Dry Eye Treatment
Augusta, Georgia
When we reach mid-life, the eyes have often started to develop other problems besides “middle-aged vision” (presbyopia) that requires reading glasses. You may have glaucoma, cataracts or dry eyes. In fact, dry eyes can be caused by both cataract surgery and glaucoma eyedrops. Dry eyes can be temporary, caused by factors such as LASIK surgery, wind, or insufficient blinking; or long-term, caused by local or systemic disease conditions.
The Eye’s Tear System
Tears have three components or layers, each produced by different glands:
A lipid (oil) component that keeps tears from running out of the eyes and slows down their evaporation.
A water component that helps spread the tears over the eye surface
A mucus component that covers the cornea and helps with an even distribution over the eye
When you blink, you are re-distributing tears over the eye’s surface. Tears leave the eye through two canals next to the nose, one in the upper eyelid and one in the lower eyelid. These openings are called punctae (singular: punctum). Tears then drain out through a channel called the canalicular pathway, then into the nasolacrimal canal and into the nose.
Dry Eye Causes
Anything that interferes with the eye’s production of tears, the tear composition, or tear drainage can cause dry eyes. Simple aging is a cause, as the body produces fewer tears as we get older. Contact lenses tend to absorb tears, causing dryness. Autoimmune diseases such as Lupus, Rheumatoid Arthritis, and Sjogren’s Syndrome all cause dry eyes as part of how they affect the whole body.
The thyroid gland in the neck produces two hormones and if it produces too much or too little of either one, you have a thyroid imbalance. This causes dry eyes as part of a general body dryness that includes dry hair and skin and constipation.
Diabetes causes dry eyes by reducing tear production. Diabetic neuropathy affects the nerves controlling the lacrimal gland that produces the water component of tears. It is the same basic mechanism that gives rise to diabetic digestive problems and tingling or burning of the hands and feet.
Dry Eye Treatment Approaches
When the eye has insufficient tears to keep it moist and comfortable, there are three ways of approaching treatment:
Increasing the Density, Thickness, and Surface Tension of Tears
- This can be done by adding more omega-3 essential fatty acids to your diet. Studies have found that the tear glands use these in making the lipid component of tears. Without that component, the tears evaporate quickly. Some foods that contain omega-3 fatty acids are:
- Certain fish such as salmon, sardines, mackerel and herring
- Eggs when they are from cage-free hens
- Walnuts
- Flax seeds
- Cooked soybeans
Decreasing Tear Drainage
A Smart Plug™ is an excellent way of decreasing tear drainage. It is a clear acrylic polymer rod that Dr. Bruckner inserts painlessly into the eye’s punctae in the lower lids. It is sensitive to temperature. At first it protrudes but in a matter of seconds, your body warmth softens it to a gel, shortens it to become invisible, and expands its width to fit snugly in your individual tear canal.
Dr. Bruckner uses specially-designed forceps to insert these Smart Plugs and once in, they cannot be rubbed out – which has happened with older silicon punctal plugs. However, they can be surgically removed if that were to become necessary.
Increasing Tear Production
In some cases Dr. Bruckner will prescribe Restasis® Ophthalmic Emulsion for chronic dry eyes. It works by protecting the lachrymal glands that produce the water component of tears. You would use it twice a day – one drop in the morning and one in the evening. Each person responds individually to this treatment.
Augusta eye doctor Howard L. Bruckner will be happy to discuss all these options with you. To schedule a consultation or an initial visit to our Augusta, Georgia ophthalmology office, please contact us today.
