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"Dry Eye" What is dry eye? Some people do not produce enough tears to keep the eye comfortable. This is known as dry eye. There are two kinds of tears: those that constantly lubricate the eye and those that are produced as a response to irritation or emotion. Tears that lubricate are constantly produced by a healthy eye. Excessive tears occur when the eye is irritated by a foreign body or when a person cries. What are the symptons of dry eye? The usual symptons include stinging or burning eyes, scratchiness, stringy mucus in or around the eyes, eye irratation from smoke or wind, excess tearing, difficulty wearing contact lenses. Excess tearing from �dry eye� sounds illogical, but your tears must have the right balance of oil, water and mucus to protect the eyes. Without this balance, your eye produces too many tears because it is dry and irritated. What is the tear film? A film of tears, spread over the eye by a blink, makes the surface of the eye smooth and clear. Without our tear film, good vision would not be possible. The tear film consists of three layers: outer oily layer which smooths the tear surface and reduces the evaporation of tears, middle watery layer that cleanses the eye and washes away foreign particles or irritants, and the inner mucus layer that allows tears to adhere to the eye. What causes dry eye? Tear production normally decreases as we age. Although dry eye can occur in both men and woman at any age, women are most often affected, especially true after menopause. Dry eye can also be associated with arthritis and accompanied by dry mouth (Sjogren's syndrome). Medications can also cause dry eye by reducing tear secretion. Since these medications are often necessary, the dry eye condition may have to be tolerated or treated with �artificial tears�. Be sure to tell your ophthalmologist the names of all the medications you are taking; prescription and over the counter. How is dry eye treated? Tears are replaced by using eye drops called artificial tears, which imitate all of the layers in the tear film, by lubricating the eye and replacing the missing moisture. There are many brands of artificial tears on the market available without a prescription. You may have to try several to find the one you like best. If you need artificial tears more than every two hours, preservative-free brands may be better for you. Solid inserts that gradually release lubricants during the day may be beneficial to some people. Conserving your eyes' own tears is another approach to keeping the eyes moist. Tears drain out of your eye through a small canal into the nose. Your ophthalmologist may close these canals either temporarily or permanently to conserve your own tears and make the artificial tears last longer. Tears evaporate like any other liquid. You can take steps to prevent evaporation, which irritates the eyes. In winter, when indoor heat is on, a humidifier or a pan of water on the radiator adds moisture to dry air. Anything that adds to dryness, such as an overly warm room, hair dryer or wind, should be avoided by a person with dry eye. Smoking is especially bothersome. Some people with dry eye complain of �scratchy eyes� upon wakening. This sympton can be treated by using an ointment at bedtime. Use the smallest amount necessary for comfort, as the ointment can cause your vision to blur temporarily. American Academy of Ophthalmology |
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| FLOATERS AND FLASHES What are Floaters? The small specks, �bugs� or clouds that you may sometimes see moving in your field of vision are called floaters. They are tiny clumps of gel or cellular debris within the vitreous, the clear jelly-like fluid that fills the inside of the eye. Although these objects appear to be in front of the eye, they are actually floating in the fluid inside the eye and cast their shadows on the retina. What Causes Floaters? The vitreous gel degenerates in middle age, often forming microscopic clumps or strands within the eye. Vitreous shrinkage or condensation is called posterior vitreous detachment, and is a common cause of floaters. The appearance of floaters, whether in the form of little dots, circles, lines, clouds or cobwebs, may be alarming, especially if they develop suddenly. However, they are ususally nothing to be concerned about, and simply result from the normal aging process. Are Floaters Ever Serious? The vitreous covers the retinal surface. Occasionally the retina is torn when degenerating vitreous gel pulls away, causing a small amount of bleeding in the eye which may appear as a group of new floaters. A torn retina can be serious if it develops into a retinal detachment. Any sudden onset of many new floaters or flashes of light should be promptly evaluated by your medical eye doctor. What Can Be Done About Floaters? Floaters may interfere with clear vision and can be quite annoying. Although there is no treatment or cure for most floaters, they usually diminish by themselves over time. You can take simple measures to temporarily move them from your sight. If a floater appears directly in your line of vision, try moving your eye around. The inside fluid may swirl and allow the floater to move out of the way. Moving your eyes up and down will cause different currents within the eye and may be effective in getting the floaters out of the way. What Causes Flashing Lights? When the vitreous gel rubs or pulls on the retina, it sometimes produces the illusion of flashing lights or lightening streaks. The flashes of light may appear off and on for several weeks or months. This commonly occurs as we grow older and is usually not cause for worry. On rare occasions, however, light flashes accompany a large number of new floaters and even a partial loss or shadowing of side vision. When this happens, prompt examination by a medical eye doctor is important to determine if a torn retina or retinal detachment has occurred. The examination will involve a careful observation of the retina and vitreous gel after your pupils have been dilated with eye drops. The American Academy of Ophthalmology
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