Dry eye syndrome is an extremely common condition, thought to affect approximately 60 million Americans. The cause is usually an imbalance between tear production and tear volume drainage via the nasolacrimal (NLD) ducts. The tear film is made up of a mucous layer against the eye, a middle aqueous (water) layer, and an outer lipid (oily) layer. All three components are critical to a normal tear film. If any of the three layers of the tear film are deficient, the eye may suffer symptoms of dry eye.
People with dry eye syndrome usually present with complaints of burning, stinging, redness of the eyes, and tearing. The tearing seems paradoxical at first, but is explained by the fact that an underlying dry eye may become irritated, perhaps sending a signal for increased tear production to flush-out the eye. This response is physiologically equivalent to the presence of a foreign body, such as a hair, in the eye. Tearing that becomes symptomatic usually occurs in conditions that more rapidly evaporate tears from the eye, such as being outdoors in the wind. Heat, low humidity, and the presence of smoke may compound the problem.
The severity of dry eye syndrome generally dictates the course of treatment. In many cases, the patient is recommended to use artificial tears in the eye on a regular basis, perhaps four times a day. For those patients who need artificial tears on a regular basis, tear duct plugs are an excellent alternative that may eliminate the need for artificial tears. The tiny plugs, which block the tear drainage ducts, can be inserted with little or no discomfort and are rarely felt by the patient afterwards. In the unusual case that the patient then has too many tears, the plugs can just as easily be removed.
Some patients may benefit from topically applied medications to increase tear production. These may include Restasis, Alrex, and Lotemax.