We tell our children to dry their
eyes after they've been crying, but for more than 10
million Americans -- mostly women -- dry eyes are the
problem, causing itchiness and constant pain. If left
untreated, dry eye syndrome (technically called kerato
conjunctivitis sicca, or, more simply, dry eye)
can cause scarring of the cornea and even lead
to blindness.
About your Tears
Healthy tears are made up of three
layers: The outer lipid layer prevents evaporation...
the second provides antibodies, salinity and acidity
to the cornea... and the inner layer contains mucus
that coats the cornea (the better for sticking).
Although aging eye glands are the most frequent
culprits in dry eye syndrome, it also can result
from several diseases and immune disorders that
affect tear production, including rheumatoid arthritis,
lupus and Sjogren's syndrome, as well as
some allergies.
Dry eyes also can be a side effect
of laser surgery, a procedure that involves
cutting the nerve of the cornea, which disrupts
tear production. Additionally, certain medications,
including diuretics, beta-blockers, antihistamines,
antianxiety and antidepression drugs, can cause
dry eyes. (Once you stop taking the medication,
dry eye problems usually go away.)
Although dry eye syndrome is
largely incurable, there is movement on the
research and treatment front. ophthalmologist Stephano Barabino,
MD, who is a specialist in dry eye and currently on a
research fellowship at Harvard University in
Boston. He explains that there is exciting new
research that is revealing more precisely what
the syndrome is. The long-held belief about dry
eye is that it is simply not having enough tears
or having them evaporate too quickly. Now, though,
it appears that the syndrome frequently involves
inflammation as well, and that it affects both
the tear glands and the surface of the eyeball.
Consequently, says Dr. Barabino, current treatment
research is focused on therapies that diminish
inflammation, which in turn leads to an
improvement in symptoms.
Treatment options
Inflammation: Before
discussing treatment options, Dr. Barabino
stresses that anyone with dry eye must first
go to an ophthalmologist to determine what is
causing the problem. Treatment methodology is
determined by the underlying cause.
The new drug cyclosporine
(Restasis), which you probably have seen
advertised on TV, is designed specifically to
treat inflammation, and it seems to help many of
these patients. A simpler approach is one that
Dr. Barabino and his colleagues tried in Italy.
They gave patients with inflammation supplements
of the anti-inflammatory essential fatty acid omega-6.
(Although they used omega-6 alone, he suggests that
Americans take a balanced combination of omega-3 and
omega-6 because of the common dietary imbalance here
in which omega-6 vastly outnumbers omega-3.)
E. Michael Geiger, OD, an
optometrist who specializes in using nutrients
to combat eye disease and author of Eye Care Naturally,
also advises essential fatty acids as a treatment for
dry eye. He has patients take 1,000 milligrams of
omega-3 three times a day with meals. He also advises
buying omega capsules with a small amount of vitamin
E in them (the vitamin E acts as a preservative).
Flaxseed oil -- generally a good source of omegas --
is not effective in this case.
Another important element to help reduce
inflammation -- improving immune function. This
is accomplished by taking an antioxidant supplement
and an additional source of selenium. Selenium, once
plentiful in the American diet, has been lost to modern
fertilization and farming techniques. It is recommended
80 micrograms (mcg) to 100 mcg of selenium a day, which you
can get as part of a general supplement.
Check the labels.
Eye Infection
Patients with an infection of the eyelid glands,
called meibomianitis, can use antibiotic drops.
This requires cleaning the gland daily to remove
the lipid buildup. Over time, the antibiotic generally
improves the patient's condition, but Dr. Barabino
stresses that these patients remain prone to recurrence.
Patients who have insufficient tear production have the
option of plugging the eye ducts that normally drain tears.
Successful for about 90% of patients, the plugs can
remain in place indefinitely -- but this is not available
to patients with considerable eye inflammation.
As a general guideline, Dr. Barabino
advises relieving discomfort with frequent use of artificial
tears (avoid drops that reduce redness -- they may further
dry your eyes), keeping humidifiers going in your home and
avoiding smoke, dust, pollen and the like. Certain activities,
including using a computer, watching TV, driving and reading,
tend to reduce blinking. This aggravates dry eye even more,
so remind yourself to blink regularly in these situations.
For severe cases, your eye doctor can give you a special
prescription for "moisture chamber" goggles. Similar ro
ski goggles, they wrap around completely, protecting your
eyes from outside forces, such as the wind and allergens,
and they keep natural moisture in. Although these won't
make a fashion statement, those who wear them value the
comfort they provide.
