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Tears and Dry Eyes

What you can do about eye dryness

The surface of our eyes is protected against infection and irritation by a layer of tears. Tears are produced by the tear glands, which are made up of special cells that can produce the watery component of tears. These gland cells can be found all over your conjunctiva and are responsible for the normal wetness of the eye. When one gets emotional or if one’s eye is irritated, a pouring of tears is produced by tear glands found under the upper eye lid.

Patients with dry eyes often complain of a dry or burning sensation in their eyes. Some patients feel their eyes are drier in the morning, while others feel it worse at the end of the day. Ladies tend to complain of dry eye more often. This is especially so after menopause.

352209_xlTreatment of Dry Eyes

Medication

The treatment of dry eyes can be divided into medical or procedural. In the vast majority of cases, most people use tear replacement in the form of artificial tear drops. Some are formulated to be more slippery to touch and can last longer on the eye. Some are in the form of gels and can be used when a prolonged duration without eye drops is expected, for example, before sleep. These drops provide relief but do not treat the cause of the dryness.

Dryness of the eye can be due to underproduction of tears or abnormal quality of tears. In both cases, an underlying factor we now recognise is inflammation. Inflammation both perpetuates and exacerbates dryness by damaging the tear producing cells or glands on the conjunctiva. Inflammation may also be present in the oil glands or on the edges of the eye lids which then produce abnormal or poor quality oils, which disrupt the wetting effect of the tears.

It is, therefore, not surprising that treatment of dry eyes now includes the use of anti-inflammatory agents, most commonly in the form of eye drops. These eye drops can contain steroids or agents that have similar effects to steroids, like cyclosporine (an anti-rejection drug used in organ transplants). When used judiciously, these drops can help restore wetness by creating a ‘friendlier’ environment for the production of tear and to regenerate tears. However, these drops should always be used under a specialist’s supervision to avoid the unwanted side effects of treatment. More recently, the use of natural supplements of omega fatty acids and linoleic acids in the correct proportion has also proven useful in this respect, as they also help the body produce better quality tears and reduce inflammation, respectively.

Good Hygiene Habits

Good hygiene of the eyelids also plays an important role in treating dry eyes, and this should not be overlooked. Choked and inflamed oil glands produce abnormal oil secretions which tend to have an effect on the tear film of the eye. Using a warm compress by wetting a folded clean towel with hot water and then applying it on the eyes with gentle pressure can help unchoke the oil glands. It can then be followed by a lid-cleansing preparation to remove the oils that have been released. This should be done as part of a hygiene routine twice a day, much like brushing your teeth.

There are devices on the market that can help the dry eye sufferer by reducing the evaporation of tears. These can come in the form of goggles with wet sponges inside that keep the chamber humid and the eye wet. Some of these devices are quite cleverly designed to look more socially acceptable.

Surgery

In more severe cases of dry eye, punctal plugs, which are plugs that fit into the tiny channels on your eye lids that drain your tears away to the back of your nose, may be used to reduce the drainage of tears so as to maximise the wetness of whatever tears are produced. If this strategy proves useful, a permanent option to seal of the channels may be considered. In the more extreme cases of dry eyes, specialised contact lenses that effectively create a reservoir of liquid over the cornea and offer great relief in some cases may be used.

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Dr Gerard Nah is the Medical Director of W Eye Clinic.
Posted by ezyhealth on May 12 2014. Filed under Eye Health. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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