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What is Dry Eye?
- In medical terms,
  Dry Eye is lovingly known as "KERATOCONJUNCTIVITIS SICCA".
  The tear film consists of 3 layers: A superficial lipid (oily) layer which decreases evaporation, a middle aqueous layer which contributes 90% of the tear film, and a deep mucin layer which facilitates spreading of the tears over the cornea.

What causes Dry Eye?
- Dry eye can be caused by many different factors.
  
  Age. The most common cause of Dry Eye is age. Reduced tear production is a natural part of aging. Most people over 65 years old experience some symptoms of Dry Eye.
  
  Hormonal changes. Women are more likely to develop Dry Eye than men. This is, in part, because of the hormonal changes that take place during pregnancy and after menopause.
  
  Medications. Certain medicines cause Dry Eye as a side effect. These include antihistamines, decongestants, blood pressure medications, birth control pills, hormone replacement therapies to relieve the symptoms of menopause, Parkinson’s disease medicines, and antidepressants.
  
  Medical conditions. People with rheumatoid arthritis and other autoimmune diseases are more likely to have symptoms of Dry Eye. The same is true for people with other medical conditions such as diabetes, thyroid disorders, and inflammation in the eye. Seasonal allergies can also contribute to symptoms of Dry Eye.
  
  Environmental conditions. Windy, smoky, or dry conditions can increase the speed of evaporation of tears on the surface of the eye. Additionally, people who stare at computer screens for long periods of time can fail to blink enough to keep the eye adequately moist.
  
  Other factors. Long-term use of contact lenses or LASIK eye surgery can reduce the production of tears and lead to symptoms of Dry Eye. With LASIK, the condition is generally temporary and resolves as the eye heals.

What are the symptoms of Dry Eye?
- Dry Eye feels irritating like something is scratching the eye. People with Dry Eye also feel stinging, burning, or gritty sensations as well as periods of dryness followed by excessive tear production. Sometimes people with Dry Eye feel as though their eyelids are heavy and they may have blurred vision and trouble seeing.

How do you treat Dry Eye?
- An exam conducted by a qualified eye doctor will help you determine the underlying cause of your symptoms. Your treatment will vary, depending on what your doctor finds. Common treatments include:
  
  • Changing medications with side effects linked to dry eye may help relieve your symptoms.
  • Over-the-counter artificial tears may be taken as often as needed and may help with mild cases of dry eye.
  • For symptoms that don’t go away with over-the-counter products, doctors can prescribe medications to increase tear production.
  • When inflammation in the eye is the underlying cause of the problem, using prescription medicines, warm compresses, and other methods might help relieve your symptoms.
  • Surgery can be used in certain cases to plug tear ducts, which prevents tears from draining out of the eyes too quickly.

Can Watery Eyes Be a Symptom of Dry Eye?
- Yes. As odd as it sounds, many Dry Eye sufferers experience ‘wet eyes’ due to the tear glands overproducing watery or reflex tears to compensate for a lack of a balanced tear film.

Can reading & TV or computer viewing cause Dry Eye?
- During reading and TV or computer viewing, the rate of eyelids blinking reduces significantly. This causes the tear film to evaporate leading to dryness of the eyes. This may happen in some people, especially more when they are tired, or have spent long hours watching TV or computers. Computer Users tend to blink much less frequently (about 7 times per minute vs. a normal rate of around 22 times/minute).
  
  This leads to increased evaporation along with the fatigue and eye strain associated with staring at a computer monitor. Ideally, computer users should take short breaks about every 20 minutes to reduce this factor. Also, adjusting the monitor so that it is below eye level will allow the upper lid to be positioned lower and cover more of the eye’s surface, again to reduce evaporation..

What else can cause Dry Eye?
- Blepharitis can often cause Dry Eye symptoms due to inflammation of the eye lid margins, which is caused by a bacterial infection (Staphylococci). This condition can compromise the quality of the tear film causing tears to evaporate more quickly. The bacteria produce waste material that can cause a mild toxic reaction leading to chronic red, irritated eyes. Click Blepharitis for treatment.
  
  LASIK surgery temporarily disrupts the ocular surface/lacrimal gland unit. This condition usually eventually clears up.
  
  Diseases that may be associated with Dry Eyes include Rheumatoid Arthritis, Diabetes (especially when the blood sugar is up), Asthma, Thyroid disease (lower lid does not move when blinking), Lupus, and possibly Glaucoma.
  
  Age - Tear volume decreases as much as 60% by age 65 from that at age 18. Dry Eye Syndrome affects 75% of people over age 65.
  
  Hormonal changes for women can cause decreased tear production brought on by pregnancy, lactation, menstruation, and post menopause.
  
  Dust, Pollen, and Tobacco - When tear production decreases, dust and pollen stay in the eye longer and are more likely to stimulate an allergic response. In addition, anything that makes an eye more irritated, including Dry Eye, will make an eye more sensitive to environmental irritants such as tobacco smoke.
  
  Other - Too much coffee drinking, smoking, wearing contact lenses, air-conditioning or heat.

What are the warning signs and how is it detected?
- People with Dry Eye have sandy-gritty irritation or burning in their eyes. Initially people may have symptoms only after particularly long days, or when driving, or with contact lens wear, or when exposed to extremely dry environments such as that seen in airplane cabins.
  
  Eventually symptoms become more consistent, and if someone has sandy-gritty irritation or burning that gets worse as the day goes on, and if they have had these symptoms for more than a few days, Dry Eye should be ruled out by an eye doctor.
  
  We will review your history and examine your eyes to make sure you do not have any other problems, and determine the cause for your Dry Eyes.

Can Dry Eye syndrome come and go?
- Dry Eye syndrome does not truly come and go, but in the early stages of the condition, or with mild Dry Eye, you may only have symptoms after long days, or with environmental conditions that decrease your blink rate (i.e. computer use) or under conditions that increase evaporation from your tear film (i.e. wind, dry air, etc.).
  
  Some patients may notice discomfort only when they wear their contact lenses. Some people may develop symptoms only when they are dehydrated--just like your mouth becomes dry, your eyes can become dry in this way.

What if I don't treat Dry Eye. Can I lose sight?
- If untreated, Dry Eye can progress to a more irritable, troublesome condition called chronic conjunctivitis. It can cause considerable trouble, and Dry Eye can lead to loss of sight due to corneal scarring, so delaying treatment is not recommended.

Is there treatment for corneal scarring caused by Dry Eye
- When patients experience corneal scarring from Dry Eye, sight may be restored by corneal transplants. However, the original cause of the scarring should be addressed to prevent a recurrence of vision loss.

What can I do to prevent or control Dry Eye syndrome?
- Have annual eye exams.
  See us immediately if you notice Dry Eye symptoms or any decline in your vision..