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Dry eyes: Relief is in sight

January 12, 2017 | UC Irvine Health
dry eyes woman reading book

Dry eye symptoms are the No. 1 complaint heard by ophthalmologists and other eye doctors.

It’s estimated that 50 percent of all individuals suffer from the red, itching, burning, gritty or scratchy eyes and blurred vision of the disease.

What causes dry eyes?

It occurs when the tears produced are not adequate to keep the surface of the eyes lubricated and healthy, says UC Irvine Heath ophthalmologist Dr. Matthew Wade of the Gavin Herbert Eye Institute.

“A large part of the problem is often excessive tear evaporation. The tear film is coated by oil from the meibomian glands. This oil layer is supposed to keep the tears from evaporating too quickly,” he says.

Eighty percent of patients with dry eye disease suffer from some kind of dysfunction of the meibomian glands, says Dr. James V. Jester, UC Irvine professor of ophthalmology and biomedical engineering, who studies the causes and mechanisms of dry eye. These glands, located along the margin of the eyelid, produce the eye’s oily protective coating.

“Often there is atrophy of the glands due to aging or environmental, lifestyle or health factors which affect not only the amount of oil released, but also the quality, leaving the eyes vulnerable to dryness and discomfort,” Jester explains.

Risk factors

And with more time spent focusing on our computer and smartphone screens, the incidence of dry eye is likely to increase because we’re neglecting to blink.

March is Workplace Eye Wellness Month. Your job may be contributing to the disease.

“Many of us have jobs that require staring at a computer all day,” says Wade. “It is important to take frequent breaks, allow your eyes to rest and resume normal blinking.”

Additional risk factors include:

  • Smoking
  • Dry environments, including air travel
  • Contact lens intolerance
  • Antihistamines and decongestants
  • Antidepressants
  • Oral contraceptives
  • Advancing age
  • Hormonal changes, including menopause
  • LASIK or other eye surgery
  • Diseases including sleep apnea and Sjogren’s syndrome

How to prevent dry eye disease

Doctors recommend these prevention tips:

  • Don’t smoke
  • Avoid dry environments
  • Limit allergy and cold medicines
  • Purposefully blink more often when using a computer

Dry eye treatments

The condition cannot be cured, but there are safe and effective treatments to relieve symptoms:

  • Over-the-counter and home remedies

  • “Generally, over-the-counter options should be tried first,” advises Wade.

    “Warm compresses and artificial tears in the form of lubricant eye drops can improve the majority of dry eye symptoms to tolerable levels in many people.”

    Omega-3 fatty acids are another over-the counter treatment which may help improve the health of the meibomian glands.   

  • Eye drops

  • If over-the-counter remedies are not effective an ophthalmologist may recommend additional treatments. Steroid drops can help decrease inflammation of the eye and eyelids. Antibiotic drops can help remove abundant bacteria. Doctors may also prescribe medication called Restasis® to increase natural tear production.

  • Office procedures

  • If tear production remains low, tiny plugs can be inserted into to block tear drainage ducts and keep tears in the eyes longer.

    Doctors may treat meibomian gland disease with LipiFlow®, a device that uses heat and pressure to unclog the meibomian glands.

  • Customized tear substitute

  • Another therapy uses an autologous serum, that is, eye drops are developed from the patient’s own blood to produce a natural tear substitute unique to that individual.

    “When other treatments are providing inadequate relief, I have seen great success with the addition of serum drops,” Wade says.

  • Using stem cells to identify a cure

  • In the lab, Jester is working on the possibility of using stem cells to restore meibomian gland function.

    “We’ve identified where these stem cells are and are now studying what regulates their renewal,” he said. “Potentially, there may be some way to protect this stem cell population from being lost.”

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