The surface of the eye is very dynamic as tears are produced in the temporal region of the eyelid and with each blink nourish and replenish the cornea while maintaining a healthy conjunctiva. Tears are then drained into your sinuses through your lacrimal puncta which are the openings of 2 small canals between your eyes and your nose. Excessive rubbing of the eyes can be quite detrimental to a functioning tear film as this disrupts the cyclic events that maintain proper gland functioning. These glands are responsible for good quality secretions which prevent inflammation on the surface of the eye. Inflammation associated with a low tear break up time manifests as a burning sensation. Lid hygiene is also crucial to a healthy surface as blepharitis and meibomian gland dysfunction are chronic issues that contribute dry eyes. There are 3 layers to our tears: In addition to the aqueous layer, there is a sticky mucous layer that facilitates adhesion to the cornea and a superficial oily layer that prevents tear evaporation. Many of the most common ocular symptoms such as redness of the eye, photophobia, glare, foreign body/burning sensation, as well as intermittent sharp pain represent an underlying dry eye condition. Excessive tearing (epiphora) can also be a sign of dry eyes as the eyes produce "reflex tears" when certain parts of the eye are not being properly hydrated and nourished. If you notice your eyes feeling very sensitive to changes in setting have your surface properly evaluated; I encourage you to try OTC products as well as the following supplemental options that can alleviate many mild cases:
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Systane/Refresh Artificial Tears
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Omega 3-6-9 via Fish Oil or Flaxseed Oil
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Genteal Ointment/Night Time Cover
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Hot Compresses/Ocusoft Lid Scrubs
Images from Left to Right:
Fluorescein staining of mild SPK on cornea due to marked dry eye (treatable w/Genteal)
Clogged Meibomian Glands (treatable with Complete Omega 3-6-9 & Lid Hygeine)
Characteristic fluorescein pattern of inflammatory dry eye (may need Restasis)
Images Above
Top Right: Ocusoft Lid Scrubs along with Hot Compresses treat Blepharitis, which is often an underlying cause of Dry Eye Syndrome.
Bottom Left: Punctal Plug inserted into inferior punctum. Superior punctum patent for aqueous flow
Bottom Right: Restasis, Anti-Inflammatory Agent
If your dry eye symptoms do not resolve with OTC products, you may have an underlying condition causing decreased aqueous tear production and/or chronic inflammation. These are often side effects of many common systemic medications and can be treated with relative ease via Punctal Plugs and/or Restasis. Inserting a biodegradable collagen or silicone plug into the inferior punctum allows for tears to stay in the eye 50% longer which is often breakthrough for longstanding cases. Restasis is a form of cyclosporine which is a natural cure-all and results in better quality and quantity of tears. These are covered by most medical insurances and something I do nearly every day. Recently Xidran has also been prescribed for complicating dry eye.