I’m going to take a break from discussing cataract surgery today and focus on something even more common: dry eye syndrome. One of the most common eye diseases I see is dry eye syndrome. The most common symptom of dry eyes: tearing. The most common response I get when I tell someone with tearing that they have dry eye syndrome: “My eyes can’t be dry. They water all the time.”
Yes, it appears to be contradictory but it’s a fact. The reason dry eyes lead to tearing is as follows: dry eyes (like dry skin) are more sensitive to irritation; irritation is interpreted by the brain as “there is something in the eye;” the brain’s response to this is to flush it out resulting in a flood of tears being release by the lacrimal gland. It’s an issue of too much, too late.
It is common for the eyes to dry out with any activity that involves extended concentration such as computer use. In addition to tearing, symptoms of dry eyes include: an “awareness ” of the eyes, soreness, redness, discharge, “sticky” eyes, itching, foreign body sensation, blurred vision, “tired” eyes.
Treatment Options Include The Following:
1) Tear Replacement Therapy (artificial tears).There are so many brands out there it is difficult to recommend just one.Some of the better brands include:
- Blink
- Endura
- Optive
- Refresh
- Soothe (my personal favorite)
- Systane
- Theratears
Each one is formulated differently so which one works best is hard to determine without first trying it.
2) Nutritional Supplements. There is some evidence that taking Omega-3 fatty acids (such as fish oil or flax seed oil) by mouth can benefit the symptoms of dry eye.These come in gelcaps and are generally recommended once or twice a day with food.
3) Prescription medication. Currently only one medication, Restasis, is approved by the FDA for treatment of dry eye.This must be used twice a day for at least a month.It stings, is expensive, and only works in 50% of people who take it.
4) Punctal plugs. When someone’s eyes are not producing enough tears to keep the eyes lubricated it does not help that tears drain through “puncta” into the nose (this is why you get the sniffles when you cry).The solution: plug these drainage duct with small silicon plugs.This can be done by an eye doctor in the office.It is a painless procedure that only takes a few minutes.
© 2009 David Richardson, MD
How Your Eye Doctor Can Tell If You Have Dry Eyes
How do you diagnose dry eyes ?
What exactly do you mean by foreign body sensation ?
Thanks.
I had lasik 2 years ago and now live in a living hell with dry eye. shirmers conclude that I have near zero tear production in my eyes.my ducts are plugged upper and lower,restasis only irritates more. All eye drops seem to make dry eye worse except celluvisc at nightime.
isthere anything new to help?
Recent studies (and my own personal experience) supports taking Omega-3 fatty acid supplements by mouth to improve the symptoms associated with “dry eyes.” I generally recommend taking between 1,000-4,000mg per day of a combination of fish oil and flax seed oil. For those who cannot tolerate those oils there are also chia seeds and black current oil available in specialty stores.
It is important to check with ones personal physician before taking higher doses (above 2,000mg) of omega-3 as there can be a “blood thinning” effect.
Dear Dr. David:
Based on your personal experence using Omega- oil for dry eye, how long did it take before you began seeing noticable improvement in your dry eye?
And at what dose per day?
Thank you!
I generally recommend a combination of fish and flax seed oil in the range of 1,000-4,000mg combined total per day (usually divided among meals). It can take up to two months to see a positive effect.
Enjoyed reading this, very good stuff, thanks .