Let's begin by discussing what dry eyes are. It is a multifactorial disease at the front surface of your eye that impacts your tear film and causes discomfort to the patient. There are conservatively an estimated 4.88 million Americans aged 50 and older who suffer from dry eyes.

What are scleral lenses? How can they be used to treat dry eye syndrome?

Scleral lenses can be used to treat dry eyes. Scleral lenses are specialty hard contact lenses that help relieve the symptoms of dry eyes. They do not cure dry eyes, but can provide relief by better moisturising the eyes. These lenses rest on the white part of your eyes called sclera and are larger in diameter than rigid gas permeable lenses. Since these lenses are larger, and they cover the whole corneal surface, and even a little bit beyond that, they help to protect your eyes from different irritants such as smoke, wind, dust debris, which may reduce your symptoms. Scleral lenses are also filled with fluid before they are inserted into your eyes, which provides a cushion and keeps your eyes moist during the day when they are instilled.

These lenses are comfortable for people with dry eyes to wear their lenses for an extended period of time. As a result, patients are less likely to need to use eye drops and keep their eyes moist. Not only can scleral lenses help reduce dry eye symptoms, but also symptoms of keratoconus if you have them. Sclerals are a great option for anyone who has a sensitive ocular surface, is bothered by symptoms and wants more immediate relief, or who is bothered by dust, smoke or other irritants in addition to dry eye.

What are the different components of dry eye?

There are two different components of dry eyes. There is aqueous deficient dry eye and evaporative dry eye. Having aqueous deficient dry eyes means you aren't producing enough lubricating fluid so your eyes aren't properly lubricated. You can also suffer from the evaporative component of dry eyes, where there is an issue with the outermost layer of your tears, causing the tears to evaporate more quickly, causing ocular surface inflammation.

What are the most common symptoms of dry eyes?

Dry eyes can lead to a whole host of symptoms including:

  • Irritation
  • Burning and stinging
  • Foreign body sensation
  • Gritty feeling
  • Fluctuations in your vision
  • Excessive tearing
  • Eye pain
  • Dryness in your eye or a crusty film at the corner of your eye

How can symptoms of dry eyes be alleviated?

Different types of treatment options are available depending on the severity and type of dry eye.

  • Eye drops - Dry eyes can be treated with eye drops that keep your eyes lubricated and relieve your symptoms. There are over-the-counter artificial tears available, although they are generally considered a way to stop the symptoms but not a treatment. Your  eye doctor may decide that prescription eye drops are best, such as xiidra or restasis, which specifically target the inflammatory component of dry eyes.
  • In-office procedures - Additionally, your eye doctor may recommend in-office procedures that can help with the evaporative component of dry eyes, such as heating and expressing your glands. Having clogged meibomian glands can reduce the amount of oil coming out of your glands, causing your tears to evaporate more quickly. This helps address that issue.
  • Punctal plugsAnother treatment option may be Punctal plugs, which increase the amount of tears that remain on the front surface of your eye to make them more lubricated and reduce dry eye symptoms.
  • Medically Necessary Contact Lenses - Many patients with dry eye will find improvements of their symptoms and vision when they use advanced contact lens modalities such as scleral lenses. This solution is usually a more advanced treatment, which comes after the eye doctor has tried simpler solutions. However since scleral contacts provide great vision and reduction of dry eye symptoms, it is a great option for someone who is looking for immediate relief of dry eye symptoms and is also doing treatment to address the underlying causes of the symptoms.
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