Thursday, 18 January 2018

Alarming Causes Of Dry Eye Syndrome And Treatments

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Dry eye syndrome (DES) also called dry eye, dry eye disease, or keratoconjunctivitis sicca (KCS) is a common condition of the tear film that affects a significant percentage of the population, especially those older than 40 years of age. Dry eye syndrome can affect any race and is more common in women than in men. Another term used for dry eye is ocular surface disease. See your doctor right away if you have dry eyes and a sudden increase in discomfort or a sudden decrease in your ability to see.

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Reading extensively, working on the computer, or spending long hours in a dry environment may further aggravate your eyes if you have this condition. If you have dry eye syndrome, your eyes may also be prone to bacterial infections or the surface of your eyes may become inflamed, causing scarring on your cornea. Although it’s uncomfortable, dry eye syndrome almost never causes permanent vision loss.

Causes Of Dry Eye Syndrome

An adequate and consistent layer of tears on the surface of the eye is essential to keep your eyes healthy, comfortable and seeing well. Tears bathe the eye's surface to keep it moist and wash away dust, debris and microorganisms that could damage the cornea and lead to an eye infection.
Factors that can contribute to dry eye includes :

  • Medications including antihistamines, decongestants, antidepressants, birth control pills, hormone replacement therapy to relieve symptoms of menopause, and medications for anxiety, Parkinson’s disease, and high blood pressure have been associated with dry eye.
  •  Autoimmune disorders such as Sjögren’s syndrome, lupus, scleroderma, and rheumatoid arthritis and other disorders such as diabetes, thyroid disorders, and Vitamin A deficiency are associated with dry eye. 
  • Advancing age is a risk factor for declines in tear production. Dry eye is more common in people age 50 years or older.
  •  Windy, smoky, or dry environments increase tear evaporation. 
  • Women are more likely to develop dry eye. Hormonal changes during pregnancy and after menopause have been linked with dry eye. Women also have an increased risk for autoimmune disorders.

Diseases associated with dry eyes include vitamin A deficiency, autoimmune/connective tissue disease, hepatitis C infection, HIV infection, Sjögren's syndrome, sarcoidosis, diabetes mellitus , and androgen  or estrogen deficiency.



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Wearing contact lenses increases the risk of dry eye syndrome. Refractive surgery, especially LASIK , frequently causes dry eyes.

Diagnosis
Schirmer’s test may also be used to measure how quickly your eyes produce tears. This tests your rate of tear production using a paper wick placed on the edge of your eyelid. Different dyes may be used during a patient's eye examination. These are placed into the tears in the form of a drop. Fluorescein is a yellow dye that stains the cornea where epithelial (surface) cells have been worn away because of the lack of an adequate protective tear film. Rose Bengal is a red dye that stains the cornea and the conjunctiva where the cells are dead or dying as well as where healthy cells are inadequately protected by the tear film. Lissamine Green is a green dye which can help differentiate between normal and abnormal surface cells of the cornea and conjunctiva.

Treatments For Dry Eye Syndrome

  • Testosterone cream : It doesn’t happen often, but dry eye can be related to a lack of testosterone in the oil glands on your eyelids. The doctor might give you a testosterone cream that you apply to your eyelids. It can help your oil glands work better.
  •  Over-the-counter (OTC) topical medications : Mild dry eye symptoms may be treated with over-the-counter medications such as artificial tears, gels, and ointments.
  • Lacrimal Plugs : Your eye doctor might use plugs to block the drainage holes in the corners of your eyes. This is a relatively painless, reversible procedure that slows tear loss. If your condition is severe, the plugs may be recommended as a permanent solution. 
  • Surgery : Punctal plugs made of silicone or collagen may be inserted by an eye care professional to partially or completely plug the tear ducts at the inner corners of the eye to keep tears from draining from the eye. In severe cases, surgical closure of the drainage ducts by thermal punctal cautery may be recommended to close the tear ducts permanently.
  • Good nutrition : You need a well-balanced diet with enough protein and vitamins to keep your eyes healthy. Omega-3 essential fatty acid supplements are sometimes recommended to enhance the oil content of the eye. Usually, people need to take these supplements regularly for at least three months to see an improvement. 
  • Environmental and lifestyle changes. Cutting back on screen time and taking periodic eye breaks may help. Closing the eyes for a few minutes, or blinking repeatedly for a few seconds, may replenish basal tears and spread them more evenly across the eye. Sunglasses that wrap around the face and have side shields that block wind and dry air can reduce symptoms in windy or dry conditions. In cases of Meibomian gland dysfunction, warm lid compresses and scrubs may be helpful. Smoking cessation and limiting exposure to secondhand smoke also may help.
  •  Antibiotics : Antibiotic ophthalmic ointments, such as erythromycin and bacitracin, among others, are used at night for about 7-10 days to decrease the number of bacteria that break down the lipid layer of the tear film. These ointments also lubricate the eyes overnight. Oral antibiotics, particularly tetracycline and doxycycline , not only help to decrease the number of bacteria, but also help to make the oil more fluid so it flows out of the oil glands more easily.

If the eyes are dry mainly while reading or watching TV, taking frequent breaks to allow the eyes to rest and become moist and comfortable again is helpful. Closing the eyes for 10 seconds every five to 10 minutes will increase comfort, as will blinking more frequently.



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Author: Richard Smith