Many of us suffer from dry, stinging, burning, red and simply irritable eyes. They feel scratchy, teary and feels like something is inside our eye. How we decide to treat it depends on how bad we feel our symptoms are. Dry eyes is a chronic disease, and if nothing is done to treat it, it does get progressively worse causing damage to the eye surface, infection and it may even affect our vision.
Every time we blink, our eyes make a natural tear film that keeps our eyes moist, protected and clean. They also contain nutrients, electrolytes, proteins and lubricants to help fight infection and to keep our eyes healthy. If our eyes don’t make the right amount or kind of tears, our tear film will break down creating dry spots on the surface of our eyes, exposing our corneal nerves and thereby causing our eyes to become dry and irritated. This can damage the surface of our eyes making our vision blurry and cause chronic dry eyes.
What causes chronic dry eyes? The aging process as well as some health conditions can affect how our eyes make tears. These include hormonal changes related to pregnancy, menstruation, menopause and vitamin deficiencies.
Medical conditions known to cause dry eyes are thyroid problems, rheumatoid arthritis, sarcoid, diabetes, lupus, multiple sclerosis and acne rosacea. Medications such as birth control pills, beta blockers, diuretics, antihistamines, antidepressants, hormone replacement therapy, high-blood pressure medications and over the counter medications such as Claritin, Zyrtec and Allegra can all dry up our eyes.
Other risk factors include being female, pregnant or nursing, over the age of 40, a tobacco smoker, using the computer more than an hour a day, reading for more than an hour a day, having a ceiling fan in the bedroom, drinking more than 3 caffeinated drinks per day, getting less than 7 hours of sleep per night and traveling in airplanes. History of eye surgery such as lasik, PRK and cataract surgery can also cause dry eyes.
Research has shown that inflammation is a major cause of chronic dry eyes especially if one has a few of these signs and symptoms: Stinging, itching, burning, redness, eye discomfort (aching), light sensitivity and dry mouth.
The eyelids are another major cause of dry eyes especially if one has mattering on the eyelids when waking up in the morning, red or swollen eyelids, experiencing burning in the morning, significant crusting on the eyelids, vision fluctuating from clear to blurry especially in the morning. Generally, if symptoms are worse in the morning, the cause of the dry eyes is probably due to inflammation in the eyelids.
Most of us start using over-the-counter artificial tears to treat chronic dry eyes. Over time, some need them more and more and they may also find that using different kinds or brands may not be enough as artificial tears only provide temporary or short-term relief. Artificial tears alone does not treat the cause of the disease.
There are several ways to treat dry eyes and to prevent it from getting progressively worse. From simply using the right kind of artificial tears, the right dose of EPA and DHA in omega 3 fish oils, prescription medications like Restasis and Freshkote, and the temporary use of steroid drops, oral antibiotics, punctal plugs, eye-lid hygiene etc. The type of treatment plan your eye doctor will prescribe depends on the type of dry eye and its causes. It depends whether the cause is inflammation in the eyes, inflammation in the eyelids, inadequate tear production etc.
Scleral contact lenses are recommended for the severe dry eyes cases. These lenses do not touch the front surface of the eye. There is also a fluid reservoir that remains under the lens that acts as a moisture chamber at the eye surface, reducing tear evaporation and providing increased comfort for the patient with severe dry eye symptoms. Scleral contact lenses for dry eyes are now becoming the new revolution in treating the severe dry eye cases. Check out this Youtube video link on more on scleral contact lenses: http://www.youtube.com/watch?v=SGdhHAZHwmI
If you have dry eyes, it can be treated. It is easier and advisable to treat this chronic disease in its early stages. You should visit your optometrist or ophthalmologist to determine the type of dry eye you have as well as the cause, so that the correct treatment plan can be started. Dry eye therapy is a process and a commitment, and regular follow- ups are essential for its success.
Meyer Izaac, O.D.
Optometrist in Encino, Ca.
www.visionsource-izaaceyes.com
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Meyer Izaac, O.D. 
Generally speaking, should someone with chronic dry eyes avoid Lasik or PRK?
Generally, with chronic dry eyes you do want to avoid any refractive surgery. The surgeon may not even consider you as a candidate. I hope this helps.
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