alleviate your Dry Eye symptoms. This is accomplished by undergoing a thorough Dry Eye examination.

There are numerous treatment options when managing Dry Eye. Below are several that are offered at Summit Eye Center.

• Artificial Tears
  • Found over the counter, they come in many varieties with different ingredients and viscosity
  • They work by providing additional lubrication to the surface of your eye
  • Your doctor will often recommend one or more artificial tears that will likely be best suited to treat your Dry Eye
• Restasis and Xiidra
  • These are prescription medications designed to treat the inflammation that is associated with the signs and symptoms of Dry Eye
  • These medications are dosed twice a day on an ongoing basis
• Steroid Eye Drops
  • These are prescription medications that treat episodes of increased inflammation
  • They are typically prescribed for short-term use to quickly manage symptoms
• Punctal Plugs
  • This is a small device that is inserted the small openings of the tear drainage ducts located in the nasal corner of the upper and lower lids
  • Typically, the doctor will initially place a plug in the lower tear duct of each eye
  • The placement of punctal plugs allows your natural tears to remain on the eye for a longer period of time, providing lubrication
• Meibomian Gland Probing/Expression
  • The meibomian glands line the upper and lower lid margins, secreting oil (meibum) into the tear film
  • These secretions can become thickened, leading to clogging of the meibomian glands
  • The insertion of a probe can open these clogged glands
  • The lids can then be warmed and pressure applied to the lid to express the clogged contents
• Warm Compresses
  • At home patients can employ warm compresses followed by lid massage
  • After heating a clean facecloth, you close your eyes and press the hot facecloth closely against your lids and eyelashes
  • You need to continue soaking for 5-10 minutes, which may require 3 trips to the faucet
  • Then looking upwards, place the tip of your index finger just under the eyelashes and squeeze the lid firmly between your finger and the eyeball. Move your finger across each lower lid hitting 4-5 areas. While looking downward, repeat this across the upper lid.
  • A Bruder Mask is a great alternative to the facecloth, as it will remain heated for the full 10 minutes without needing to be reheated
• Intense Pulsed Light (IPL)
  • With Intense Pulsed Light (IPL), the doctor uses a hand-held device that flashes bright light onto the skin
  • The light is filtered so that only wavelengths that can be absorbed by blood vessels on the skin’s surface are used
  • IPL reduces inflammation within the lids and meibomian glands
  • IPL also has a thermal effect, generating heat that melts the meibum, opening the glands
• TrueTear
  • TrueTear is an intranasal tear stimulator that provides a temporary increase in tear production
  • It stimulates a nerve in the nasal cavity with tiny pulses of energy. The brain then sends nerve signals to the tear glands to temporarily increase tear production.
  • This is a drop-free, medication-free treatment option that can be done at home
• Thermi
  • Thermi uses radiofrequency energy which stimulates the production and remodeling of collagen
  • This results in a tightening of the skin reducing wrinkles, fine lines and sagging skin
  • This improvement of elasticity and reduction of laxity in the skin around the eyes has been shown to reduce symptoms of dry eye
  • Thermi also has a thermal effect, similar to IPL, targeting the meibomian glands
• Nutritional Supplements
  • Omega-3 fatty acids
  • Flaxseed oil
  • Drinking plenty of water throughout the day
• Lifestyle Changes
  • Blinking more frequently
  • Taking breaks when working on the computer, such as the “20-20-20 Rule”...every 20 minutes, take a break and look at something 20 feet away for 20 seconds
  • Thorough removal of eye makeup
  • Wearing sunglasses when outdoors

The doctors at Summit Eye Center are dedicated to treating patients with Dry Eye Disease. This starts with a comprehensive examination to access the current state of the ocular surface. They will then determine a customized treatment plan that is tailored to address the needs of each individual patient. You can visit our website, www.summiteyekc.com, call us at (816) 246-2111 or email us at This email address is being protected from spambots. You need JavaScript enabled to view it. to schedule an appointment.