Your eyes require a constant flow of tears to stay healthy and comfortable. If your eyes fail to make enough tears or if your eyes don’t make the right type of tears, you may have an irritating condition called dry eye.

July is National Dry Eye Awareness Month, so let’s take a look at the ailment in detail.

Every time you blink, a thin film of tears spreads across your eye to keep its surface smooth and clear. The tear film is made up of three layers: an oil layer for lubrication, a water layer for moisture and a mucus layer to make tears adhere to the surface of the eyes. While each layer serves an important purpose, oil and water are the most important components of the tear film.

You must have the right balance of oil and water to maintain a healthy tear film. Without oil, which is produced and released by the meibomian glands in the eyelids, the tear film becomes unstable and fails to spread evenly across the eye’s surface. As a result, the tears evaporate more quickly, resulting in dry eye. The meibomian glands can malfunction due to blockages of debris and hardened oil.

There are other potential causes for dry eye as well. Certain diseases, including rheumatoid arthritis, Sjogren’s syndrome, thyroid disease and lupus, can lead to dry eye. Being in smoky, windy or dry environments can contribute to the condition. Hormonal changes, such as those during menopause, are linked to dry eye, which may be why dry eye is nearly twice as common in women than in men.

Looking at computers and other digital devices for extended periods can cause dry eye because we tend to blink less when staring at screens. Wearing contact lenses for a long time or having had LASIK or cataract surgery can promote dry eye. Certain medications, including some antihistamines, diuretics, antidepressants and blood pressure medicines, can also dry your eyes.

Dry eye is a common condition. According to the National Eye Institute, nearly 16 million Americans have dry eye. Other sources suggest that as many as 48 percent of adult Americans regularly experience dry eye symptoms.

Symptoms include stinging and burning, fluctuating or blurred vision, a scratchy or gritty feeling like something is in your eye, redness or irritation, pain when wearing contact lenses, eye fatigue, light sensitivity, stringy mucus near your eyes, and an excess of tears.

Having lots of tears may seem odd when you have dry eye, but your eyes make more tears when they are irritated by dry eye.

Untreated, chronic dry eye can lead to serious complications, including eye infections, eye inflammation, abrasions of the corneal surface, corneal ulcers and vision loss. The cornea is the clear outer layer at the front of your eye.

To diagnose the condition, your doctor will first ask about your symptoms and general health, any medications you take and any environmental conditions you experience that may be contributing to your dry eye. The doctor will then perform a comprehensive exam to evaluate the surface of your eyes. The exam will likely include tests to measure the quantity and quality of your tears and an observation of tear flow and evaporation rate.

Treatment aims to keep the eyes well lubricated and prevent vision from being affected. The treatment approach taken depends on the severity of the condition. Mild cases can often be managed using over-the-counter artificial tears as needed to supplement natural tear production. Preservative-free preparations are recommended.

If your dry eye is more serious, your doctor may prescribe a medication such as cyclosporine (RESTASIS®, CEQUA™) or lifitegrast (XIIDRA®). These eyedrops are used twice a day to reduce inflammation and relieve the symptoms of dry eye.

To conserve the natural tears on the surface of your eyes, your doctor may recommend placing tiny silicone or gel-like plugs, called punctal plugs, to block the ducts that drain the tears. In extreme cases, surgery to permanently close the ducts may be performed.

Your doctor may recommend other treatments, such as intense-pulsed light (IPL) and the LipiFlow® Thermal Pulsation System.

Light energy from IPL warms the meibomian glands and any material clogging them. This allows the oil to flow normally from the glands into the tear film.

LipiFlow combines the controlled application of therapeutic heat with a gentle, pulsating massage. These functions work to liquify, then remove the clogging debris from the meibomian glands, enabling them to function efficiently.

A scleral lens is another way to keep the natural moisture on the eyes. This is a special contact lens that rests on the sclera, the white part of the eye. It creates a fluid-filled layer over the cornea, preventing it from drying out.

There are some steps you can take to improve dry eye. Humidify your bedroom to keep moisture in the air. Take frequent breaks when using a computer or other digital device. Wear wrap-around sunglasses when outside to protect your eyes from the wind and sun. Avoid dehydration by drinking eight to 10 glasses of water each day. Keep air from being blown directly into your eyes. Direct fans and car heaters away from your face.

And finally, use your artificial tears and/or prescription eyedrops as recommended by your doctor.

Patti DiPanfilo

Newborns can see colors and objects up to 12 inches away, and their vision gets progressively sharper as they get older. By the time they reach school age, children should possess clear, comfortable vision at all distances. But problems can develop as your child’s vision matures. Most childhood vision problems emerge between 18 months and 4 years old.

The most common vision problems affecting children are refractive errors, amblyopia and strabismus.

Refractive errors occur when the eye can’t focus light entering the eye onto the retina, the thin layer of nerve tissue lining the back of the eye. The retina organizes the light into nerve signals, which it sends to the brain to create visual images. When light isn’t focused on the retina properly, the images appear blurry. There are three main refractive errors: myopia, hyperopia and astigmatism.

With myopia, the eyeball is longer than normal or the cornea, the clear front part of the eye, is curved too steeply. This causes the light to focus in front of the retina instead of directly on it. As a result, your child sees near objects more clearly than objects far away. Myopia is also called nearsightedness.

With hyperopia, or farsightedness, the situation is reversed. Your child can see objects in the distance clearly but near object6s are blurry. In cases of hyperopia, the eyeball is shorter than normal or the cornea isn’t curved sufficiently, and the point of focus falls behind the retina.

Astigmatism is an imperfection in the shape of the cornea or lens of the eye. Instead of being round like a ball, the cornea with astigmatism is shaped more like a football, which distorts the light focusing on the retina. With astigmatism, vision is blurry at all distances.

Refractive errors are typically corrected with glasses or contact lenses. Your child’s eye doctor can prescribe the lenses that will give your child the clearest vision.

Sometimes, there’s a breakdown in the way the brain and eyes work together, and the brain doesn’t accept the visual images coming from one eye. The brain relies on the stronger eye, and the vision in the weaker eye gets worse. This condition is called amblyopia, or lazy eye, and it is the most common cause of vision loss in children.

Amblyopia can be caused by crossed eyes (strabismus) or a difference in the refractive error between the two eyes. If that’s the case, your child’s eye doctor will likely correct those conditions first. Treatments for amblyopia include patching the stronger eye, which forces the weaker eye to work harder, and putting special eye drops in the stronger eye, which temporarily blurs the vision in that eye, forcing the weaker eye to work harder.

Strabismus, or crossed eyes, is a condition in which the eyes are misaligned; they don’t point in the same direction. One eye may point inward, outward, upward or downward. To prevent double vision, the brain may ignore the images from the misaligned eye, and that eye may not develop properly as a result. Strabismus occurs in about four out of 100 children or 4 percent.

Strabismus is caused by problems with the eye muscles, the nerves that transmit signals to the muscles or the control center in the brain that directs eye movement. It has been associated with uncorrected refractive errors, poor vision in one eye and certain medical conditions, such as cerebral palsy and hydrocephalus. Strabismus is often inherited. About 30 percent of children with strabismus have a family member with a similar problem.

Strabismus in children can result in amblyopia and can lead to permanent vision loss if not treated. Potential treatments include prescription glasses, special prism glasses, eye patching, BOTOX® injections and surgery to strengthen the weakened eye muscles.

Most vision problems, such as refractive errors, cannot be prevented. But there are steps you can take to safeguard the health of your child’s vision. Start by scheduling routine eye exams. This will enable the eye doctor to follow your child’s visual development at every stage and be there if there are any changes along the way.

Encourage healthy eating habits with a diet rich in fruits and vegetables. Fruits and vegetables contain many vitamins and nutrients that are necessary for maintaining healthy bodies, including healthy eyes.

Spend at least an hour outside every day. Playing outdoors, or even just taking a walk, helps the muscles in your child’s eyes to relax. This goes hand-in-hand with limiting screen time. Prolonger time staring at screens can cause blurry vision, focusing problems and may even increase your child’s risk for developing myopia.

Have your child wear sunglasses outdoors to protect their eyes from the harmful effects of the sun’s UV rays. They should also wear protective eyewear during sports and activities to prevent serious eye injuries. Eye injuries account for more than 1.5 million visits to the emergency room in the United States.

These are easy ways to protect your child’s vision. But if you notice that your child constantly rubs their eyes, has excessively watery eyes, is extremely sensitive to light, has trouble focusing on moving objects or has chronically red eyes, see an eye doctor. These are common signs of vision problems that may need correction.

How often do you think about the health of your eyes? Do you care for them as you do the rest of your body? This National Eye Exam Month, we’re reminded that we need regular eye check-ups, just like regular physicals and screenings, to keep our eyes healthy and optimally functioning. And for some people, a routine eye exam could even be a vision saver.

The Centers for Disease Control and Prevention (CDC) describes a laundry list of disorders that can affect the eyes. Some are primarily associated with aging, such as macular degeneration, cataracts, diabetic retinopathy and glaucoma. Diseases like these are the leading causes of blindness and low vision in the United States. All of them require close management by a qualified eye care professional. And, of course, regular eye exams are critical.

Eye disorders that get a little less attention but are just as important to the nation’s collective eyesight are the refractive errors, including myopia, hyperopia, astigmatism and presbyopia. These disorders are the most common eye problems affecting our country. In fact, recent studies by the National Eye Institute concluded that about 11 million Americans 12 and older could improve their vision with proper correction of their refractive conditions. They can be detected during a routine eye exam.

Myopia is more commonly known as nearsightedness. With myopia, objects that are up close, or near, can be seen clearly, but objects further away are blurry. Hyperopia, or farsightedness, is a little more complex than just the opposite of myopia. While in its truest sense near objects are blurry and objects further away are clearer, hyperopia can express differently in different people. For some, objects at any distance can be out of focus.

 

With astigmatism, the eye does not focus light properly on the retina. That’s the light-sensitive patch of tissue at the back of the eye that converts light into the messages that get sent through the optic nerve to the brain. Without the proper focus, images look blurry and can even seem stretched out. Presbyopia occurs as people age. In this case, the eye’s crystalline lens can no longer change shape well enough to focus clearly on near objects. That’s why people in their 40s and 50s start holding out that newspaper in order to read it!

To stay ahead of all these disorders and maintain good eye health, don’t forget to see to your eyes. An ophthalmic exam is nothing to fear.2 How often should you go? Well, for adults between 20 and 39, the recommendation is to have a complete eye exam every five to ten years.

Adults over 40 need more frequent exams. Those between 40 and 54 should be seen every two to four years. Those between 55 and 64 should be seen every one to three years, and those age 65 and older need exams every one to two years. Adults of any age who wear contact lenses should be examined yearly.2 Anyone with symptoms or risk factors for eye disease should follow their doctor’s recommendations.

If you’re interested in eye health and would like to know more, check out this web page. It has links to information about many eye disorders and treatments. Just don’t forget how important your eyes are to your overall health and wellbeing. Happy National Eye Exam Month!