Dry Eyes

Dry Eyes

How can a “Dry Eye” water excessively?

This is a paradox but is typical of dry eyes.  There is normally two different types of tear production.  One is called “Basal” and this keeps the eyes lubricated at all times without producing excessive tears and without the person knowing.  Then there is “Reflex” tear production, which occurs only when the eyes are irritated by dust for example, the smell of onions or when emotional.  This mechanism is switched off under normal circumstance.  When there is deficiency in “Basal” tear production, the front of the eye dries out stimulating the “Reflex” tears.  The reflex tears do not know when to stop over-flooding the eyes.  In severe cases there may be excessive mucous accumulation in the eyes as the there is not enough water to wash away the natural mucous secretions of the eye.

What is the function of tears?

Basal tear production is important to keep a smooth surface to the front of the eye, which is vital for clear vision.  It also provides lubrication to the eyelids.  Reflex tears help to washout irritants in the eyes.

Why do you get dry eyes?

There is a constant decrease in basal tear production in adulthood. It may reach a stage in some people when it becomes symptomatic. Sometimes, it may be associated with few medical conditions such as Rheumatoid Arthritis and Sarcoidosis. In such cases it is labeled as Sjögren’s Syndrome.

What is the treatment?

There is no cure but in most circumstances, dry eyes can be easily controlled.  There are several options.  Eye Drops in the form of “Artificial Tears” are useful in mild to moderate cases.  Such agents are available without prescription from pharmacists such as Hypromellose,  Tears Naturale™,  Liquifilm Tears™,  Hypotears™,  Celluvisc™ , Ilube™, Viscotears™,  Gel Tears™ and many others.  There are also “Ointments” that can be used for lubrication.  They last much longer than eye drops but they do blur vision.  Therefore, they are particularly suited at night before bedtime. Examples of such ointments Simple Eye Ointment, Lacrilube™, Ilube™.  In some resistant and very severe cases, there could be other medical and surgical approaches.  However, these require monitoring by an eye doctor.

Novel New Treatments!

There has been a new revolutionary treatment for Dry Eyes.  It is the “Smart PLUG™”.  Normally the tears flow out of the eye by special drainage canals located at the inside corners of both the upper and lower lids.  The lower canals drain about 80% of the tears while the upper ones drain only 20% of the tears.  Therefore the lower ones carry most of the load. The Smart PLUG is made out of clever material that has a thermoexpansion property at 32 degrees C.  Is totally inert and non-toxic.  It is inserted into the drainage canal of the lower lid and at body temperature it contracts to form a plug. Once the drainage canal is blocked, it keeps the natural tears in the eye longer maintaining lubrication. The procedure is quick, does not require an anaesthetic and can be done in the consulting room.  It is perfectly safe and effective.  Studies have shown that 96% of eyes with Smart PLUGS have reduced symptoms of dry eyes and reduced use of lubricant eye drops. This procedure is also totally reversible. Should for any reason the canals need to be unblocked, this can easily be done by flushing it out with cold water. The cost of this procedure way undercuts the long term cost and hassle of eye drop use!

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“Men are born with two eyes, but only one tongue, in order that they should see twice as much as they say.”                           Charles Caleb Colton


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