Dry Eye

Wiping away tears over a sad movie or a good laugh is important for your heart, but let’s not forget that tears play an important role in the health of your eyes. A healthy adult is constantly producing tears. These tears help wash away irritations, provide lubrication and help keep the surface of the eye nice and smooth. However, most healthy adults do not have a steady flow of tears running down their cheeks, so where do they all go?

Each time you blink, your eyelids coat your eyes with tears. At the same time, your eyelids are acting as pumps to remove the previous tears. In the corner of your eyes, closest to your nose, there are drainage openings called “puncta.” Puncta allow the tears flow out of your eyes and into your nasal passage (not down your cheeks). Dry eye disease is the eye’s inability to either produce enough tears, or an overall lack of “quality” tears.

What Causes Dry Eye Disease?

Sometimes, the eyes just don’t produce enough tears. Other times, the tears being produced are not “good quality.” There are three main components that make up your “tear film.” When one of these components is not there or insufficient, dry eye symptoms will appear. This is commonly referred to as “evaporative dry eye.” There are a few reasons why you could develop dry eye disease. The most common is growing older. By the age of 45, most people will be experiencing some symptoms of dry eye. As we grow older, decreased hormone production can lead to a dysfunction in tear production. A common risk factor is gender. Because of the hormonal changes that occur in women during pregnancy or menopause, women are at a higher risk of developing dry eye. Other causes can be certain lifestyle choices, such as smoking, or environmental issues such as being in a dry and windy climate. Even staring too long at a computer screen can cause dry eye disease. Autoimmune diseases, such as rheumatoid arthritis or diabetes, are also known to cause dry eye disease. Blood pressure medication, decongestants and antidepressants can also result in dry eye disease.

Diagnosing Dry Eye Disease

Diagnosing dry eye disease is not as easy as simply realizing you have dry eyes. There could be contributing factors that need to be examined by your doctor. In addition to the factors mentioned above (environment, age, etc.) Dr. Alan Mendelsohn or Dr. Nathan Klein will need to examine your eyes, your eye lids and the surrounding area to determine what is causing your symptoms.

There are multiple tests available to diagnose dry eye disease. Alan Mendelsohn, M.D., and Nathan Klein, O.D. may perform multiple tests, as different types of dry eye require different methods of diagnosis. Unlike retail eye centers, Eye Surgeons and Consultants features the most state-of-the-art diagnostic equipment, which allows us to both measure the quantity of tears that the eyes produce AND evaluate the exact cause of our patients’ dry eye disease.

Treating Dry Eye Disease

Treatment for Dry-Eye Disease is dependent on the cause. Frequently, adding additional tears via over-the-counter eye drops is sufficient. The supplemental tears should be used four times a day; occasionally, drops at two-hour intervals are required to clear the symptoms. Drs. Mendelsohn and Klein recommend refrigerating these over-the-counter eye drops because at lower temperatures, the viscosity of the drops increase and they are better able to penetrate the eye.

If over-the-counter drops aren’t working for you, Alan Mendelsohn MD, FACS, and Nathan Klein OD, often recommend one of two prescription options: Restasis or Xiidra. Restasis can help your eyes’ natural ability to produce tears. These drops contain cyclosporine, which is an immunosuppressant and should be utilized one drop, twice a day. While Restasis is more convenient and often more effective than the over-the-counter eye-drops, it brings with it unfortunate side effects, including blurred vision, burning, or mild discomfort. Albeit very rare, worrisome allergic reactions to Restasis can develop, which may include hives, difficulty breathing, and swelling of the face, lips, tongue, or throat.

In 2016, an additional prescription medication for dry eyes surfaced: Xiidra. This medication works by reducing inflammation in the eye that can contribute to dry-eye. These drops should be utilized one drop, twice a day. While Xiidra is more convenient and effective than the over-the-counter options, it brings with it side effects. Most common adverse reactions are ocular irritation, impaired sense of taste, and reduced visual acuity.

While rare, Restasis and Xiidra’s side effects can be formidable. In addition, many insurance companies won’t cover these medications and the high annual out-of-pocket cost encourages many patients to seek alternative options. Dr. Nathan Klein specializes in performing a two-minute in-office non-invasive procedure called punctal plug insertion. The microscopic-sized punctal plugs are inserted into tear ducts to increase the eyes’ tear film and surface moisture. Dr. Klein works with each individual patient to customize plug placement for ideal comfort and ocular surface health. Following the insertion of punctal plugs, patients do not experience pain or downtime and can resume normal activities immediately, including exercising and swimming. Due to his excellent skills and gentle touch, Dr. Klein is able to ensure patients are thrilled with their tremendous symptom relief and newfound comfort.

If you are dealing with dry eye syndrome and would like to discuss your treatment options, be sure to contact Eye Surgeons and Consultants of Hollywood, Florida today! Dr. Alan Mendelsohn and Dr. Nathan Klein boast years of experience and are happy to help you get rid of your frustrating dry eye symptoms. Call (954)894-1500 to set up your appointment today.


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