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Dry Eyes or Sjögren’s
Syndrome
Eye Institute in Auckland is the acknowledged
leader in diagnosing and treating
Dry Eye or Sjogren's Syndrome and continues
to be involved in dry eye research
in New Zealand. Aided by specialist
equipment such as the Tearscope
and autologous human serum
eye drops, they offer sight-saving
treatment for some patients with severe dry eyes |
What is Dry Eye?
Dry eye or more commonly Dry Eye Syndrome,
is a collection of symptoms that results
from insufficient quantity or quality
of tears.
Symptoms may include dry, red, irritated
eyes
or difficulty wearing contact lenses.
Often
people suffering from dry eyes will
feel a “gritty,
sandy” sensation in their eyes. They may even
have seemingly paradoxical watering
eyes. The
eyes may water or tear excessively
as a reflex
response to the dryness and irritation.
The cause
is usually due to either a decreased
production
of “normal” tears or increased evaporation
of tears related to poor quality of
the tear
film. Dry Eye Syndrome has also been
called
kerato-conjunctivitis sicca or sicca
syndrome.
What causes Dry Eye Syndrome?
Several factors commonly contribute to
Dry Eye Syndrome, including:
- Meibomian gland inflammation and Blepharitis
 Often dry eye symptoms can result
from inflammation of the eyelid glands (meibomian
glands). This is frequently associated
with red eyelid margins and
scaly eyelashes. These conditions compromise
the quality of the tear film causing
tears to evaporate more quickly.
Over-growth of
bacteria (usually Staphylococci)
normally found on the eyelids also contribute
to the
inflammation of the meibomian glands
and eyelash
follicles. These problems can be improved
with warm
compresses, eyelid hygiene and sometimes
special antibiotics.
- Medications
Several medications can increase
dry eye symptoms:
decongestants, antihistamines, blood
pressure medications, oral contraceptives, antidepressants,
drops for “red eyes” (e.g. Visine, Naphcon, Clear
Eyes).
- Diseases
Diseases that may be associated with
dry eyes include
rheumatoid arthritis, diabetes, asthma,
thyroid disease,
lupus. Sjögren’s Syndrome is the name given to the
combination of dry eyes, dry mouth and
arthritis.
- Age and Gender
Tear production steadily decreases
with age. Dry Eye
Syndrome affects 75% of people over
age 65. Women
suffer from dry eye syndrome far more
than men.
Hormonal changes causing decreased
tear production
are associated with pregnancy, lactation,
menstruation
and menopause.
- Computer users
Computer users tend to blink much
less frequently (about
seven times per minute versus a normal
rate of around
22 per minute). This leads to increased
evaporation along
with the fatigue and eye strain associated
with staring at
a computer monitor. Evaporation of
tears can be reduced
by adjusting the monitor so that it
is below eye level thus
allowing the upper lid to be positioned
lower and cover
more of the eye’s surface. Trying to be more conscious
of blink rate, air circulation and glare can
also help to reduce
dry eye symptoms.
- Contact lenses
Dry eye is the leading cause
of contact lens discomfort or
intolerance. It more commonly affects
soft contact lens
wearers causing irritation, protein
deposits and red eyes.
How is Dry Eye Syndrome Diagnosed?
 In-office diagnostic tests can be
used to evaluate both the quality
and the quantity of your tears. General
health, medications, environmental
factors and examination findings
are all important in determining
the factors contributing to your Dry
Eye Syndrome.
How is Dry Eye Syndrome Treated?
It is important to have the particular
factors contributing to your Dry
Eye Syndrome properly identifi ed.
Following this assessment, you will
have the greatest chance of symptom
relief with a personalised treatment
programme. As there are frequently
several factors contributing to Dry
Eye Syndrome, it is not uncommon
for treatment to be a staged process
in order to properly address the
various causes and to maximise long-term
comfort. With respect to the tear
film, tears need to be replaced or
conserved in order to provide relief.
- Replacing
Tears
Artificial tears are usually the
first line of treatment for Dry
Eye Syndrome. They give temporary
relief, and can be purchased without
a prescription. There are many brands
of preserved multi-dose artificial
tears. While these drops suit a few
people, if you need to use these
drops any more than three times daily,
the preservatives that they contain
will lead to toxicity and increasing
irritation. For frequent use, preservative-free
artificial tears are essential
(Bion tears, Cellufresh, Polytears-free
or Refresh).
 These preservative-free drops are
also safe to use with contact lenses. A
clever eye drop has recently been
developed. These multi-dose artificial tears
(Genteal or Refresh Plus) contain
a special type of preservative that gets
neutralised and disappears upon contact
with your own tears. Occasionally
thicker drops (Celluvisc, PolyVisc) or ointments
are required for longer lasting comfort.
In special situations, tear replacements
need to be manufactured from the
serum component of the patient ’s own blood.
- Conserving Tears
 In
cases of persistent dry eye symptoms despite the use of frequent
preservative-free artificial teardrops,
reduction
of tear drainage may be the best
solution. This temporary or permanent
closure of a tear drainage channel
is termed punctal occlusion.
You have four tear drainage channels,
one in each eyelid. For permanent
but reversible punctal occlusion,
silicone plugs can be placed
into one or more of the tear
drainage channels. Punctal occlusion
allows you to retain your own, natural
tears without the bother of constantly
replacing the tear film with
artificial tears.
What has Eye Institute done to help patients with Dry Eye
Syndrome?
Eye Institute has and continues to
be involved in dry eye research in
New Zealand. We have purchased an important
research tool called a Tearscope that
provides unique information about a
patient’s tear film. This Tearscope continues to be used
for the analysis of current dry eye
treatments and the development of new
treatments. Eye Institute introduced
the use of autologous human serum eye
drops in New Zealand. This has been
a sight-saving treatment for some patients
with severe dry eyes. Eye Institute
specialists are invited to lecture
to other eye care professionals as
well as annual lectures to members
of the NZ Sjögren’s
Society.
To make an appointment, or
to find out more information, fill out our enquiry
form, or contact Eye Institute's
friendly team on free phone 0800 393 527.
Affiliated provider benefit to Cataract Patients
- no need for prior approval
- no money up front for surgery
- Southern Cross pays us directly
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