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Dry Eye Syndrome

Most of us have met with days of red, irritated, burning and dry eyesDry eyes are caused by insufficient natural tear production by the lacrymal glands around the eyes. See Eye Diseases – Dry Eyes..  You found that rubbing the eyes do not relieve the symptoms and you might even experience a burning sensation, followed by excessive tear formation from the eyes.

These symptoms are common and are present because you are most likely exposed to a climate that is hot and dry, an air conditioned environment, air pollution or windy and dusty conditions.  Smoke and contact lens wear may also contribute to the discomfort of dry eyes.

Dry eye is caused by insufficient natural tear production by a variety of lacrimal glands present around the eyes.  The tear layer protecting the front surface of the eye is constituted from 3 different fluid layers.  It has a number of functions, including optical, anti-bacterial, lubricating and wetting properties.  Several medical conditions may be associated with dry eye sindrome, namely blepharitis (inflammation of the eyelids), Sjögren’s syndrome (dry eye associated with certain arthritic and rheumatologic conditions) and thyroid disorders.  It is therefore important to have your eyes checked for these conditions should you experience symptoms of dry eye.

It is known that the volume of tear production reduces with age.  This is more common among females, especially post-menopause.  The use of certain medications may also prohibit tear production.  Whatever the reason for your dry eyes, you don’t need to live with it forever.

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Treatment options

Artificial tear supplementation

A variety of tear supplementations are available on the market.  These range from preparations that have a watery constitute to more viscous substances.  These medications may be presented in a multidose bottle, implicating that a preservative has to be added to the substance, or it may be packed as small single dose vials, which are unpreserved.  From a clinical standpoint, the use of single dose vials hold preference over the multidose packages, as the unwanted effect of preservatives are negated, and the chances for causing an eye infection through the use of a contaminated bottle is limited.

Recently, the use of omega 3 oils have gained popularity in the treatment of dry eye.  These supplements may also be used with great benefit.

Punctal occlusion

This may either be done as a semi-permanent procedure via the use of artificial punctal plugs, or it may be done by permanent surgical closure of the puncta.

The puncti are the minute orifices of the tear drainage system to the nose, and are located on the nasal aspect of the upper and lower eyelid margins.  The function of the punctum in the normal state is to collect and drain excess amounts of tears into the nose via the lacrymal drainage system.  In some cases this mechanism is too efficient, leading to a dry eye.

A punctum plug is a tiny device made of thermodynamic hydrophobic acrylic material which is placed into the punctum.  This prevents the tears from draining into the nose, with the result that the eyes are kept moist.  Patients are routinely fitted with a temporary collagen dissolvable punctum plug in each punctum for a trial period of 3 to 5 days before permanent plugs are inserted.  This trial period enables the patient to determine whether the proposed occlusion will yield the desired effect.  It is also done to ensure that no excessive tearing will occur, with tears spilling over the eyelids, once the semi-permanent punctum plugs are inserted.

The insertion of punctum plugs is a simple procedure and Dr Potgieter will do this during a routine consultation with minimal discomfort.

For patients who have worn punctal plugs successfully over an extended period of time, the option of permanent surgical closure may also be considered.

Autologous serum

In extremely resistant and difficult cases, the use of autologous serum is advocated.  These eye drops are prepared on special request by the SA Blood Bank.  Blood is donated by the individual, from which eye drops are manufactured containing natural proteins and antibodies unique to the specific patient.  These specially prepared eye drops are used as prescribed by Dr Potgieter, and are kept in the freezer at home.  A supply that lasts for approximately 6 months is usually provided from each donation.

Protective eye wear

Special protective goggles and 'bandage' contact lenses may also be used in extreme cases to restrict the evaporation of tears from the eyes.