A New Standard for the Treatment of Dry Eye

Cynthia Matossian

Founder of Matossian Eye Associates, Cynthia Matossian MD, has long been an industry leader in the field of ophthalmology, performing research studies to advance the treatment of eye related diseases including dry eye, cataracts and glaucoma.  Recently, Dr. Matossian has transitioned her focus exclusively to the treatment of Ocular Surface Disease, Dry Eye and related clinical trials. The causes and symptoms of dry eye disease are vast.  Due to this, there are many treatment options.  Through her clinical studies, Dr. Matossian has played an important part in bringing new and advanced treatments to benefit patients.  Matossian Eye Associates is pleased to offer the most comprehensive and state of the art technologies in dry eye treatments.  If you or a loved one is suffering from this frustrating and painful eye disease, we recommend you read through this section to learn more about dry eye disease and the available treatment options available.  The next step is to schedule an appointment to determine what treatment options are recommended for your specific needs.

About Dry Eye Disease

Dry eye is a chronic condition in which there is an insufficient quantity or unhealthy quality of tears to lubricate and nourish the eye. Dry eye often goes undiagnosed and untreated, despite being a very common and treatable disease. As the population ages, its prevalence is also increasing. Currently between 20 and 25 million Americans suffer from dry eyes. Women are more prone to suffer from dry eye disease. This includes 3.2 million women over the age of 50 and 15% of all Americans over age 65.

With each blink of the eyelids, tears are spread across the front surface of the eye. Tears provide lubrication, reduce the risk of eye infection, wash away foreign matter on the eye, and keep the surface of the eyes smooth and clear. Tears are necessary to maintain the health of the ocular surface and to provide clear vision. People with dry eyes either do not produce enough tears or have a poor quality of tears. Treatments are directed at improving the tear film balance to maintain good quality vision and minimize symptoms.

What is the Tear Film?

When you blink, a film of tears spreads over the eye, making the surface of the eye smooth and clear. Without this tear film, good vision is not possible. The tear film consists of three layers, each with its own purpose:

  • An Oily Layer
  • A Watery Layer
  • A Mucus Layer

The oily layer, produced by the Meibomian glands in the eyelids, forms the outermost surface of the tear film. Its main purpose is to smooth the tear surface and reduce evaporation of tears.

The middle watery layer makes up most of what we ordinarily think of as tears. This layer, produced by the lacrimal glands in the eyelids, cleanses the eye and washes away foreign particles or irritants.

The inner layer consists of mucus produced by the conjunctiva. Mucus allows the watery layer to spread evenly over the surface of the eye and helps the eye remain moist. Without mucus, tears would not stick to the eye.

What are the Symptoms of Dry Eyes?

  • Stinging or burning eyes
  • Grittiness or scratchiness
  • Stringy mucus in or around the eyes
  • Discomfort when wearing contact lenses
  • Blurred or Fluctuating Vision
  • Pain
  • Light Sensitivity
  • Tired Eyes
  • A feeling of a foreign body or sand in the eye
  • Excess tearing
  • Redness of the eye
  • Heavy eyelids
  • Increased eye irritation from smoke or wind
  • Decreased tolerance of reading, working on the computer, or any activity that requires sustained visual attention

Visual tasks can cause excessive evaporation of tears from reduced blinking. These tasks include prolonged periods of reading or computer use.

Excess tearing from “dry eye” may sound illogical, but it can be understood as the eye’s response to discomfort. If the tears responsible for maintaining lubrication do not keep the eye wet enough, the eye becomes irritated. Eye irritation prompts the gland that makes tears (called the lacrimal gland) to release a large volume of tears, overwhelming the tear drainage system. These excess tears then overflow from your eye.

What Causes Dry Eye?

Patients typically fall in two categories: those who have excessive tear evaporation and those who do not produce enough tears. Dry eye can be a temporary or a chronic condition that can have multiple causes. They include:

  • Agedry eye is a part of the natural aging process. The majority of people over age 40 experience some symptoms of dry eyes due to reduced tear production.
  • Gender – women are more likely to develop dry eyes due to hormonal changes caused by menopause, the use of oral contraceptives, and pregnancy.
  • Medications – certain medicines, including antihistamines, decongestants, pain relievers, blood pressure medications and antidepressants, can reduce the amount of tears produced in the eyes and produce dry eye symptoms.
  • Blepharitis or Meibomian Gland Dysfunction – these are chronic inflammatory diseases of the eyelids which can interrupt the production of tears and lead to evaporative dry eye.
  • Environmental Conditions – exposure to cigarette smoke, wind, fans, forced hot air heat, and dry climates can increase tear evaporation resulting in dry eye symptoms.
  • Certain Visual Tasks – extended periods of reading or prolonged computer use can lead to excessive tear evaporation from reduced blinking.
  • Medical Conditions – persons with Sjogren’s syndrome, rheumatoid arthritis, lupus, ocular rosacea, diabetes and thyroid problems are more likely to have symptoms of dry eyes.
  • Low Omega 3 Fatty Acid Intake – Can lead to a decreased top lipid layer with faster tear evaporation and secondary dry eye issues.
  • Other Factors – long term use of contact lenses, or a history of refractive eye surgery, such as LASIK, can cause decreased tear production and dry eyes.

Things You Can Do at Home to Help Ease Dry Eye:

  • Avoid air blowing in your eyes. Don’t direct hair dryers, car heaters, air conditioners or fans toward your eyes.
  • Wear glasses on windy days and goggles while swimming. The wraparound style of glasses may help reduce the effects of the wind.
  • Add moisture to the air. In winter, a humidifier can add moisture to dry indoor air. Some people use specially designed glasses that form a moisture chamber around the eye, creating additional humidity. These glasses can be worn at night, and may be especially helpful for people who sleep with their eyes partially open. They can also be worn during the day to relieve dry eye symptoms.
  • Avoid rubbing your eyes. You can irritate your eyes further by rubbing them.
  • Take preventive steps. Use eye drops before, rather than after the symptoms begin; your eyes become irritated as a result of visually demanding activities. Try to avoid activities that might worsen the problem.
  • Remember to blink. Consciously blinking repeatedly helps spread your own tears more evenly. When performing tasks that require intense visual concentration, take occasional breaks and rest your eyes by closing your lids for several seconds.
  • Avoid smoke. Smoke, whether yours or someone else’s, can contribute to dry eyes.
  • Avoid anti-histamine or other allergy medications: Often these medications are designed to ‘dry up’ your nose; they tend to dry your eyes at the same time.
  • Stay hydrated by drinking plenty of water regardless of the season: If your body becomes dehydrated, so do your eyes.