Dry eyes are a serious and growing concern for millions of individuals. The eye will be bathed in a continuous flow of the tear film that consists of several parts. A healthy tear film contains at fats, aqueous, and mucus. The outer lipid layer prevents evaporation, keeping the inner layers intact. The aqueous component is a mixture of proteins, mucus and salts. The mucus provides viscosity; stabilizing the tear film. The mucus is the highest concentration of the deeper into the tear film one goes.
In dry eye, it tends to be a lower concentration of proteins in many cases. As the water-soluble component of mucus also tends to be much lower in strength as well. These shortcomings tend to promote inflammation, and reduce the stability of the eye. Serum electrolytes tend to increase in volume as well, which will enhance the dry eye problem. Since dry eye symptoms can be varied, the condition is often under diagnosed.
According Archive of Ophthalmology 14.4% of Americans report dry eye symptoms, and it increases with age. 8.4% of people under the age of 60 report dry eye discomfort, but 19% of people over those who do. It is a progressive disease. Individuals undergoing Cataract and refractive trenching report worsening symptoms of decreased corneal sensitivity. In addition, damage tear producing goblet cells cause further compromise in tear production and quality.
Analysis based on the symptoms include discomfort, dry, gritty feeling, burning, light sensitivity, and blurred vision. An important test to confirm the disorder involves assessing the tear film and corneal with Lissamine green and Rose Bengel fluorescein staining, Schirmer test, tear meniscus corneal staining. The process is simple. Irritation triggers inflammation followed by tears of misery and instability.
The therapeutic goals are to increase tear production, and quality / components of the tear film. To that end, the first step is to use artificial tears. They come in various combinations starting with a simple low viscosity drops, and includes thicker Gel drops. The thicker the better closer fall corneal surface. However, the down side they will also blur vision, they get thicker. In extreme cases gels / ointments are employed to keep an eye drop for the long term. This makes the cornea surface to renew and heal.
In worse cases of dry eye, topical steroid eye drops. This reduces inflammation in the tear producing glands as lacrimal Gland. Often they are used for up to 3 weeks in connection with artificial tears. If further treatment is necessary, Restasis is used to increase tear production. This is actually Cyclosporin which is an anti-autoimmune disease agents. It is spiritual, it must be used twice a day for at least 3-6 months, often longer.
New developments in the treatment of dry eye is better care of the eye lids. It has now been established that inflammation valve, blepharitis, reduces tear production and quality. As such, adding this important area has emerged as a focal point of treatment. New antibiotics called Azasite is now used to kill bacteria eyelids, and clear out invasive organisms that inflame the lid margin. It is used twice daily for 2 days and then once daily for a week. Many offer eye care also advise using it once a day for the first day of very month for 6 months. In doing so, it keeps a good lid hygiene. Since dry eye is a chronic disease, treatment should be designed for the long term.
In the most extreme we now have Puntal plugs in the lid sticks in an effort to keep all the tears in the lower eyelid area, increase the tear meniscus. It has significantly improved many symptoms, and helped cure ailing cornea.
In short, dry common and chronic condition that requires aggressive treatment in order to prevent long-term damage to the eye, and improve patient comfort.