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 Post subject: Dry Eye 101
PostPosted: Fri Jun 09, 2006 11:23 pm 
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http://www.nei.nih.gov/health/cornealdisease/#d

Dry Eye. The continuous production and drainage of tears is important to the eye's health. Tears keep the eye moist, help wounds heal, and protect against eye infection. In people with dry eye, the eye produces fewer or less quality tears and is unable to keep its surface lubricated and comfortable.

The tear film consists of three layers--an outer, oily (lipid) layer that keeps tears from evaporating too quickly and helps tears remain on the eye; a middle (aqueous) layer that nourishes the cornea and conjunctiva; and a bottom (mucin) layer that helps to spread the aqueous layer across the eye to ensure that the eye remains wet. As we age, the eyes usually produce fewer tears. Also, in some cases, the lipid and mucin layers produced by the eye are of such poor quality that tears cannot remain in the eye long enough to keep the eye sufficiently lubricated.

The main symptom of dry eye is usually a scratchy or sandy feeling as if something is in the eye. Other symptoms may include stinging or burning of the eye; episodes of excess tearing that follow periods of very dry sensation; a stringy discharge from the eye; and pain and redness of the eye. Sometimes people with dry eye experience heaviness of the eyelids or blurred, changing, or decreased vision, although loss of vision is uncommon.

Dry eye is more common in women, especially after menopause. Surprisingly, some people with dry eye may have tears that run down their cheeks. This is because the eye may be producing less of the lipid and mucin layers of the tear film, which help keep tears in the eye. When this happens, tears do not stay in the eye long enough to thoroughly moisten it.

Dry eye can occur in climates with dry air, as well as with the use of some drugs, including antihistamines, nasal decongestants, tranquilizers, and anti-depressant drugs. People with dry eye should let their health care providers know all the medications they are taking, since some of them may intensify dry eye symptoms.

People with connective tissue diseases, such as rheumatoid arthritis, can also develop dry eye. It is important to note that dry eye is sometimes a symptom of Sj?gren's syndrome, a disease that attacks the body's lubricating glands, such as the tear and salivary glands. A complete physical examination may diagnose any underlying diseases.

Artificial tears, which lubricate the eye, are the principal treatment for dry eye. They are available over-the-counter as eye drops. Sterile ointments are sometimes used at night to help prevent the eye from drying. Using humidifiers, wearing wrap-around glasses when outside, and avoiding outside windy and dry conditions may bring relief. For people with severe cases of dry eye, temporary or permanent closure of the tear drain (small openings at the inner corner of the eyelids where tears drain from the eye) may be helpful.

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 Post subject:
PostPosted: Fri Jun 09, 2006 11:50 pm 
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http://www.theschepens.org/dry_eye_fact_sheet.htm

Quote:
The diagram on this website, the tear film, shows the layers of the tear film and the location of the glands responsible for the secretion of the film's components onto the surface of the eye: The outer, oily layer of the tear film is produced by the meibomian glands in the eyelids and reduces evaporation of the tears. The thick, middle, watery layer is made by the lacrimal gland above the upper eyelid and washes away irritants. The inner, mucus layer is secreted by the goblet cells in the conjunctiva of the eyelids and helps the tear film stick to the cornea.


http://www.theschepens.org/tear_film.htm

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 Post subject:
PostPosted: Thu Jun 15, 2006 1:29 pm 
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EyeWorld
June, 2006

Tear film stabilization: tools and treatments

by Mark B. Abelson, M.D., George Ousler, and Michael Schindelar

Excerpt:

The tear film often is described as being comprised of three distinct layers: mucin, aqueous, and lipid. Though in actuality, these layers mesh somewhat in a healthy tear film to form one overlapping interconnected unit covering the ocular surface, with each melding into the next.
When any one of these layers is inadequate or absent, the cohesive tear film structure begins to deteriorate. Thus, the stability of each tear film layer is determined by the delicate balance of the three component layers, which dynamically are replenished by the act of blinking and subject to the effects of viscosity, surface tension, gravity, and evaporation.i
The glycocalyx extending from the ocular surface provides the scaffold upon which the inner layer of the tear film is built. It resembles a cotton candy?like meshwork of small molecules, anchored by membrane-bound mucins, extending from the ocular surface cells.
This provides an ideal system onto which the unbound mucins in the tear film will anchor. This coating allows the aqueous layer to spread evenly across the ocular surface, and the system is topped by an external lipid layer that helps retard evaporation of the entire tear film.
The function of this unit, as a whole, is to both lubricate and protect the surface of the conjunctiva and cornea. The microenvironment of the tear film is subject to alteration due to numerous factors, including the delicate balance of nutrients, oxygenation, and hydration that must be maintained for a healthy ocular surface.

Read the entire article at:
http://www.eyeworld.org/article.php?sid=3213

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 Post subject:
PostPosted: Thu May 03, 2007 1:51 am 
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http://www.revophth.com/index.asp?page=1_13334.htm

"Dry-eye syndrome can have a significant impact on visual function that can diminish a person?s quality of everyday living, according to researchers in Boston."


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 Post subject:
PostPosted: Mon Jun 25, 2007 12:16 am 
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Tear Volume and Stability After LASIK

Journal of Refractive Surgery Vol. 23 No. 3 March 2007

Sudi Patel, PhD, FCOptom, FAAO; Jorge L. Ali?, MD, PhD; Alberto Artola, MD, PhD; Maria-Jose Martinez, OD


Quote:
Tear stability <10 seconds is normally indicative of a dry eye...

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 Post subject:
PostPosted: Thu Jun 28, 2007 12:32 pm 
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Review of Ophthalmology
11/1/2005

http://www.revophth.com/index.asp?page=1_823.htm

Quote:
To diagnose dry eye, I prefer to use Schirmer?s tests with anesthesia, and will start Restasis if the test result is 5 mm or less.

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 Post subject:
PostPosted: Mon Oct 29, 2007 10:23 pm 
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Typical signs and symptoms of ocular surface disease

Sore or tired eyes
Burning or itchiness
Stinging
Foreign body sensation
Light sensitivity
Decreased tear volume
Decreased tear breakup time
Tear film instability
Tear film debris
Vision impaired
Ocular discharge
Corneal superficial punctate staining
Conjunctival staining
Conjunctival hyperemia
Thickened lid margins, blepharitis
Corneal eronsions, ulcerations

Source: http://www.osnsupersite.com/view.asp?rID=24299
OCULAR SURGERY NEWS EUROPE/ASIA-PACIFIC EDITION October 2007

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"The price good men pay for indifference to public affairs is to be ruled by evil men." Plato


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 Post subject:
PostPosted: Wed May 28, 2008 2:38 pm 
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http://www.escrs.org/PUBLICATIONS/EUROT ... ations.pdf

"Dry-eye syndrome after LASIK with transient
poor visual acuity, burning and stinging, a subjective
feeling of dryness, and significantly increased rate
of regression, is due to a neurotrophic
epitheliopathy that includes increased tear film
osmolarity, decreased goblet cell density, decreased
corneal glycogen, and a decreased tear film lipid
layer.While the majority of cases improved over
time, 20 per cent of cases with dry eye persist for
longer than six months after surgery."


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