Dry Eyes (cont.)
Andrew A. Dahl, MD, FACS
Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
In this Article
- Dry eye syndrome facts
- What is dry eye syndrome?
- What is the impact of dry eye syndrome?
- What causes dry eye syndrome? What are the types of dry eye disease?
- What are the risk factors for dry eye syndrome?
- What are dry eye syndrome symptoms and signs?
- What tests do health care professionals use to diagnose dry eye syndrome?
- What is the medical treatment for dry eye syndrome?
- What types of medications are used in the medical treatment of dry eye syndrome?
- Can self-care treatments and remedies help alleviate dry eyes?
- What is chronic dry eye syndrome?
- Can surgery treat dry eye syndrome?
- What other therapies are used in the treatment of dry eye syndrome?
- What are the health complications of dry eye syndrome?
- What is the prognosis of dry eye syndrome?
- Is it possible to prevent dry eye syndrome?
- Find a local Eye Doctor in your town
What are dry eye syndrome symptoms and signs?
A person with dry eye syndrome may experience dry, gritty/scratchy, or filmy feeling, burning or itching, redness of the eyes (conjunctivitis), blurred vision, foreign body sensation, and light sensitivity.
Dry eye symptoms seem to worsen in dry or windy climates and with higher temperatures and lower humidity. Symptoms may also be worse with prolonged use of the eyes (for example, while reading and watching TV) and toward the end of the day.
Sometimes a symptom of dry eye syndrome may actually be intermittent excessive tearing. With dry eye, when the eyes becomes slightly dry and irritated, it may initiate reflex tearing with the production of a large amount of tears all at once to try to get moist and comfortable again. Unfortunately, the eyes can only handle so many tears at any one time; the rest pour over the eyelids and down the cheeks. Those tears that pour down the cheeks do not help the eyes and are wasted. A short time later, the eyes will become slightly dry and irritated again and the whole process may repeat itself.
What tests do health care professionals use to diagnose dry eye syndrome?
During an eye examination, an eye care specialist (ophthalmologist) will most likely be able to diagnose dry eye syndrome just by hearing the patient's complaints about his or her eyes. Confirmation of the diagnosis can be made by seeing signs of dry eyes. As part of the eye examination, a doctor may perform the following tests:
- The front of the eyes is examined using a special microscope, called a slit lamp.
- The amount and thickness of the tear film are inspected.
- The stability of the tear film is assessed by checking the tear breakup time.
- The conjunctiva is examined to determine if it is too dry.
- The cornea is checked to see if it has dried out or become damaged.
Different dyes may be used during a patient's eye examination. These are placed into the tears in the form of a drop. Fluorescein is a yellow dye that stains the cornea where epithelial (surface) cells have been worn away because of the lack of an adequate protective tear film. Rose Bengal is a red dye that stains the cornea and the conjunctiva where the cells are dead or dying as well as where healthy cells are inadequately protected by the tear film. Lissamine Green is a green dye which can help differentiate between normal and abnormal surface cells of the cornea and conjunctiva.
Schirmer tests measure the amount of tears produced by the eyes. The ophthalmologist places the end of a thin strip of filter paper just inside the lower eyelid. After a minute, the filter paper is removed and the amount of wetting is measured. Less wetting of the filter paper is more indicative of dry eye syndrome.
The osmolarity (salt content) of the tears may be measured. This is a new test which has been developed to aid in the diagnosis of dry eye syndrome, in which tear osmolarity is increased over normal levels.
If autoimmune diseases or Sjögren's syndrome are suspected as a cause of a patient's dry eye syndrome, blood tests may be performed. These blood tests check for the presence of different autoantibodies that may be associated with dry eye syndrome.
Rarely, a doctor may perform a biopsy of the salivary glands. Certain disease processes, such as Sjögren's syndrome, affect both the salivary glands, which produce saliva in your mouth, and the lacrimal glands, which produce tears.
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