Dry Eye Clinic
Dry eyes affect an estimated 33 million people in the U.S. in varying degrees. Many of us don’t know why our eyes constantly feel hot, gritty, sandy, scratchy, gravelly, or experience difficulty reading for long periods of time. Others report excessive reflex tearing especially after hot sensations. Those are all symptoms of dry eyes!
What causes dry eyes? Dry eyes have numerous causes, here is a partial list:
1) Insufficient secretion of tears by our lacrimal (tear ) glands.
2) Insufficient intake of water.
3) Extended computer use, which decrease blinking rates from the normal of 22 times per minute to 7, causing tears to evaporate quickly.
4) Excessive reading.
5) Too much omega 6 fatty acids (from fried foods) instead of omega 3 fatty acids (from salmon, and cold water fish. Omega 3 works because it decreases the amount of inflammation in the tear glands. Blocked glands result in dry eyes. Some omega 6 fatty acids tend to promote inflammation. A healthy diet contains a balance of omega 6 and 3. However, the typical American diet tends to contain 14-25 times more omega 6 than omega 3.
6) Too much caffeine, coffee or tea intake.
7) Pollutants, cigarette smoking.
8) Air conditioning or areas where there is forced air such as in shopping malls, because air conditioning removes moisture from air. (Turn the A/C vent in your car air away from your face).
9) Home heating.
10) Dry, arid climates and windy conditions. (Las Vegas)
11) Air travel, because the air in planes is dry.
12) LASIK. During LASIK procedures, 60-70% of corneal nerves are severed, causing dry eyes.
13) Many medications cause dry eyes as side effects such as: antibiotics, blood pressure medications, antidepressants, diuretics, OTC vasoconstrictors such as Visine, antihistamines, oral birth control pills, appetite suppressants, ulcer medications, hormonal replacement medications.
14) Aging. As we grow older, our bodies produce less oil – 60% less at age 65 then at age 18. This is more pronounced in women, who tend to have drier skin then men. The oil deficiency also affects the tear film layers of our eyes because without as much oil to seal the watery layer of the tear film, the tear film evaporates much faster, leaving dry areas on the cornea.
16) Contact lens wear exacerbates dry eyes because our tears will have to work overtime to keep both our eyes and our contact lenses lubricated.
17) Vitamin A deficiency.
18) Eye blinking disorders, which could be result of poor cosmetic surgeries or diseases, such as Thyroid diseases when the lower lid doesn’t move during the blink.
Why should we treat dry eyes? What happens to the ocular surface if there is not enough tears? Why do we need tears? What is the function of tears? How do tears prevent dry eyes?
Tears are a major protective agent for the eyes. Tears not only wash away dust from the eyes, but also soothe the eyes, provide oxygen and nutrients to the cells of the corneal surface. Tears also help fight against eye infections by removing microorganisms that can colonize in the eyes. Tears are of composed of three distinctive layers. The outer lipid section consists of an oily film that counters evaporation and keeps the eye moistened. The middle region is made of mostly water that moisturizes the eyes and some nutrients and proteins that assist in limiting eye infections. The inner coating contains mucous that allows the tear film to spread and reduces evaporation from the eye. Each layer is vital to the health of the eyes.
The outer surface of the cornea will become dried out, dessicated, if not properly lubricated. When that happens, it cannot act as a good barrier to protect the eyes against foreign agents in the environment. In addition, dried corneal cells cannot serve as a smooth optical surface necessary for clear vision.
Dry eyes has been documented to cause enough discomfort to affect productivity and efficiency at work, not to mention quality of life especially for those who love to read or do near tasks.
Dr. Sophie Dao is a speaker for Alcon and Allergan pharmaceutical companies. Her topics include dry eye and ocular allergies. She is the top prescriber for Restasis in Santa Clara county. Restasis is the only prescription eye drop available that stimulates tear production. Dr. Dao treats dry eyes aggressively and employs modern techniques which have resulted in great success.