Dry Eyes

Article Submitted by Dr. Logan Smith of Birmingham Eye Center. He can be reached at 595-5544.

As the years go by we all begin to notice that our eyes get more tired throughout the day. As we age our eyes put out less tears. This is called dry eyes or tear dysfunction. Why does this happen?

The tear film that covers our eye is very complex. It is made up of three layers. Next to the eye is a mucous layer that attaches to the eye on one side and holds water with the other. Over this is the watery or aqueous layer. And on top of that is an oily layer that prevents the tears from evaporating. Pretty complex for a film the thickness of a soap bubble.

Each of these layers can be affected by life events and by time. The mucous and aqueous layers are produced by "goblet cells" and tear glands in the conjunctiva, the tissue covering the eyeball itself. Infections, trauma, and toxins can all reduce the number of cells producing these components. The oily layer of tears is produced by oil glands in the eyelid that open right behind the eyelashes. These glands can have chronic infections that reduce the layer and let tears evaporate.

To diagnose tear dysfunction requires a thorough examination focusing on the whole exterior of the eye and surrounding tissue. Treatment of chronic infection can make a big difference in comfort. But the bedrock of treatment for dry eye is artificial tears. There are many brands but the big difference between brands is the type of preservative used in the solution. By the way one should never use anything for "reducing redness." This is very bad for you in the long run.

There is also a new treatment for dry eyes called "Restasis." It is a drug called Cyclosporine, used originally to reduce rejection in transplant operations. It can be helpful in some patients. But to determine what type of problem is causing your dry eyes and the best treatments you should be examined by your ophthalmologist.