Dry Eyes & Dry Eye Syndrome at D’Ambrosio Eye Care serving greater Boston Massachusetts

About Dry Eyes

Dry Eyes or Dry Eye Syndrome is one of the most common eye problems people experience. Typically, when we think of dry eyes, we mainly think of the symptoms such as dryness, redness, grittiness, burning, tearing and the discomfort created. However, in order to have clear and consistent vision, it is necessary to have a normal and healthy tear film of adequate quality and quantity on the eye’s surface. Without a healthy stable tear film, not only will you suffer the symptoms of dry eyes, but you will likely experience visual symptoms as well.

Dry Eyes is an eye problem caused by a deficiency of the tear film from not producing enough of one’s own natural tears or an excessive evaporation of tears. As a result of either of these problems or both of these problems there is a compromise of tear film quantity and quality

Insufficient Tear Production

Inadequate tear production can result from a number of different causes. Certain systemic conditions such as Sjorgren’s Syndrome and autoimmune connective tissue diseases such as Rheumatoid Arthritis and Lupus Erythematosis may decrease the quantity of tears that you produce due to the chronic inflammation associated with these diseases. Often, patients with Sjorgren’s Syndrome will experience a triad of dry eyes, dry mouth and arthritis all at the same time. Diseases or inflammation of the Lacrimal Gland, which produces normal healthy tears may also cause patients to produce a reduced quantity of tears resulting in an inability to maintain a normal and healthy tear film. Conditions that can cause Lacrimal Gland inflammation can include contact lens wear, eye infections, allergies and even some vitamin deficiencies.

top

Excessive Evaporation of Tears

There are a number of factors that can cause your tears to evaporate too quickly. This includes environmental factors such as being exposed to forced hot air heat at home or at work, dry climates in general, air travel, reduced blinking from contact lens wear, reduced blinking from looking at a computer screen or reading for long periods of time, air pollution or even just blowing your hair dry. Tears may evaporate too quickly even if you suffer from minor low-grade eyelid inflammation. Your eyelids contain small tubular glands called Meibomian Glands. Even minor inflammation of the eyelids, or blepharitis or ocular rosacea can cause the Meibomian Glands to stop secreting their oily film. This oily film is required as an outer layer of the tear film to prevent evaporation. Without it, you will almost certainly experience quick evaporation of tears and dry eyes. This is especially noteworthy for perimenopausal women as it is believed that 75% of women in this age group have some presence of facial rosacea. This along with the general hormonal changes occurring during this time, make perimenopausal woman particularly susceptible to dry eyes.

In addition, your tear film may evaporate too quickly if the tears are not properly spread and replenished over the surface of the eye because of inadequate eyelid movement This may be due to improper or incomplete closure of your eyes during sleep, certain eye “bulging” conditions that may be related to thyroid problems, or a loss of tone or shape of the eyelids with age or as a result of trauma or inflammation, so that they turn in or turn out.

Dry Eye Diagnosis and Treatment

During your routine eye examination or with a dry eye consultation, eye doctors can evaluate your tear production by using a specialized microscopic technique to observe the height of the tear film. By also using a Schirmer Test they can actually measure the rate at which you produce natural tears by placing a piece of absorbent paper inside the lower eyelid for a brief period of time. The eye doctors will also use  eye drops which contain dyes to help observe the functioning of the various layers of the tear film as well as the underlying surface of the eye.

Based on these observations and tests it is possible to diagnose the specific deficiencies in the tear film that are causing your dry eyes. From the diagnosis and the severity of the tear film deficiency the proper artificial tears, lubricant eye drops, punctual plugs, Restasis eye drops and/or other options to help restore your tear film back to normal and make you more comfortable can be prescribed. The specific treatment options that your eye doctor may prescribe will really depend on the likely cause and the severity of your dry eyes.

For those patients with mild to moderate dry eyes the first course of treatment may be to use unpreserved artificial tears or lubricant eye drops. Depending on the nature of your tear film deficiency, your eye doctor may prescribe a specific type of artificial tear that has different characteristics in terms of salt content, viscosity or lubricity. It is important that you use only the eye drops that the eye doctor prescribes. You may need to modify certain environmental factors that may be contributing to the dry eyes.

If the oily layer of the tear film is deficient your eye doctor may suggest that you increase your consumption of oily fish or even take flax seed oil as a dietary supplement. Your eye doctor will again make specific recommendations about dietary supplements if they are necessary. Water intake is quite important and so you must drink plenty of water throughout the day.

In addition, it may be necessary to insert tiny punctual plugs in order to slow down or even stop the drainage of tears from the eye. These plugs are easily and comfortably placed in the lacrimal puncta in the eyelids. Initially you may have a temporary dissolving plug put in place to see if your signs and symptoms are actually responsive to this treatment. If the results are good, it may be necessary to place a more permanent type of plug in the lacrimal puncta to affect a long-term solution.

Occasionally there are some cases that may not respond to the above sequence of treatment options because of some underlying low-grade inflammatory or infectious process. In these cases it may be necessary to also prescribe an oral antibiotic such as a tetracycline or and anti-inflammatory eye drop such as a corticosteroid eye drop.

If it is found that you suffer from moderate to severe dry eyes and have been using artificial tears, lubricant eye drops and already have punctual plugs without relief, the prescription of Restasis eye drops in addition to the other treatments can often help alleviate your symptoms. Restasis is an advanced type of cyclosporine eye drop that acts by blocking a specific type of inflammatory cell from entering the Lacrimal Gland, which produces normal tears. By reducing or blocking inflammation in the Lacrimal Gland, it functions much more effectively so that you can actually make more of your own natural tears. Dr. D’Ambrosio Jr. has extensive clinical experience with Restasis as he was one of the eye physicians who conducted the clinical trials for evaluating the safety and efficacy of Restasis for the Food and Drug Administration.

top

D’Ambrosio Eye Care provides diagnosis and treatment of Dry Eyes and Dry Eye Syndrome including Restasis Eye Drops and Punctal Plugs in greater Boston Massachusetts and is conveniently located for Massachusetts dry eye patients from Lancaster, Acton, Gardner, Athol, Clinton, Harvard, Fitchburg, Westminister, Templeton, Worcester, Milford, Marlborough, Boxborough, Westborough, Lowell, Lexington, Leominister, Lunenberg, Shirley, Winchendon. Sterling, Littleton, Boyleston, Hudson, Berlin, Bolton, Stowe, Sudbury, Chelmsford, Groton and Concord Massachusetts.

To schedule an appointment for a Consultation for Dry Eyes or Dry Eye Syndrome please call us at 1.800.325.3937.