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About Your Tears

What is Chronic Dry Eyes Syndrome

Tears are produced to keep the eye bathed in fluid, lubricate the surface, and keep the eye free from infection. Chronic Dry Eye Syndrome results from poor tear volume or poor tear quality, With this disease, tear glands either don't produce enough tears or they are of poor quality resulting in redness, irritation, burning, and inconsistent vision. Ultimately, it can cause a reduction in the quality of life since it can affect how we feel, how we work, and how we live our lives and is one of the most overlooked problems since most people think it;s something expected, CDES affects about 20% of our population.

What are the Types of Tears

There are two different types of tears: constant lubrication tears and reflex tears. Constant lubricating tears are what bathe and nourishes our eyes on a daily basis and reflex tears are what is produced in response to irritation factors such as smoke, injury,or emotion. Since reflex tears do not have the proper composition as our constant lubrication tears,flood that usually results washes out all the nutrients, enzymes, proteins that are needed for a healthy eye. If it persists it can further exacerbate CDES. A "watery eye" may be a symptom of CDES.

Treatment

ARTIFICIAL TEARS are often the only treatment that people think of when it comes to CDES. They add to the moisture that eyes need and may temporarily soothe dry eye symptoms.

Most bottles of artificial tears contain preservatives which with repeated application can be toxic to the eyes. Artificial tears can also cause a dyruption in the normal function of tears on the surface of the eye. This sequence leaves the surface of the eye vulnerable and can lead to CDES.

Thus artificial tear use should be thought of as a second line of defense in the vast majority of cases.

Certain medications may bring relief for dry eyes. Retasis is a product that was developed specifically for dry eyes and was introduced a few years ago. Unfortunately it tends to only help about 15% of dry eye cases it takes up to 6 months to even have an effect. Steroids can be used but long term use of steroids (months of not years) is not recommended because of side effects. The only truly effective means for modifying the volume and thus composition of tears is collagen inserts or punctal plugs.

Collagen Inserts

Temporary closure of the tear duct is the main stay treatment for any dry eye condition. Tiny collagen inserts are placed into the openings of each tear duct which essentially modifies the flow of tears so there's more available on the eyes. These inserts are commonly called "punctal plugs" which refers to the anatomical label for the opening of the tear duct--the "punctum".

We have 5 day testers and ones that last up to 6 months for longer term use. The doctor looks at your puncta and estimates the diameter of the opening then picks the right size for you. After being placed into the puncta, the insert will expand some to prevent slippage. People don't normally feel anything when they are inserted of afterwards!

Why is This so Important

Collagen inserts increase the volume of tears available on the eyes. And they are YOUR tears! Since any bottled product clearly cannot make up for the complexity of important enzymes, proteins, electrolytes, and antibiotics in your tears, collagen inserts are the best way to increase tear volume! There's no pain and you don't know they are there! Your eyes will feel better, see better, and your overall life will improve! They are safe, effective, and the best means to treat Chronic Dry Eye Syndrome.

Common Causes of Dry Eye

The ocular surface can be affected by lack of tears (dry spots), lack of tear volume (not enough tears), or poor tear quality (what's in the tears). This is called "Chronic Dry Eye Syndrome or CDES." The most common causes include:

  • AGING - Tear flow normally decreases with age. 75% of those over 65 suffer from CDES.
  • CONTACT LENS WEAR - Contact lens wear can increase tear evaporation, causing discomfort, infection, and/or increased protein deposits. Research shows that CDES is the leading cause of contact lens intolerance.
  • FEMALE HORMONES - Hormonal changes at all ages, pregnancy, oral contraceptives, and menopause can contribute to CDES.
  • ENVIRONMENTAL FACTORS - Smoke, air pollution, poor indoor air quality, fans, dehumidifiers, pollen, high altitudes, jobs dealing with paint, chemicals, flying debris or dust.
  • MEDICATIONS - many medications including blood pressure medications, decongestants, antihistamines, anti-depressants, sleeping pills, diuretics, and many others can affect tear production and or tear quality.
  • AUTOIMMUNE DISEASE - Auto Immune Disease accompanied by dry mouth or dry eyes is called Sjogrens Syndrome.
  • LASER VISION CORRECTION - It is not uncommon to have symptoms of dry eyes post vision corrective surgery.

Available Treatments

For the most mildest of cases, artificial tears may help. However, for most people, artificial tears may only be a temporary treatment and more frequent use can cause problems since each drop washes out natural tears and preservatives cause toxic build up. The best longer term treatment is with collagen inserts into the tear ducts. This process is called "punctal occlusion".

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Vernon, CT

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