Several Treatment Options for Dry Eye Can Be Diagnosed With Simple Examination

LEXINGTON, Ky. (April 16, 2013) - The following column appeared in the Lexington Herald-Leader on Sunday, April 14.

By Dr. Seema Capoor

<?xml:namespace prefix = owc /> Our eyes can become dry and uncomfortable for many reasons, including irritants in the environment, age, gender, certain medications or medical conditions. Often the condition leaves the eyes feeling gritty, burning, itchy, and sometimes feeling like there is a foreign object present.

The condition, often referred to as dry eye syndrome or DES, causes the eye to produce an insufficient amount of tears to keep the eyes well-hydrated. Dry eye is a common and often chronic problem but is easily treated.

DES can be classified as mild, moderate or severe. In the majority of patients, the condition does not threaten the patient’s sight and is characterized by troublesome symptoms of irritation, redness and intermittently blurred vision.

Treatment and suggestions for mild symptoms include:

• Eliminating potentially exacerbating factors such as antihistamine or diuretic use, cigarette smoking and exposure to second-hand smoke.
• Lowering the computer screen to below eye level to decrease lid aperture scheduling regular breaks and increasing blink frequency may decrease the discomfort associated with computer and reading activities.
• Artificial tears, emulsions, gels, and ointments can be used. When tear substitutes are used more than four times a day preservative-free tears are generally recommended.

Treatment and suggestions for moderate symptoms include:

• Anti-inflammatory therapies such as Restasis and topical steroids may be considered.
• Use of omega-3 fatty acid supplements
• Closure of the eyelid puncta with plugs
• Spectacle side shields and moisture chambers are non-invasive therapies that can be used.

Treatment and suggestions for severe symptoms:

• Oral medications such as immunosuppressives.
• Autologous serum drops (made from the patient’s own blood).
• A limited closure of the eyelids (tarsorrhaphy) to decrease tear evaporation.

Patients with severe DES are at greater risk for contact lens intolerance and should be cautioned that refractive surgery, particularly LASIK, may worsen their dry eye condition.

Dry eye can be diagnosed with a simple examination of the eyelids and cornea. Your ophthalmologist can prescribe treatment to keep your eyes moist and more comfortable.

The primary approaches used to manage and treat dry eyes include adding tears, conserving tears, increasing tear production, and treating the inflammation of the eyelids or eye surface that contributes to the dry eyes.

Dr. Seema Capoor is associate professor of cornea and external diseases in the Department of Ophthalmology and Visual Sciences at the University of Kentucky College of Medicine.