Dry Eyes

For : Dry Eyes, a Sandy / Gritty feeling, a Burning Sensation, Irritation, Reflex Tearing, Contact Lens Intolerance Laser Eye Surgery

Dry eyes are our worst enemy as there is no cure for dry eyes.  We can listen to you and offer options that make sense for your particular concerns but only you can tell us what works and what does not work.  Amazingly, the proper combination of Omega 3 Triglyceride + vitamin D3 + vitamin A palmitate does an amazing job of helping post menopausal women with dry eye complaints.  Link here to Dry Eye Vitamin Therapy

The incidence of dry eye increases with age as the tear chemistry changes – especially in post-menopausal women.  In most cases the rate of tear evaporation rises and the ability of our tears to stick to the surface of the eye depletes especially when we stare at a computer, work in a place with dry heat and dry air conditioning or take medications that reduce tear production.

Levels of Management:

Lid Hygiene.  The glands that produce oil to slow down the rate of tear evaporation are in our eyelids.  Using a warm compress over closed eyes for even 10 seconds is enough to help keep the oil glands working.  Some people have a chronic eyelid condition called blepharitis, which contributes to dry eye.  In these cases this clinic would prescribe a foam to apply on the eyelids at bedtime for one week every month to sterilize the bacteria that lead to blockage of the oil glands in the eyelids.

Eye Drops can be used to provide relief but most eye drops for dry eye are made of methylcellulose which is like water – it goes on and flows off but does not provide long term relief.

Do not use the “get the red out” eye drops to treat dry eyes.  Redness is a response to the dryness.  If the eyes are not dry then they won’t be red.  The redness is a dilation of the surface blood vessel to serve the surface cells which are compromised under dry eye conditions.  The “get the red out” drops constrict blood vessels to make an eye look white but these drops can have a rebound effect which makes an eye look even redder over time.  It is better to treat the problem and not the symptom.

Lubricating eye drops containing vitamin A are a good choice as topically applied vitamin A works as nature’s steroid to reduce the inflammation of the surface cells secondary to a dry ocular surface.  It is this surface swelling (inflammation) that causes the sandy-gritty feeling, burning sensation and sensitivity to bright lights often associated with dry eye.

The better eye drops are those made with sodium hyaluronate as these drops last about an hour and absorb / retain any tears you have.  More important, these drops stop tears from evaporating.

In significant cases – when an eye is dry upon waking – this clinic might prescribe an ointment that is applied at bedtime.  This ointment would last all night long and allow the surface cells to regenerate so that the next day is a better day with fewer symptoms of dryness.  This ointment is used three nights in a row on an as needed basis.

Allergy sufferers may also have dry eye symptoms.  This clinic will treat the primary problem – the allergy – which then usually reduces the dry eye symptoms associated with the inflammation secondary to the allergic response.

Punctal Plugs – the tears drain into four little holes (puncta) – one for each eyelid.  In significantly dry eyes with a low tear volume these holes can be plugged to retain tear volume.  Most dry eye patients benefit from plugging two of the four holes so that they get symptomatic relief but retain some fluid flow through the tear ducts to keep the internal canals clean, healthy and free of infection.

Permanent silicon plugs were formerly the standard plug however recent reports have revealed that many people have an adverse reaction to silicon resulting in the need for surgical removal of the silicon plug from an inflamed canal.

Temporary plugs are made of collagen and last for about one week before they naturally pass through the drainage system.  These plugs are used to determine if a longer lasting option is reasonable.

Three-month hydrogel plugs are a safer, long lasting but not a permanent solution.  A hydrogel plug is small, soft and swells to fill the tear canal after it is placed into the canal.  These soft tear-soaked plugs pass through the tear drainage system at a very slow rate.  Using two plugs is usually adequate to provide relief.  Chronic dry eye sufferers renew their punctal plugs on a three-month cycle.

Foods that are known to reduce dry eye symptoms include:

  • Omega-3 fatty acids
  • Flax seed
  • Corn
  • Soybeans

Medications Associated with Dry Eye

  • There are 124 medications listed in Fraunfelder’s Drug-Induced Ocular Side Effects (5th Edition) which are know to reduce tear production. Common culprits include:
  • Decongestants
  • Anti-acne agents
  • Anti-histamines
  • Anti-anxiety agents
  • Beta-blockers
  • Anti-cholinergics
  • Oral contraceptives
  • Anti-depressants


Call us at (604) 681- 5351 or fill in the appointment form…