Dry Eye

Overview

Tears come from the lacrimal glands and include several important components, such as water, mucus and an oily substance. You might experience dry eye if your lacrimal glands do not produce enough tears or if your tear components are out of balance. For example, if your tears contain too little of the oily substance, they can evaporate too quickly.

Symptoms

Symptoms of dry eye include itching, redness and sensitivity to light. Dry eye can make performing some activities difficult, such as reading or working at a computer. Untreated, dry eye can cause the eye’s surface to become inflamed, resulting in pain, ulcers and scars. However, permanent vision loss is rare.

Irritation caused by dry eye sometimes triggers overproduction of tears. This extra moisture overwhelms the eye’s drainage system and flows away.

Causes

Dry eye often occurs with age as tear production slows down, especially in women.

Other causes include:

• Burns from chemicals or heat
• Contact lenses
• Cold and allergy medicines
• Dry environments
• Disorders of the glands in the eyelids
• Eyelids failing to close during sleep
• Hormone replacement therapy in women
• Immune disorders, such as Sjögren’s syndrome

Dry eye generally does not lead to serious vision problems, but it can interfere with your ability to live a productive and enjoyable life.

Treatment

You might be able to control dry eye by using over-the-counter drops and gels, wearing close-fitting glasses or sunglasses, and avoiding tobacco smoke. Keeping away from wind and dry air can also help. For tougher cases, IU Health ophthalmologists offer a variety of options for managing dry eye, depending on your specific needs and preferences.

Treatment options include:

Artificial Tears

Many brands of artificial tears are available without a prescription. Artificial tears provide temporary relief, and you may need to use them many times each day. Gel and ointment versions are also available. If over-the-counter products do not work, prescription artificial tears may be effective.

Medicine Therapy

Cyclosporine is a prescription medicine approved for treatment of dry eye. This treatment relieves symptoms, boosts tear production and reduces damage to the cornea. You might need to take this medicine for three to six months before seeing results. Short-term use of corticosteroid eye drops is another option for reducing inflammation in severe cases of dry eye.

Lacrimal Plugs

One way to keep more tears in the eye is to block their exit. Plugs made of silicone, collagen or other materials can be placed in the tiny drainage holes at the inner corners of the eyelid to prevent tears from leaving. Many plugs are semi-permanent, meaning they stay in place indefinitely but can be removed if necessary. Some plugs dissolve over time. Lacrimal plugs, also known as punctal plugs, can be placed in your eyes during an office visit. You will not normally feel the plugs when they are in place.

Punctal Cautery

In this simple in-office surgical procedure, the eye’s drainage holes are permanently closed using heat. This treatment is for severe cases of dry eye. It may be an option if other methods have not been successful.

LipiFlow

This newer technology uses gentle heat and pressure to unclog glands that normally add an oily material to the tears. When these glands do not work properly, your tears evaporate too quickly and your eyes become dry. LipiFlow treatment can be completed in an office setting and requires only a few minutes per eye as you recline in a chair. After treatment, your glands may begin producing the oily substance at normal levels again.