DRY EYE SYNDROME
ARE YOU LOOSING SPARKLE IN YOUR EYES?
God had created a mechanism to keep our eyes sparking, moist, free of waste products and infection, and lubricated to make the blinking and winking friction free.
The age, the pollution, the hormonal changes in the body, the exposure to breeze and air-conditioner and professional demand to have staring look at the computer screen etc cause deficiency of tear secretion or excess of evaporation of tears leading to collection of waste products in the conjunctival sac resulting in discomfort, foreign body sensation, irresistible desire to massage the eyes and sprinkle water to remove the waste products.
A unique gland, named lachrymal gland constantly forms the tears which have multiple qualities of nourishment, scavenging, moistening, lubricating and antibacterial.
With the age, the tear formation generally decreases. This change occurs much earlier in ladies due to change in hormones at the menopausal age , i.e, at the age of 40-50 years and a decade later in males. At menopausal age in women, an imbalance occurs between the oestrogen and androgen hormone. Decrease of androgen excites inflammation of lacrimal gland resulting in decreased tear formation.The problem becomes much more intensified when exposed to pollution which causes chronic inflammation of conjunctival sac. With the advancing age the incidence of dry eye is noted in 15-30 percent of the population. In cases of some body inflammation, namely Rheumatoid arthritis, patient's own immune system attacks his lacrimal gland, causing severe dry eye. Systemic drugs like antidepressants, antihypertensives, antihistaminics, anticholinergics, antipsychotics, angiolytics, antiparkinsonians, diuretics and hormones too can cause dry eye. The use of contact lenses and the LASIK surgery for removal of glasses has further swelled the incidence of dry eyes.
Even topically applied drugs which most often have preservatives, can cause dryness of eyes. Glaucoma patients who have to use drugs for long time are more prone to get dry eyes.
Computer Vision Syndrome
Young persons engaged in prolonged computer use, have to stare constantly, which can lead to excess of evaporation of tears ,leading to dry eye sympotoms.This condition is classically called Computer Vision Syndrome. It is advised that the computers are kept at lower level than the eyes, use anti glare screen or Anti Reflect Coated spectacle lenses and develop a habit to blink at least 15-18 times every minute and take some rest at intermittent intervals.
Treatment
Best treatment is to avoid exposure of eyes to pollution, direct wind and breeze of air condioner and any type of over exposure. Topical drugs used should preferably be preservative-free..
Computer users must take precautions as stated earlier.
The best available treatment at present is palliative. Artificial tear drops made with Carboxymethyl Cellulose Sodium.or Hydroxypropylmethyl Cellulose or Sodium Hyaluronate having no preservative, most often relieve all symptoms but the treatment has to be continued for long period. In cases where severe dry eye is suspected, an immunomodulator drug,namely Cyclosporin A drops may be used to treat ocular surface and lacrimal gland inflammation to a significant extent.
Future Therapies.
Apart from tear substitutes, anti-inflammatory therapy, androgen hormone replacement, and tear stimulant diquafosol tetrasodium may form main therapeutic measures. Herbal supplements such as oil of primrose and flax seed oil are reported to be help in relieving symptoms of dry eye and Meibomitis. Essential fatty acids of omega '3 and specially Omega-3 category as food supplements are showing some promising results.
Surgical intervention is indicated in only certain conditions with limited therapeutic advantage.
