Dry Eye

Dry Eye Management in New Jersey

At InVision EyeCare we have been treating dry eyes for over 20 years. We recognize that dry eyes can be easily misdiagnosed and sub optimally managed.

Dry eyes are the most common eye disease in the USA today. Estimates of up to 92 million people are affected by dry eyes.

Our experience has shown that a person suffering from dry eyes can become frustrated. 
If you wish to make an appointment for dry eyes, call us at 732-905-5600 and specify you are coming for a dry eye evaluation.

Please bring your medical history, a list of current medications, a list of treatments you have had to treat your dry eyes and how long you have tried them.

What are the most common symptoms of dry eyes?

Symptoms of dry eyes are different for different people. You may have one or all of the symptoms listed below. These symptoms can vary every day and during the day.

Symptoms include;

  1. Pain
    • Pain
    • Burning
    • Foreign body sensation (feels like sand in the eyes)
  2. Itching (this can be aggravated by allergies and vice versa)
  3. Redness
  4. Blurring of vision (this may be relived temporally by blinking or using lubricating drops)
  5. Decreased vision
  6. Night time glare
  7. Tearing (this is a paradox since if the eyes are wet how can they be dry? The reality is the eyes may have enough water, but not mucous or oil in the tear film.)

What is the cause of dry eyes?

Dry Eye Syndrome is the result of inadequate wetting of the ocular surface.  Dry eyes have numerous causes. In all cases, the tear film (see figure 1) which protects and lubricates the cornea is not functioning properly in dry eyes.

The composition of the tears film is rather complex. It is not simply water as many people believe. The composition of the tear film plays an important role. For simplicities sake, there are three main elements (see figure 1); (1) the lipid layer, (2)the water layer and (3)the mucin layer must be in balance to maintain eye surface lubrication.

What causes an imbalance in the tear film that leads to dry eyes?

Many things can affect the delicate balance of the tear film. Chronic inflammation which can caused by one of the conditions below can further the severity of dry eyes.

Lipid imbalance

Lipid imbalance can be caused by eyelid disease such as a condition called blepharitis (usually have visible lid crusting). There are specific treatments for blepharitis including lid hygiene, dietary changes, medications and nutritional supplements depending on the individual patients needs.

Tens of millions of Americans that have blepharitis have a skin condition called Rosacea. www.rosacea.org. These people have a reddish facial complexion, they blush easy, their eyes get read easy and the blush when the drink red wine (see figure 2).

Water imbalance

The water part of the tear film is mainly produced by the lacrimal gland (see figure 3). A smaller portion is produced by the accessory lacrimal glands (not seen in figure 2).

A water imbalance can be affected by;

  • Hormonal status - post menopausal women.
  • Medications
    • Antidepressants
    • Allergy medications
    • Eye drop medications
    • Blood pressure medications
    • Others
  • Contact lens usage
  • Evaporation
    • Air-conditioning
    • Electric or forced dry air heat
    • Arid environments
    • Activities that reduce blinking
      • Computer usage
      • Reading
      • Watching TV
  • Lasik
  • Diabetes
  • Sun damage
  • Collagen vascular disease such as rheumatoid arthritis, lupus, Sjorgens syndrome etc.

Mucin imbalance

This is seen in conditions such as chemical burns, chronic irritation from opening eyes under water, burn injuries or medical conditions like Stevens Johnson syndrome.

Tear film assessment

An exam by a specialist in our office with particular interest in dry eye conditions is the best way to determine the cause(s) of your dry eye. There are a number of good tests in our office that can be performed painlessly to determine the components of your dry eyes.

Treatment of dry eyes

The treatment of your dry eyes depends on the cause (s). It also depends on the severity. As you can see from the abbreviated list above, there are many causes and therefore many treatments. Since each person can have a variety of causes and severity with differing underling conditions, each treatment plan has to be customized.

It is very important to recognize that while there may be no cure for dry eyes, for most types of dry eyes, treatment are available that can make nearly every patient more comfortable than they  currently are.

Treatment modalities

  • Over the counter lubricating drops and ointments. There has been a large increase in the types of artificial tears and you may benefit from one type over the other depending on your condition.
  • Medicated eye drop. This includes available prescription and custom tailored medications.
  • Lid punctual (see figure 3 & 4) plugs to preserve patients tears.
  • Nutritional supplements. USP grade omega 3 fatty acids, flaxseed oil and others.
  • Lid hygiene
  • Environmental changes. Including humidifiers, positioning, blink techniques and others.
  • Moisture chambers
  • Others

Each patient is individual and needs to be treated as such. For an appointment please call us at 732-905-5600. We have computerized, high resolution video slit lamp photography to show you your eye exam finding so you can better understand your disorder.

Please bring your medical history, a list of current medications, a list of treatments you have had to treat your dry eyes and how long you have tried them.