Dry Eye

Causes, symptoms and treatments

What is dry eye?

Dry eye is a condition where the corneal surface or conjunctiva are affected due to insufficient tear production by the lacrimal glands or disturbances in tear composition. Eye lubrication is therefore deficient and eye discomfort may appear and even worsen, giving place to severe corneal lesions.

20% of the world’s population is affected by dry eye. Over 65, this percentage rises up to 75%.

Dry eye

What causes it?

As mentioned before, the principal causes of dry eye are insufficient tear production or disturbances in tear quality, but what are the causes of these?

  • As part of natural aging, cells in charge of tear production undergo atrophy and tear production decreases.
  • Hormonal changes in women are also involved in tear production. For example: pregnancy or hormonal contraceptive methods.
  • Environmental factors are essential: if there is excessive evaporation, tear production decreases and dry eye appears.
  • Lack of blinking, as when reading or using computers for long periods of time.
  • Contact lens use
  • Certain ocular disorders, such as severe viral conjunctivitis, or systemic diseases, such as Sjögren syndrome.

Symptoms

Dry eye is easily detectable as its symptoms are very noticeable. These include eye irritation, burning, redness, fatigue and excessive tearing. This may sound contradictory as tear deficit should not produce excessive tearing, but what actually happens is that our organism reacts to this tear deficiency by “naturally flooding” the eye’s surface.

Early diagnosis and treatment are crucial in order to stop severe disorders from appearing, such as keratitis, scars, corneal ulcers or even vision loss. Therefore, it is very important to visit an ophthalmologist if these symptoms appear.

Lacrimal gland


Possible treatments

Prevention is with no doubt, the best possible treatment. There are many ways to relieve dry eye, which is a very common condition especially amongst elderly people and women undergoing hormonal changes. These include:

  • Avoiding air conditioning.
  • Using sunglasses to protect the eyes against dust, smoke or other harmful external agents.
  • Increase in blinking frequency.
  • Avoiding dry environments. Humidifiers, which can be bought in pharmacies, are a good solution.

The most common treatments used for mild cases are:

  • Artificial tears several times a day or ophthalmic ointment especially at night.
  • Insertion of punctal plugs to avoid tear drainage into the small openings of tear drainage ducts.
  • Etiological treatment if underlying diseases.

If these treatments are insufficient, more sophisticated treatments can be used:

  • Autologous serum.
  • Plasma rich in growth factors.
  • Surgery: tarsorrhaphy or joining the upper and lower eyelids.

Plasma rich in growth factors (PRGF-Endoret)

Proteins known as “growth factors” are used to regenerate damaged corneal surface tissue in severe dry eye cases. These factors are in charge of crucial tissue-repairing processes such as cellular proliferation, migration and differentiation and extracellular matrix synthesis.

Tears are a fundamental organic substance which play an important role in the maintenance of the corneal epithelium as they contain the previously mentioned growth factors.

Plasma rich in growth factors is obtained from the patient’s own blood as they are in higher concentrations than in natural tears. The blood is centrifuged to obtain the growth factors and the rest is discarded. Calcium chlorate is added so that platelet-derived growth factors are released and the serum is then prepared.


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