Dry Eye Syndrome

Dr. Fouad Melamed is a dry eye specialist. Our dry eye examination includes diagnostic tests to examine the degree of dry eye and possible treatment modalities. Dr. Melamed specializes in all dry eye treatments including the newest Oasis ® Punctal Plugs & prescription Restasis. Exams are covered by your PPO Health Insurance or Medicare. Appointments: (323) 655-6582

Dry eye is a condition in which there are insufficient tears to lubricate and nourish the eye. Tears are necessary for maintaining the health of the front surface of the eye and for providing clear vision. People with dry eyes either do not produce enough tears or have a poor quality of tears. Dry eye is a common and often chronic problem, particularly in women and older adults, but it is treatable.

With each blink of the eyelids, tears are 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 in the back of the nose.

Dry eyes can result from an improper balance of tear production and drainage.

• Inadequate amount of tears – Tears are produced by several glands in and around the eyelids. Tear production tends to diminish with age, with various medical conditions, or as a side effect of certain medicines. Environmental conditions such as wind and dry climates can also affect tear volume by increasing tear evaporation. When the normal amount of tear production decreases or tears evaporate too quickly from the eyes, symptoms of dry eye can develop.

• Poor quality of tears – Tears are made up of three layers: oil, water, and mucus. Each component serves a function in protecting and nourishing the front surface of the eye. A smooth oil layer helps to prevent evaporation of the water layer, while the mucin layer functions in spreading the tears evenly over the surface of the eye. If the tears evaporate too quickly or do not spread evenly over the cornea due to deficiencies with any of the three tear layers, dry eye symptoms can develop.

The most common form of dry eyes is due to an inadequate amount of the water layer of tears. This condition, called keratoconjunctivitis sicca (KCS), is also referred to as dry eye syndrome.

Common symptoms of dry eyes?

• Red Eyes • Burning • Itching
• Foreign Body Sensation
• Sandy/Gritty Feeling
• Light Sensitivity
• Eye Soreness
• Watery/Tearing Eyes
• Contact Lens Discomfort

What causes dry eyes?

The development of dry eyes can have many causes. They include:

• Age – dry eye is a part of the natural aging process. The majority of people over age 65 experience some symptoms of dry eyes.

• Gender – women are more likely to develop dry eyes due to hormonal changes caused by pregnancy, the use of oral contraceptives, and menopause.

• Medications – certain medicines, including antihistamines, decongestants, blood pressure medications and antidepressants, can reduce the amount of tears produced in the eyes.

• Medical conditions – persons with rheumatoid arthritis, diabetes and thyroid problems are more likely to have symptoms of dry eyes.

• Environmental conditions – Staring at a computer screen for long periods of time, can also contribute to drying of the eyes.

• Other factors – Contact lens use and refractive eye surgeries, such as LASIK, can cause decreased tear production and dry eyes.

How are dry eyes diagnosed?

Dry eyes can be diagnosed through a comprehensive eye examination. Testing includes external examination of the eye, including lid structure and blink dynamics, measurement of the quantity and quality of tears for any abnormalities. Special dyes may be instilled in the eyes to better observe tear flow and to highlight any changes to the outer surface of the eye caused by insufficient tears.

Using the information obtained from testing, your optometrist can determine if you have dry eyes and advise you on treatment options.

How are dry eyes treated?

Dry eyes can be a chronic condition, but your optometrist can prescribe treatment to keep your eyes healthy, more comfortable, and prevent your vision from being affected. The primary approaches used to manage and treat dry eyes include adding tears, conserving tears, increasing tear production, and treating the inflammation of the eyelids.

Adding tears - lubricating drops may be enough, but other treatments should be considered in moderate to severe dry eyes.

Conserving tears – An additional approach to reducing the symptoms of dry eyes is to keep natural tears in the eyes longer. This can be done by blocking the tear ducts through which the tears normally drain. The tear ducts can be blocked with tiny silicone plugs, temporary or permanent plugs, that can be removed, if needed. The goal is to keep the available tears in the eye longer to reduce problems related to dry eyes.

Increasing tear production – Prescription eye drops, such as Restasis or other anti-inflammatory medicatons can help to increase production of tears can be recommended by your optometrist, as well as omega-3 fatty acid nutritional supplements.