It is estimated that 49 million Americans have dry eyes, and the number continues to rise.
Dry eye is a progressive and chronic condition that can cause severe permanent damage if untreated. As our society becomes more dependent on digital screens, the prevalence of dry eye is increasing as well. Fortunately, dry eyes can be managed and controlled.
The severity of symptoms can range from mild to moderate to more severe. Some symptoms of dry eyes include
Dry eyes can be caused by many different factors, including:
A thorough dry eye evaluation usually detects dry eyes. You would be examined by your eye doctor by going through a detailed symptoms worksheet discussing your symptoms, if you experience any of the symptoms associated with dry eyes, before you'd be put under a microscope to assess the front surface of your eyes. In addition to your lid, your lid margin is also examined, since on your lid margin are the oil glands that produce the oil that forms the outermost film of your tears, and it protects the aqueous layer of your tear film. In some cases,some of your glands may not produce enough oil, which could result in your tears evaporating faster, causing dry eyes. Different stains are used to examine the front part of your eye. The most common one is sodium fluorescein stain, which is an orange dye that reflects green light. It allows your eye doctor to see the front surface of your eye clearly, checking the breakup time of your tears and if there are any dry spots. There are various tests available to determine the volume of your tear layer and film, and if any of those values are unusual, then you may have dry eyes.
Dry eyes are treated differently depending on the type of dry eye, either aqueous or evaporative, as well as the severity of the dry eyes.
In milder cases, it is recommended that patients start applying warm compresses over their eyes twice daily for about 10 minutes followed by gentle massage and eye lid scrubs. This works by freeing up the clogged meibomian glands (heat and massage) as well as cleaning any debris or mites (scrubs). A common eye mask is the bruder eye mask, however there are many options available. In addition to the warm compresses your eye doctor will recommend the type of drops that you should use. It is important that you use the right type of eye drop depending on the type of dry eye that you have. You should also lubricate your eyes with some over-the-counter artificial tears two to four times a day.
If this initial treatment does not work, a prescription of eye drops called Restasis, or Xiidra, might be given. This is because dry eyes are a multifactorial disease process that causes instability in the ocular surface. In addition to the symptoms of dry eye, the condition causes inflammation which can lead to ocular damage to the front part of your eye. Restasis and Xiidra are prescription eye drops that tackle the inflammatory component of your dry eyes to help alleviate the symptoms and reduce risks of damage.
Punctal plugs are another treatment option. There are four drainage systems in our eyes, two on the bottom and two on top, which help drain our tears. These Punctal plugs partially block your drainage areas. The plugs are usually placed on the two bottom drainage ducts so that your tears can flow to the front surface of your eye and remain lubricated.
In the event, none of these treatments help, or if you're not so consistent with using those warm compresses every morning and night, there are other in-office treatments that remove the blockage in your meibomian glands, such as LipiFlow, iLux, Miboflow, and TearCare.
For more severe dry eye there is a specialized treatment called Amniotic Membranes which are ethically derived stem cell based ocular bandages that transfer regenerative nutrient rich tissue to the front surface of your eye. This treatment is often recommended when other treatment has been tried and is not effective or if the patient has severe corneal scarring in addition to their dry eye symptoms.