Eye Care Eye Care Treatment

Dry Eye for the Regular Guy

There are now clinical trials ongoing where testosterone drops are actually being given to patients with certain forms of dry eye to see if they respond.

What are the symptoms?
Dryness of the eye can be present without signs or symptoms. But there are several dozen symptoms that can occur, including grittiness, foreign body sensation, irritation, pain, change in vision and redness. These symptoms might be helpful in diagnosis, but on the other hand, they're really not that helpful because there are many other conditions such as allergy, to name one, that can lead to many of the same symptoms. It has taken decades for people to realize that dryness is one of the most reliable symptoms used in the diagnosis of dry eye syndrome.

Are there risk factors for dry eye syndrome?
There are many factors that can either cause or exacerbate dry eye syndrome. A very common cause of dryness in the eye is soft contact lenses. Because soft contacts have a very high water content, they act like a sponge and suck up the moisture on the eye surface.

Another cause of dryness, which we keep seeing more and more of, is LASIK refractive surgery. All the reasons for it are not quite understood. But in essence, the cutting into the cornea leads to a cutting of the nerves whose functioning is important in the physiology of the cornea. And that leads to dryness.

Exposure to dry air, in particular, dry heat, which occurs in people's homes during the winter, or even exposure to air conditioning, which is dry air in the summertime, can also cause dryness. Another factor is exposure to wind.

Medications such as anti-hypertensive medications, diuretics, cardiovascular medications and psychotropic medications, including antidepressants, can lead to significant dryness. Antihistamines used in allergy treatments can also lead to dryness. Also, medications used by older men to control what is called BPH, or benign prostatic hypertrophy, likewise can cause dryness. There are many causes of dryness that can be explained, but there are plenty of people who have dry eye without any identifiable issue.

How does dry eye affect vision?
Two-thirds of refraction, or the bending of light, occurs at the interface between the air and the tear film of the eye. Without this bending, light could not get to the retina (the film in the back of the eye), which is required for vision. When the eye is dry, the tear film on the surface of the eye is not uniformly smooth, so the light does not always get bent in the proper way, and visual distortion occurs. One way of determining if someone has visual distortion from dryness is to have them blink a couple of times. If the distortion goes away, this is a pretty reliable indicator that at least part of their problem is due to dryness.

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