Dry eye is a common condition in which the eyes are insufficiently lubricated, leading to itching, redness and pain. The dry eyes can become irritated because the lacrimal glands are not producing a sufficient number of tears, or because there is a chemical imbalance in the tears themselves. Natural tears require a particular chemical balance to lubricate the eyes efficiently. Dr. Aizuss and his team in Encino and West Hills specialize in the diagnosis and treatment of dry eyes for patients all accross Southern California.
Alleviating the symptoms of dry eyes is important. Left untreated, dry eyes have the potential to damage your vision. Dry eyes can be diagnosed after a thorough examination of the eyes, and tear film osmolality testing to evaluate tear concentration.
What causes dry eye?
During California’s typical June gloom or during a wet winter, it may seem odd that people could develop dry eye, but the causes of true dry eye are due to internal issues, usually involving tear production. Dry eye can develop when the tear ducts are not producing a sufficient amount of tears. Or the condition can be due to a chemical imbalance in the tears themselves. Your natural tears require a particular chemical balance to lubricate the eyes efficiently. Sometimes, your eyes are actually overproducing tears due to the irritation in your eyes, but the tears aren’t the right consistency to help.
Aging makes us all more likely to develop dry eye — it’s more common in people over the age of 50. It can be a side effect of taking certain medications, a sign of another medical condition, or the result from an injury.
Women tend to get dry eye more than men due to the hormonal changes that take place during pregnancy and menopause. Oral contraceptives can also lead to inconsistent tear film components.
These are other causes of dry eye:
- Antihistamines, decongestants, and blood pressure medications
- Environmental conditions such as smoke, wind, and excessive sun
- Eye injury
- Long-term contact lens use
- Eye or eyelid surgery
- Conjunctivitis or keratitis
- Rheumatoid arthritis, diabetes, Sjogren’s syndrome, thyroid disease or other vasculitis or connective tissue inflammatory conditions
What are the symptoms of dry eye?
It may seem that the symptoms of dry eye would be pretty self explanatory, but there’s much more to this condition when the causes are related to tear production. Dry eye can cause blurry vision. In fact, the tear film is the most important focusing layer of the eye. A healthy tear film doesn’t simply keep the front of the eye moist, it is also important for clear vision. Your tears must have the correct balance of water, oils, and mucus to allow the tear film to spread evenly across the surface of the cornea. If the tears evaporate too easily or become too oily and mucus filled, these can make your vision blurry. Blinking fully and frequently can decrease this, as it spreads the tear film across the cornea.
These are the signs and symptoms of dry eye, which usually affects both eyes:
- Stinging, burning, or scratchy sensation in your eyes
- Stringy mucus in or around your eyes
- Sensitivity to light
- Eye redness
- A sensation of having something in your eyes
- Difficulty wearing contact lenses
- Difficulty with nighttime driving
- Watery eyes
- Blurred vision or eye fatigue
How is dry eye treated?
Persistent dry eye isn’t something that shows up for a few days and passes. This is a chronic condition and Dr. Aizuss looks beyond temporary measures. Treatment could be as simple as changing from one medication to another to remove the side effect of dry eye. Others treatments are more involved.
Here are the options Dr. Aizuss may employ:
- Switching medications — Since certain medications, such as anti-depression drugs, have a side effect of causing dry eye, simply changing to another available drug can end your dry eye.
- Eyelid problems — For entropion or ectropion, where the eyelids are turned the wrong way, you’ll need to have surgery to correct the eye controlling muscles.
- Treating the disease — If you have rheumatoid arthritis or thyroid disease, treating those conditions can alleviate your dry eye.
- Medications for dry eye — Dr. Aizuss may prescribe various medications to treat your dry eyes:
- Eyedrops to control cornea inflammation — If you have inflammation on your cornea, this can be controlled with prescription eyedrops that contain immune-suppressing medication, called Restasis and Xiidra. Corticosteroids can also be used, but not long term.
- Drugs to reduce eyelid inflammation — If you have inflammation along the edge of your eyelids this can limit the amount of oil secreted into the tears, making them too watery and easily evaporated. Antibiotics will reduce the inflammation.
- Eye inserts — If artificial tears don’t work, we may prescribe tiny inserts, hydroxypropyl cellulose (brand name Lacrisert), to be inserted between your lower eyelid and your eyeball. These slowly dissolve, releasing lubricating substances.
- Tear-stimulating drugs — Certain drugs called cholinergics increase tear production.
- Punctal plugs — If your tears are exiting your eyes too quickly, we may opt to partially or completely close your tear ducts. To do this, tiny silicone plugs, known as punctual plugs, are inserted into the ducts. These are removable, if your condition changes. We also like absorbable punctal plugs that last up to six months.
- Unblocking oil glands — Warm compresses can be effective for clearing blocked oil glands in your eyelids.
- Special contact lenses — A newer option for chronic dry eye is contact lenses that protect the eye surface and trap moisture. These are called scleral lenses.
When does dry eye merit a call to Dr. Aizuss for treatment?
Chronic dry eye and occasional dry eye aren’t really the same thing. A dusty, windy day could cause some dry eye symptoms, but they will pass. If you need, you can alleviate the symptoms with artificial tear eyedrops. Chronic dry eye can lead to eye damage if left untreated. Chronic dry eye won’t respond to temporary changes such artificial tears or avoiding a source of blowing warm air. Chronic dry eye is more likely due to a lack of tear production or substandard tear quality, and it will likely need treatment from a professional such as Dr. Aizuss.
Preventing Dry Eye
There are steps that can be taken to prevent dry eye symptoms. Simple lifestyle modifications such as wearing protective glasses on windy days, and giving the eyes a break during reading or other tasks that require intense focus, can effectively reduce the frequency and severity of symptoms.
Dr. David Aizuss from Ophthalmology Associates of the Valley proudly serves patients in Encino, West Hills, Calabasas, Agoura Hills, Tarzana, Woodland Hills, Sherman Oaks, and Reseda, CA with treatments for dry eyes. If you are experiencing dry eye symptoms, call (818) 907-1038 to schedule an appointment today!