St. Augustine Woman's Journal - Educational Resource to the Women of St. Johns County Since 2009

Dry Eye


November 1, 2018 | View PDF

Dry Eye is quite common, and also quite irritating. People with dry eyes may experience irritated, gritty, scratchy or burning eyes; a feeling of something in their eyes; excess watering; and blurred vision. Advanced dry eyes may damage the surface of the eye and permanently impair vision. Don't ignore your dry eye symptoms.

Dry eye is a condition in which a person doesn't have enough quality tears to lubricate and nourish the eye. Tears are necessary for maintaining the health of the eye and for providing clear vision. With each blink of the eyelids, tears spread across the front surface of the eye, known as the cornea. Tears provide lubrication, reduce the risk of eye infection, wash away foreign matter in the eye and keep the surface of the eyes smooth and clear. Excess tears in the eyes flow into small drainage ducts in the inner corners of the eyelids, which drain into the back of the nose. Tears are made up of three layers: oil, water and mucin. A smooth oil layer (top) helps prevent evaporation of the water layer (middle), while the mucin layer (bottom) spreads the tears evenly over the surface of the eye. If the tears evaporate too quickly or do not spread evenly due to deficiencies with any of the three tear layers, dry eye symptoms develop. Artificial tear drops temporarily boost the tear film but do not solve the underlying problem. Drops promising to cure "redness" can actually make your dry eye worse. Supplements such as flaxseed oil improve the oil layer while medications such as Restasis help improve the

water layer.

Tear production diminishes with age and various medical conditions including chemotherapy treatment or certain medicines, especially those for high blood pressure, can cause dry eye. In one study, over 90% of post-menopausal women had signs and symptoms of dry eye. Dry eye can reveal an underlying autoimmune disease, one commonly diagnosed in women is Sjogren's Syndrome. Environmental conditions, such as wind and even air conditioning, can also decrease tear volume due to increased tear evaporation. Contact lens wearers often suffer from dry eye.

But doctor, how can my eyes be dry if I am tearing? When the tear film evaporates, signals are sent to the lacrimal gland, which produces a large volume of tears overwhelming the tear drainage system. This commonly happens when reading print or on a computer as we blink less while concentrating causing evaporation with subsequent reflex tearing.

A complete eye exam by an ophthalmologist specializing dry eye can reveal the cause of your dry eye. Treatments aim to restore the normal team film to maintain eye health and resolved symptoms. One very effective treatment is closing off the drainage ducts with collagen plugs. The exam and treatments are usually covered by insurance so if you are being asked for expensive out-of-pocket exams, diagnostic testing, and treatments, it is time to get a second opinion on your dry eye.

Kathleen Krepley MD, MHS is the only practicing glaucoma specialist in St. Augustine with fellowship training at New York Presbyterian/Columbia University. She also completed fellowship training in Cornea/Anterior Segment at Johns Hopkins Hospital. With her dual fellowship training, she is an expert in the anterior segment diseases of the eye.


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