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Tearing eyes need attention.

It seems strange that tearing eyes need eye drops, but they do. Regular use of lubricating eye drops of the proper composition can help ease eye discomfort and prevent unsightly redness of the eyelid margins in many cases.

The reason you need moisture for eyes that already "water" is that tearing is frequently due to irritation. Eye-moistening drops reduce the irritation that causes watering in the first place.

Healthy tears form a smooth, uninterrupted film over the eye that is replenished with each blink. This complex film--comprised of mucus, water, and oil layers--keeps the cornea moist, cleans it of debris to promote clear vision, and protects the eye from bacteria and viruses.

When tears lack important components, however, the complex film breaks down, resulting in dry spots on the cornea that can trigger a cycle of eye irritation and excessive tearing.

We asked Indiana University ophthalmologist Dr. Shailaja Valluri about conditions that can cause disruptions in the tear film.

"There are several reasons why people get this problem," Dr. Valluri said. "As we age, we produce fewer tears. Some people may develop a dysfunction of the tiny oil-secreting glands that line the eyelids. In both instances, the tear film breaks down and tears evaporate faster than usual. In other patients, their eyelids do not close properly and, again, the tears evaporate too quickly.

"Medicines and systemic conditions may also interfere with the production of normal tears. People who have been on diuretics (water pills), allergy medications, and some antidepressants may be at risk. Those with rheumatoid arthritis and connective tissue diseases such as lupus often experience eye symptoms. In addition, HIV infection may damage or destroy the tear-producing lacrimal glands."

Doctors recommend the lubricating eye drops for moderate to severe symptoms. If all else fails, surgery may help. In a very common procedure, eye surgeons can tighten a lax lower eyelid to help keep tears from evaporating. Left untreated, irritated and tearing eyes can lead to more serious problems such as blurry vision, cornea infections, and even an ocular surface disease called keratoconjunctivitis sicca.

On another front, recent research suggests that inflammation may contribute to chronic, ineffective tearing.

"There is a new theory that 'dry eye' is not solely an insufficiency of tears but is also an inflammatory process," reports ophthalmologist Stephen Massicotte. "An anti-inflammatory eye drop called Restasis is FDA-approved for the condition. The prescription eye medicine is basically topical cyclosporin. While I have prescribed the drug for only a few patients, it does seem to help people see and feel better."

Studies show that continued use of Restasis helps eyes form normal tears. The most common side effect is a burning sensation.
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Title Annotation:Medical Mailbox
Author:SerVaas, Cory
Publication:Saturday Evening Post
Date:Jan 1, 2005
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