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Symptomatic Dry Eye

Tears are the outermost covering of our eyes. The Dry Eye Condition occurs when your body does not make the correct amount or type of tears layering the eye surface. This leads to redness, itching, burning and foreign body sensation. Present treatment includes topical drops, Tear Duct Plugs, Lipiflow and other lid massage stimulating therapy.

Our group here at East West Eye Institute is participating in on-going research trials for eligible patients whom are presently failing conventional therapy.

An unstable tear film is the main feature of the Dry Eye. In the healthy eye, a film of tear covers the outermost front skin of the cornea and eye wall skin-conjunctiva for the total duration of the normal eyelid blink period. In abnormal conditions the tear film disappears prematurely or is insufficiently produced resulting in evaporation and or creation of a deficient tear condition. With tear film evaporation, dry spots appear on the corneal surface creating local surface irritation and subsequent poor rewetting for the remainder of the day. This leads to symptoms of itching, burning, gravely foreign body sensation and /or subtle to profound progressive visual blurring

With each blink the normal eye is moistened by a steady supply of a tear complex containing a watery component, mucous and oily mixture, each produced by separate outer eye glands. 

Age related hormonal body effects are the most common cause of Dry Eye and is associated with reduction in lubrication throughout the body. This is particularly prominent in postmenopausal women. Eyeliner and Mascara facial cosmetic application too close to and along the edge margin of the lids adjacent to the eye can plug the vertical tubular gland openings that secrete tears. In addition, the cosmetic particles are washed into and mixed with the reduced tear film during the blink. These cosmetic act like dirt particles embeding in the soft pink back lid surface closest to the eye effectively acting like sandpaper scraping the eye. 

Medical causes associated with reduced tear production/Dry Eye include Diabetes, Arthritis, Thyroid Disease and Hypertension as well as an assortment of medications. The worse topical bad actors are allergy drop medications and over the counter products such as Visine, Murine and Clear Eyes which lead to eye skin/conjunctival extreme surface drying. 

Topical Artificial Tear Lubricants applied frequently during the day are the mainstay for Dry Eye Symptom therapy. However, a very effective and popular passive treatment is the placement of plugs into the lid drainage canals effectively and significantly reducing the natural flow of tears from the eye to the throat, causing retention and elevation of the amount of the tear film to protect and cover the eye longer. Restasis and Xiidra are expensive medications which have proven to stimulate the eye structures to increase production of natural tears. Lipiflow and similar techniques are directed to tears oil glands cleansing and stimulation.