Dry Eye Therapy
What is Dry Eyes?
The eye depends on the presence of a tear film to provide constant moisture and lubrication to maintain vision and comfort. Tears are a combination of:
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Water, for moisture
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Oils, for lubrication and to prevent evaporation of tear liquid
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Mucus, for even spreading of tears on the surface of the eye
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Antibodies and special proteins, for resistance to infection
These components are secreted by special glands located around the eye.
When there is an imbalance or deficiency in this tear system, or when the tears evaporate too quickly, a person may experience dry eye.
When tears do not lubricate the eye enough, you may experience:
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Pain
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Burning
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A gritty sensation, like a feeling of a foreign body or sand
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Itching
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Redness and blurring of vision
Sometimes, a person with dry eyes will have excess tears running down the cheeks. This happens when the eye isn't getting enough lubrication. The eye sends a distress signal through the nervous system and, in response, the eye is flooded with emergency tears.
However, these tears are mostly water and do not have the lubricating qualities or the rich makeup of normal tears. They will wash dirt away from the eye, but they will not coat the eye surface properly. In addition, because these emergency tears tend to arrive too late, the eye needs to regenerate and restore itself, and treatment is necessary.
Solution to Dry Eyes
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Topical cyclosporine A eye drops (Restasis®): These are given twice a day in each eye to treat the underlying inflammation in the tear glands so they produce more and better quality tears. It typically takes 1 to 4 months before the cyclosporine A drops reduce symptoms and signs of dry eye.
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Lifitegrast (Xiidra®): These drops are also done twice a day in each eye, to treat the underlying inflammation in the tear glands. The Food and Drug Administration (FDA) has approved Xiidra to treat both the signs and symptoms of dry eye diseases with an onset of action in as little as 2 weeks.
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Artificial teardrops and ointments: The use of artificial teardrops is a palliative treatment that helps symptoms for a few minutes but does not treat the underlying cause of the dry eye disease. Artificial tears are available over the counter. No one drop works for everyone, so you might have to experiment to find the drop that works for you.
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Temporary punctal occlusion: Sometimes it is necessary to close the ducts that drain tears off the eye. This is done via a painless procedure where a plug is inserted into the tear drain of the lower eyelid. The plug will dissolve.
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Surgery: If needed, the ducts that drain tears into the nose can be permanently closed to allow more tears to remain around the eye.
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In some cases, dry eye is caused by another disease or condition, like rheumatoid arthritis or systemic lupus erythematosus. If this is the case, the systemic disease should also be treated in order to relieve the dry eyes.