Dry eye syndrome
Dry eye syndrome is a chronic lack of lubrication and moisture in the eye. Its consequences range from minimal but constant irritation to ocular inflammation of the anterior tissues of the eye.
Persistent dryness and scratches, and burns in the eyes are signs of dry eye syndrome. Some individuals will also experience having an external body, the sensation that something is within the eye. Sometimes the eyes can become watery due to dry eye syndrome because the excessive dryness works to overstimulate the production of the watery component of tears.
Dry eye syndrome occurs from several causes: as a natural part of the aging process, especially during menopause, as an adverse effect of many remedies, such as antihistamines, antidepressants, birth control pills, and certain antihypertensive medications. Living in a dry, dusty, and windy climate can also cause dry eyes. If your home or office has air conditioning or a dry heating system, that can also cause dry eyes. Another cause is insufficient blinking, such as when you are in front of the computer all day.
Dry eyes are also synonymous with systemic diseases, such as lupus, rheumatoid arthritis, rosacea, and Sjorgren’s syndrome (a triad of dry eyes, dry mouth, and rheumatoid arthritis).
Other causes include incomplete eyelid closure, eyelid disease, and deficiency of the glands that produce tears. Tears are made up of three layers: the outer (oily and lipid), the intermediate (watery and lacrimal), and the mucin or mucous layer. A different set of eye glands produces each layer. So a problem with any of these sources can lead to dry eye syndrome.
Dry eye treatment
Until now, the main dry eye treatment has involved the use of a variety of artificial tears. One eye drop, Restasis (cyclosporine in a castor oil base), actually helps the eyes increase tear production.
Recent research has shown that scleral lenses are one of the most promising systems for alleviating pain caused by dry eye’s worst ocular surface conditions. These lenses that we wear are measured and shaped to avoid contact with the cornea, and a gap is maintained between the back surface of the lenses and the dry and compromised corneal tissue.
Since the surface of the cornea is immersed in artificial tears at all times, it is protected from the effects of dissection from exposure to air and friction caused by blinking. This allows scleral lenses to be tolerated and therapeutic for dry eyes and other ocular surface complications.
Scleral lenses have successfully eliminated pain and light sensitivity in eyes that suffer from the severe ocular surface disease. Dry eyes severely affected by LASIK surgery are best cared for through scleral lenses. The corneas, after LASIK surgery, usually have very irregular surfaces induced surgically in addition to the condition of dry eye. Scleral lenses will do very well to remedy both conditions in most cases.
The following are eye photos of patients we have treated who suffered from dry eyes due to disease or refractive or eye surgery.
Eye, Retina
Dry eye syndrome
What is dry eye syndrome?
Dry eye is a complex pathology today of multifactorial and chronic origin that affects the ocular surface.
It usually produces great discomfort accompanied by blurred vision; it can even cause conjunctival and corneal lesions. So it becomes a pathology in which it is not only associated with “not having a tear,” but with something more complex.
It currently affects 30% of the population and requires adequate diagnosis and treatment to mitigate its effects.
Why is it produced?
The causes are diverse: hormonal, advanced age, drug use, excessive use of contact lenses, environmental factors (heating, air conditioning), poor diet, and autoimmune diseases.
The causes of tear deficit can be summarized in 3:
One, due to low tear production.
The second is by evaporation.
The third is due to problems of dysfunction in the meibomian glands, often associated with blepharitis.
And all of this can be classified into degrees of inflammation.
What are the types of dry eye?
There are several types of dry eye, and depending on the causes and the degree of severity, the best treatment is prescribed to obtain the best results.
Can it be prevented?
The only way to abort prevent dry eye is through routine check-ups at the ophthalmologist, especially if one of the factors, as mentioned above, is present, to avoid more serious consequences.
Dry eye symptoms
The most relevant symptoms are:
Red-eye
foreign body sensation
itching/stinging
eye irritation
tearing
photophobia
fluctuating vision
Diagnosis
To determine our patient’s degree of dry eye, we have specific objective tests in consultation, such as Schirmer and Lipiscan strips.
What does the Schirmer test consist of?
Before the examination, an anesthetic drop is applied to the patient in each eye to avoid the tearing reflex; then the Schirmer strip is placed individually in each eye, held in the conjunctival sac of the lower eyelid, where it will remain for at least 5 minutes. Subsequently, the test is withdrawn, and the extent to which the paper is wet is evaluated (the paper is calibrated in millimeters). The maximum would be 25 mm, a patient with a Schirmer of less than 10 mm would be indicated to perform a PRK.
Lipizzan
The Lipiscan is a diagnostic device in itself, in which a little more progress would be made in the classification of dry eye, being able to determine if said affectation is caused by a pathology associated with the Meibomian glands (glands located on the palpebral edge, responsible for secreting the lipid part of the tear). Lipiscan also has a video system in which the patient’s blinking is recorded and the tear rupture time is measured.
Treatments
As specialists in refractive surgery in Madrid, we carry out very exhaustive preoperative studies taking into account, among other things, the assessment of tear quality and dry eye.
Thanks to all these values, we can guide and advise our patients towards the best surgical technique beneficial to their eyes.
PRK surgical technique or photorefractive keratotomy
The PRK surgical technique, or photorefractive keratotomy, is a type of refractive surgery to correct myopia, hyperopia, astigmatism, and eyestrain indicated in the case of mild dry eye.
Potential patients to apply this technique are:
Contact lens wearers who no longer tolerate them due to overuse and have significant dry eye.
Also, people who perform contact sports and with professions are at risk of receiving an eye impact.