One of the most common ocular health issues we eye care practitioners see is dry eye disease. Some patients have typical symptoms of a gritty, sandy feeling, burning, irritation, etc.
Another common symptom is tearing, which might seem counterintuitive. Surprisingly, it does make sense.
These are simply reflex tears produced when the brain gets the signal that the eyes are dry. Moderate to severe dry eye can significantly affect vision.
The cornea is a clear and smooth structure that lies in front of the iris (the colored part of the eye).
When the cornea gets dry, some of the cells swell or die off, the clear surface gets rough and hazy, and blurred vision ensues.
Surprisingly, your natural tears have multiple layers. The base layer is made up of mucous strands that help attach the tears to the front of the eye; the middle layer is the watery layer; and the outer layer is an oily layer that prevents the tears from evaporating too quickly.
Dry eye can stem from a deficiency in the watery layer or the oily layer, or a combination of both. There are different treatments depending on the cause of the dry eye.
To get more moisture on the eye, we have multiple treatment options. Our easiest, first-line treatment is often a lubricant drop used anywhere from as needed, up to four times a day, or up to every hour, depending on the severity.
Another treatment is a prescription eyedrop called Restasis. This drop stimulates your own tear glad to produce more natural tears.
In addition to adding more moisture to the eye, you can keep more moisture on the eye by plugging the drain through which the tears flow out.
This is done using a punctal plug, which is a tiny collagen or silicone stopper inserted into a small hole in the corner of your eyelid.
There are a couple additional treatments that will likely be available in the near future. One is another prescription drop called Xiidra.
The second is a very intriguing device called Oculeve Intranasal Tear Neurostimulator. It is a handheld device that the patient uses to stimulate tear production by probing inside of the nose.
It is hard for me to imagine myself prescribing something that you will see people sticking up their nose, but many chronic dry eye sufferers would be glad to do it if it works.
The jury is still out, but until then be sure to ask your eye care practitioner which treatment is right for you.
Caroline Bundrick, O.D. is an optometrist practicing at Darling Eye Center, with offices in Bluffton and on Hilton Head Island.