Dr. Valerie Vick, M.D. Oculoplastic Surgery at Premier Medical Aestetic Center in Mobile, AL

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Dry Eye

What is dry eye?

Normally, the eye constantly bathes itself in tears. When tears are produced at a slow and steady rate, the eye stays moist and comfortable. In some cases, people do not produce enough tears or the appropriate amount required to keep eyes healthy and comfortable. This is known as dry eye.

What are the symptoms of dry eye?

Symptoms usually include:

stinging or burning eyes;
scratchiness;
excessive eye irritation from smoke or wind;
excess tearing;
discomfort when wearing contact lenses

What is the tear film?

When you blink, tear film spreads over the eye making the surface smooth and clear. This film of tears is essential for maintaining good vision.

The tear film consists of three layers:

an oily layer
a watery layer
a layer of mucus

Each layer of the tear film has its own purpose. The oily layer, produced by the meibomian gland, forms the outermost surface of the tear film. This layer is responsible for smoothing the tear surface and reducing the evaporation of tears. The middle watery layer makes up most of what we ordinarily think of as tears. This layer, which is produced by the lacrimal gland, cleanses the eye and washes away foreign particles. The inner layer consists of mucus and is produced by the conjuctiva. Mucus allows the watery layer to spread evenly over the eye surface and helps retain moisture. Without mucus, tears would not stick to the eye.

Similar Links

Common Eye Disorders

Lacrimal Duct Obstruction

Corrective Surgery Page

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Dry Eye Treatment

Dry Eye Testing

What causes dry eye?

Tear production normally decreases as we age. Although dry eye can occur in both men and women at any age, women are most often affected.

Dry eye can also be associated with other problems. A wide variety of medications-both prescription and over-the-counter-can cause dry eye. Be sure to tell your ophthalmologist the names of all the medications you are taking.

How is dry eye treated?

Adding tears

Eyedrops containing artificial tears are similar to your own natural tears. They help to lubricate the eyes and maintain moisture. They may be used once or twice a day or as often as necessary.

Conserving your tears

Tears drain out of the eye through a small channel into the nose (which is why your nose runs when you cry). Your ophthalmologist may close these channels either temporarily or permanently. This conserves your own tears and makes artificial tears last longer.

Other Methods

Tears evaporate like any other liquid. You can take steps to prevent this. In winter, a humidifier adds moisture to dry air. Wrap-around glasses help reduce the drying effects of the wind.

More information is located at The American Academy of Ophthalmology. www.aao.org

We recommend RESTASIS™

RESTASIS™ Ophthalmic Emulsion is both an artificial tear to treat your symptoms in the short term combined with medicine to treat your dry eye disease in the long term. RESTASIS™ Ophthalmic Emulsion actually helps you restore your own natural tears- something that an artificial tear cannot do by itself!

RESTASIS™ Ophthalmic Emulsion costs more than artificial tears because of its unique formulation. If you have a prescription drug card, RESTASIS™ may be covered by your insurance plan for a modest co-pay.

Many patients experience relief from their symptoms of itching, grittiness, blurred vision, and light sensitivity within their first month of therapy. For patients who have struggled with dry eye disease for many years, RESTASIS™ may take two to three months- with a maximum of six months- to achieve full relief.

Remember, dry eye is a chronic disease that requires your long-term commitment- and that means taking your RESTASIS™ everyday.

For more information, please visit www.restasis.com.

Dry eye testing

Testing for dry eye syndrome includes evaluation of the tear film layer and "tear lake" (an accumulation of tears along the lower eyelid margin), Schirmer testing, evaluation of the tear break-up time, and rose bengal staining.

Schirmer Testing involves placing a thin tear strip (paper) inside the lower eyelid for a given interval of time (usually 5 mnutes), with or without topical anesthesia. The tear strip is then removed and the length of the strip that is wet from tears is measured and compared to a standard. Individuals with dry eye syndrome will have less wetting of the tear strip than normal controls.

Tear Break-Up Time (TBUT) is another method of evaluation for dry eye syndrome. The ophthalmologist applies fluorescein dye to the tear film, asks the patient not to blink momentarily, and then times the interval until dry spots begin to occur on the corneal surface. This interval of time is known as the TBUT, and the interval is decreased in patients with dry eye syndrome.

Rose Bengal Staining is yet another method of evaluating patients for dry eye syndrome. Rose bengal is a dye that, when applied to the ocular surface, is taken up by devitalized (sick) epithelial cells. Positive staining of the conjunctiva with rose bengal is consistent with a diagnosis of dry eye syndrome.