Dry Eye Syndrome; Key Q&A.

* What is dry eye syndrome?

Dry eye syndrome is a group of disorders affecting the film of tears over the eye. When you have dry eye syndrome, either you don't produce enough tears, or you have poor quality tears and excessive tear evaporation.

* Who is at risk for dry eye syndrome?

Dry eye occurs most often in the elderly, and nearly 75 percent of people over age 65 may experience dry eye symptoms, according to Schepens Eye Research Institute in Boston, the largest independent eye research institute in the U.S. and an affiliate of the Harvard Medical School. Although the cause of dry eye syndrome is unknown, it tends to occur more often in women, especially those who are pregnant or postmenopausal. Nearly 3.2 million American women and more than one million American men age 50 and older suffer from painful and debilitating dry eye syndrome, according to results of a recent study administered by the Schepens Eye Research Institute and Brigham and Women's Hospital. The condition affects women two to three times more than men.

* How do I know if I have dry eye syndrome?

The early symptoms of dry eye syndrome include eye redness; a burning, stinging, and/or gritty sensation in the eye, especially in an environment with low humidity; a feeling that something is in the eye; trouble wearing contact lenses; and a gritty feeling that is persistent and painful. In minor cases, these symptoms may come and go. As dry eye worsens, the symptoms become more persistent. Severe cases of dry eye may also have eyes that are unusually sensitive to light, and may experience severe eye pain or notice changing vision.

* What's a Schirmer test? Will it hurt?

A Schirmer test measures your tear production. It is often conducted when your health care professional sees a lack of a tear pool during the initial slit lamp examination, and finds dry areas in one of the stain tests. Your health care professional will take a special strip of filter paper, put a tiny fold in it, and place it on the tear pool on the edge of the lower eyelid. The paper remains in place for five minutes, absorbing the tears. The test produces no pain, but some patients find it slightly uncomfortable. It does not affect vision. After the five-minute time period, the paper strip is removed and the area of wetness measured in millimeters (mm). A wetness area of 15 mm is normal. A reading of 10 mm is below normal, but most patients can tolerate it, and may have a few symptoms. A reading of 5 mm is low, and most patients at this level do have some symptoms. Patients with many dry eye symptoms may have a reading of 2 mm or lower.

* Can dry eye syndrome be cured?

No, but it can be treated. The cause of dry eye at this time is unknown. Dry eye can be associated with rheumatoid arthritis. It also is a symptom of Sjogren's syndrome, an autoimmune disease that attacks the body's lubricating glands, such as the tear and salivary glands. And, it can be a side effect of a variety of over-the-counter and prescription medications. Because there is no cure, health care professionals direct treatment at managing symptoms.

* What is the most common treatment for dry eye?

Over-the-counter artificial tears in the form of eye drops are the mainstays of dry eye treatment. Most health care professionals recommend you take the drops as often as you need them to relieve symptoms. Your health care professional can recommend what brands may be best for you.

* Artificial tears don't seem to be relieving my dry eye symptoms. Will punctal plugs help me?

Possibly, but talk to your health care professional about what treatment might be right for you. In cases of moderate to severe dry eye, a temporary or permanent plug about the size of a sesame seed can be inserted into some of the channels, or puncta, at the inner corner of the eyelid where tears drain into the nose and back of the throat. This helps conserve tears. Plugs are inserted by your health care professional in the office in minutes using a magnifying instrument to best see the punctum. Collagen punctal plugs eventually dissolve, and often are used to see whether permanent plugs will help the eye retain tears and can be tolerated by the patient. Silicone punctal plugs are considered permanent, although your health care professional can remove them.

* How can I prevent dry eye syndrome?

There is no way to prevent dry eye syndrome. But, you can help preserve your tears by avoiding anything that can cause dryness, such as hair dryers, rooms with low humidity, and wind. Placing a humidifier in the room when indoor heat is used, and wearing wrap-around glasses when outside may provide some relief from dry eye. Smoking is especially bothersome to dry eye sufferers, and should be avoided.

Bensinger, R, MD, FAAO, spokesman for the American Academy of Ophthalmology, and chief of ophthalmology at Swedish Hospital, Seattle, WA. Direct interview. Nov. 6, 2000.

"Dry Eye Syndromes, Your Questions Answered." The Schepens Eye Institute, Harvard Medical School. http://www.eri.harvard.edu. Accessed Sept. 2002.

"Fact Sheet: The Cornea and Corneal Disease." National Eye Institute. http://www.nei.nih.gov. June 2001. Accessed Sept. 2002.

"Frequently Asked Questions About Dry Eye." Prevent Blindness America. http://www.preventblindness.org. Updated May 2003. Accessed Sept. 2003.

"Hydroxypropyl Cellulose (Ophthalmic)." Medlineplus Health Information, National Library of Medicine. Updated Sept. 2002. http://www.nlm.nih.gov. Accessed Sept. 2002.

Petrauskas, JL, MSPH. "Digging in the Ocular Desert." EyeNet Magazine Online. American Academy of Ophthalmology. http://www.aao.org. July 2000. Accessed Sept. 2003.

"Studies Show Promise for Drug to Treat Dry Eye Syndrome." American Academy of Ophthalmology. http://www.medem.com. News release April 11, 2000. Accessed Sept. 2002.

"Dry Eye Syndrome" EyeMDLink. Updated Oct. 2001. http://www.eyemdlink.com. Accessed Sept. 2002.

"Conjunctival Histologic Findings of Dry Eye and Non-Dry Eye Contact Lens Wearing Subjects" The CLAO Journal. Jan. 2001. http://www.clao.org. Accessed Sept. 2002.

Cross WD et al. "Clinical and Economic Implications of Topical Cyclosporin A for the Treatment of Dry Eye." Managed Care Interface. Vol. 15 (9): 44-9. Sept. 2002.

Sullivan DA et al. "Androgen Deficiency, Meibomian Gland Dysfunction, and Evaporative Dry Eye." Annals New York Academy of Sciences. Vol. 966: 211-22. June 2002.

"LASIK Safe, Effective in Patients With Dry Eyes" Medscape Medical News. Aug. 16, 2002. http://www.medscape.com. Accessed Sept. 2002.

"Hormone Replacement Therapy and Dry Eye Syndrome" JAMA. Vol. 286 No. 17, Nov. 7, 2001. http://jama.ama-assn.org. Accessed Sept. 2002.

"New Dry Eye Therapy Launched" Sjogren's Syndrome Foundation. 2003. http://www.sjogrens.com. Accessed Sept. 2003.

Schaumberg DA, et al. "Prevalence of Dry Eye Syndrome Among US Women" Aug. 2003. American Journal of Ophthalmology, 136:2 : 318-326.

Editorial Staff of the National Women's Health Resource Center 2002/03/07 2005/03/16 Tears are what keep your eyes moist, lubricate the surface of the eye for eyelid closure, and guard against infection. They also keep the eyes smooth and clear. Without tears, good vision is impossible. Dry eye syndrome is a group of disorders affecting the film of tears over the eye. Aqueous,Dry eye syndrome,Fluorescein Stain Test,Keratoconjunctivitis sicca,Lipid,Mucin,Rose Bengal Test,Schirmer test