2007-06-20
Douglas K. Devries, O.D.

Chronic Dry Eye Disease is caused when the body’s lacrimal system (responsible for making tears and keeping a healthy “tear film” on the eyes) fails to produce tears containing the proper amount of moisture, lubrication and proteins that help keep the eyes protected and comfortable.

Besides creating a healthy eye surface and lubricating the entire eye, a natural tear film also works to fight infection, provides important nourishment and is vital for clear vision. When tear production is reduced over a period of time, serious irritation of the cornea can occur. This increases the likelihood of permanent damage and scarring – which can result in infection and serious visual impairment.

Dry eyes can be caused by a number of factors, including aging, the environment, work conditions, watching television, working on the computer or lack of sleep. Symptoms include discomfort in the eyes, itching, redness, excessive tearing, a gritty feeling or feelings of strain in the eyes. Often overlooked, common medications used to treat high blood pressure, diabetes, allergies, arthritis and many others can cause CDED. A large percentage of patients with arthritis also suffer from this condition.

Testing can be performed to determine if the patient produces a proper amount of tears. One of the simplest, Zone Quick, is performed by placing a small thread along the lower lid margin. The eyes are closed for a few seconds; the thread is then removed to measure the tear production. Fluorescein eye drops may also be used to determine tear production. Flourescein drops contain a dye that can be traced with a special light as it is washed out of the eyes by the tears.

As we age, we produce fewer tears, which evaporate faster. Women approaching or past menopause are at a particularly high risk, due to hormonal changes. Dusty air, dry or windy weather, or fumes such as cigarette smoke can cause discomfort in contact lens wearers, as proper lubrication is required in order to successfully wear contact lenses.

Depending on the condition’s intensity, treatment solutions can be as simple as using artificial tears a few times a day, providing quick but temporary symptom relief by lubricating the eyes for a short time. Artificial tears may help temporarily but they are not a cure for CDED.

In more persistent cases, a simple, non-surgical procedure is available providing long-term relief through the use of tiny plugs called "punctal occluders." These devices, barely visible to the naked eye, are made of a very soft, flexible silicone, similar to that in contact lenses. The punctal occluders block the punctum, or tear duct, which is the drainage duct that carries tears away from the surface of the eye. Blocking the tear duct allows the tears to remain on the eye's surface for longer periods. Now common, the procedure is safe, quick, painless and reversible, and in many cases gives permanent relief from dry eye symptoms. Punctal Occlusion is often part of a comprehensive treatment of chronic dry eye disease.

Odyssey Medicals Parasol® Punctal Occluder – one of the most advanced occluders on the market – is easy to insert and adjusts to each patient's tear duct opening. In addition to a custom fit and greater comfort, the Parasol occluder can also reduce or eliminate discomfort for many contact lens wearers.

To learn more about Chronic Dry Eye Disease or Parasol Punctual Occluders, you can visit www.odysseymed.com.

Dr. Devries is cofounder of Eye Care Associates of Nevada, a medical/surgical co-management referral practice.

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