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Frequently Asked Questions About Chronic Dry Eye

What is Chronic Dry Eye?

Chronic Dry Eye (also known as keratoconjunctivitis sicca) can be defined as a condition involving abnormalities and deficiencies in the tear film initiated by a variety of causes. Many Chronic Dry Eye sufferers experience a reduced ability to produce tears in sufficient quantity or quality.

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What are the causes of Chronic Dry Eye?

Chronic irritation of the surface of the eye can eventually cause a disruption in the normal tear-producing system, including the lacrimal gland. This results in declining production, quantity, and quality of natural tears. High risk factors for Chronic Dry Eye include hormonal changes associated with aging and menopause, autoimmune diseases such as arthritis, lupus, and Sjögren's Syndrome, diabetes, or blocked tear ducts.

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What about allergies and weather conditions?

Environmental, occupational, and lifestyle factors, such as allergies, smoke, dry air, dust, the wearing of contact lenses for extended periods of time, or prolonged computer use can aggravate Chronic Dry Eye, but they are not the cause. The cause of Chronic Dry Eye is a dysfunction of the tear-producing glands.

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What is the prevalence of Chronic Dry Eye?

It is commonly accepted that the prevalence is greater in women than men, and is most prevalent between the ages of 18 and 65. A cross-sectional survey conducted in the United States places the prevalence of Chronic Dry Eye at more than 3.2 million women over the age of 50.1

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What are the symptoms of Chronic Dry Eye?

Symptoms include: feeling of dryness and/or not enough tears, the need to blink constantly, itching and/or burning, irritation and/or pain, foreign body sensation (“sand in the eye”), sensitivity to light, blurred vision, lack of tears alternating with excessive tearing, difficulty opening the eyes after sleeping and tendency of contact lenses to “stick.” Patients with moderate to severe Chronic Dry Eye may find they have a more and more frequent need to use artificial tears.

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What functions and activities can be adversely affected by Chronic Dry Eye?

Functions/activities adversely affected by Chronic Dry Eye include reading, working on the computer, doing “close” work (such as embroidering, sewing, etc.), driving at night, being in bright sunlight, and being in an environment with bright or fluorescent lights.

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What are the possible long-term effects of untreated Chronic Dry Eye?

If left untreated, Chronic Dry Eye can

  • Damage the delicate tissues of the eye’s surface and disrupt the cornea of the eye, which may lead to impaired vision
  • Make patients who have it more vulnerable to eye infections

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How is Chronic Dry Eye diagnosed?

  • Schirmer test – used to measure ocular moisture that collects over a specific period of time
  • Staining – used to highlight areas of possible damage to the ocular surface
  • Slit lamp examination – used to determine changes in the ocular surface. Many times this is used in conjunction with staining
  • The Ocular Surface Disease Index© (OSDI©) is a validated instrument accepted by the FDA for use in diagnosis of Chronic Dry Eye. This questionnaire provides rapid and accurate assessment of range of symptoms, severity of symptoms and impact of symptoms on patient’s performance of daily functions.

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What treatments are available for Chronic Dry Eye?

Management approaches for Chronic Dry Eye include:

  • Artificial tears
  • Prescription therapies
  • Punctal plugs

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What do artificial tears do?

Over-the-counter artificial tears can provide temporary symptom relief by lubricating the eyes. Some over-the-counter drops, designed to get rid of redness, may actually worsen the condition and create potential eye health problems.

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References
1. Schaumberg DA, Sullivan DA, Buring JE, Dana MR. Prevalence of dry eye syndrome among US women. Am J Ophthalmol. 2003;136:2318-2326.