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Johns Hopkins Health Alert

Soothing Dry Eye

Blink! Feel better? Every time you blink, you refresh the layer of tears that covers and protects your eyes from irritants and infection. If your body fails to produce enough tears or produces less-than-perfect tears, your eyes can burn and feel itchy, gritty, or irritated -- like you have an eyelash or dust in your eye. This condition is called dry eye and affects millions of Americans.

Dry eye rarely causes blindness, but dry eye can affect the quality or sharpness of vision; also, living with constant eye fatigue and irritation can raise stress levels and limit activities like reading and driving. In rare instances, if severe dry eye isn’t treated, scarring can occur and can affect vision -- especially if it’s located in the central cornea.

Artificial tears are the primary treatment for dry eye. They are sold over-the-counter; some contain preservatives, some do not. The preservatives found in artifical tears won’t harm your eyes, but they may irritate the eye’s surface. If you experience a lot of burning, you might try switching to nonpreservative formulations. Preservative-free teardrops contain fewer chemicals, but they are only available in single-use applications and, as a result, are more expensive than tears with preservatives. There are also thicker gel lubricants that stay on your eye longer. Your ophthalmologist can help determine which product is best for you.

A prescription medication called Restasis (cyclosporine) was approved to treat dry eye in 2004; it reduces inflammation on the surface of the eye, but it doesn’t work for everyone with dry eye. Sometimes, the use of mild steroid drops for short periods of time also can be effective. However, steroids used for long periods can increase the risk of glaucoma and cataracts.

Tears drain into channels at the corner of your eye that empty into your nasal cavity. If artificial tears and prescription medications don’t adequately alleviate symptoms, your eye doctor can block the tear drainage system in at least one eye either temporarily or permanently with silicone plugs or other techniques. This procedure is called punctal occlusion.

A note of warning: Using over-the-counter eyedrops that “get the red out” may aggravate your dry eye condition. If your eyes are red and irritated from dry eye, artificial tears will help offer relief, whereas these other types of eyedrops “bleach” the so-called white of your eye by constricting ocular blood vessels, and this may contribute to your symptoms.

Posted in Vision on July 11, 2008
Reviewed July 2009

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The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or MediZine LLC, which has no responsibility for any comments posted on this site.




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