Dry eye or Ocular Surface Disease (OSD) is a condition that affects the outermost layer of the eye called the tear film. Left untreated OSD can affect the cornea and eyelids.  The cornea or surface of the eye, can become weakened as the tears that protect the eyes do not work adequately. Over time the cornea can become scarred and weakened and develop infections. Infection can also affect the eyelids and become more common because eye fluids that protect the eye and help carry away debris are no longer present. Vision can be affected, and patients often develop chronic red eye and  pain.

What is dry eye? or Ocular Surface Disease?

Dry Eye Syndrome is a condition associated with one or any of three things, insufficient quantity and/or inadequate quality of tear film coating the front surface of the eye, problems with the normal drainage of the tears and it's components, and or problems with the structures that maintain the ocular surface.

It is usually accompanied by symptoms like dryness, grittiness, irritation, intermittent blurry vision, stinging, burning and a sensation that something is in your eye when nothing is there. Dry eye symptoms can also include light sensitivity. Dry eye symptoms may worsen with activities that are associated with reduced blink frequency, such as complex technical or mechanical tasks, work at a computer, or driving. Certain physical environments or weather conditions can also worsen dry eye, including arid, windy settings, air-computer users & dry eye syndrome, air conditioning, forced heating and airplanes.

What causes dry eyes?

Dry eyes develop mainly for many reasons:

1. Insufficient oil production by the meibomian glands (found in the inner eyelids)

2. Disruption in the normal concentration of proteins in the tears.

3. Lack of production of tears

4. Surgical changes in the surface of the eye (surgeries like Lasik, PRK, etc.)

Most people with dry eyes are affected by both low oil and high evaporation. Symptoms of dry eye are also common with certain auto-immune disorders, like diabetes, arthritis, lupus, and Sjögren’s syndrome.

Dry eyes are more pronounced in persons with certain disease, as a medication side effect or in persons who have reduced blink frequency. Also detailed technical work or those who work at a computer can cause ocular surface disorder. Dry eye is sometimes worsened by contact lens wear or surgery such as LASIK or lid surgery.

If you think you may have dry eye, call us and schedule an evaluation of your eyes. You will also be asked a number of questions about your lifestyle and habits. Lifestyle factors that contribute to dry eyes include:

* Looking at computers or reading without blinking often enough to redistribute eye fluids
* Living and working in dry places
* Wearing contact lenses that absorb and disrupt eye fluids
* Having LASIK surgery, which cuts eye nerves, reducing impulses for blinking
* Taking medications like allergy pills, diuretics, beta-blockers, birth control pills among other drugs.
* Diets that don’t provide sufficient essential fatty acids or anti-inflammatory foods
* Droopy eyelids or certain health conditions, particularly autoimmune disorders like diabetes, arthritis, lupus, and Sjögren’s syndrome, which also causes dryness in the mouth.

Dry Eye Symptoms

Symptoms of dry eyes can include redness, dryness, burning, grittiness, excessive tearing, blurry vision, and sensitivity to light. Patients with dry eyes rate their discomfort at a level similar to the way heart patients rate chest pain.

Dry Eye Syndrome and Blepharitis are often un-diagnosed, usually because both patients and eye care professionals do not consider the symptoms to be a significant threat to vision. The symptoms, however, are a burden to the patient, and worsen with age.

If you or one of your loved ones suffer from dry eyes, our eye specialist may be able to help with a noninvasive treatment. Contact us today. Count on our doctor to discuss possible treatments, repercussions (if any) and ways to keep your eyes health.

Evaluate your symptoms with this

What can you do?

Learn

"Dry eye" is a misnomer. In your case, it may or many not have anything to do with dryness (lack of moisture). "Dry eye" is really a descriptive or catchall name for a complex collection of diseases that affect the ocular surface.

Define your SYMPTOMS.

If you want to communicate effectively with doctors, you must take some time to sort out your symptoms, and start identifying patterns such as what time of day and in which environment(s) you get certain symptoms. This is important for getting an accurate diagnosis and also for sorting out dry eye from other eye complaints.

Second, we strongly recommend that you use a scientifically validated method of measuring the severity of your symptoms. This is very helpful in communicating with your doctor and also with tracking your progress with specific treatments. 

The most readily available tool is the Ocular Surface Disease Index Download OSDI here. Download it, print it, and fill it out right now! It's quick and easy.

Understand your DIAGNOSIS.

This is critical. We get calls all the time from people saying "I have dry eyes." But that means nothing. If that's all your doctor has told you, it's absolutely inadequate. You need to start asking a lot more questions.

Understand your TREATMENT options.

I wish I had a nickel for everyone who's called me and said, "Dr Gonzalez, I've tried EVERYTHING!" Nine times out of ten, the "everything" they are talking about means multiple brands of artificial tears, medications like Restasis and maybe some steroids; and punctal plugs. Believe me, if that's where you're at, you've only scratched the surface - AND this is a vital sign that you may not have begun to get a thorough and accurate diagnosis yet!

There are many symptoms, including unremitting pain; unsightly red eyes; lack of validation from physicians even lack of understanding from loved ones and occupational impact, to name just a few!

TRACK treatments, products and progress methodically.

Use a journal to track your progress - noting down things such as:
* Dates when you started or stopped a treatment
* What you observed about your symptoms during different treatments or while using certain products
* Changes you've observed at different times of the day, month or year
* OSDI scores from time to time, month to month.
* Results of clinical tests from your doctor appointments

REPORT dry eye to the FDA!

If you think your dry eye may have started or worsened because of a medication, surgery, or anything regulated by the FDA, PLEASE take ten minutes to file a MedWatch report on the FDA website. This is vital so that other people can eventually learn that dry eye may be a risk of the drug or treatment you had! As just one example, we know that tens of thousands of people have moderate to severe dry eye from LASIK eye surgery, yet in April 2008 it was widely reported that the FDA only had 140 complaints filed between 1998 and 2006. Why? Because no one knows they should report the problem to the FDA, who regulate the lasers used in LASIK.

http://www.fda.gov/Safety/MedWatch/default.htm


Here are examples of when you should report your dry eyes to the FDA:

* If your dry eyes started after LASIK, PRK, LASEK, Epi-LASIK or other elective vision surgery, or cataract surgery. (If this is you, find out what laser was used in your surgery. You don't need the exact model. You can usually get this information from your surgeon's website, or you can call them to find out.)
* If your dry eye, or eyelid dysfunction resulting in dry eye, was caused by BOTOX injections.
* If your dry eye started or got worse after being on prescription or over-the-counter eyedrops of any kind.
* If your dry eyes started or got significantly worse after taking a systemic drug such as:

o Antihistamines
o Diuretics
o Acne medications
o Hormone replacement therapy
o Beta blockers
o Pain medications
o Decongestant



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