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Lancaster, PA 17602
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Home » Eye Care Services » Dry Eye Disease and Treatment

Dry Eye Disease and Treatment

Dry eye syndrome (DES) is a chronic condition that develops when your eyes do not produce and maintain enough tears to keep the eye’s surface lubricated resulting in multiple symptoms that range from person to person. This can be due to a reduction in tear production or increased tear evaporation from a lack of lipid in the tears that stem from oil glands in the eyelids. The effects can range from minor dryness and discomfort to pain, blurred vision and frequent infections.

Symptoms of Dry Eye Disease

Symptoms of dry eye syndrome can vary depending on the severity of the condition but can include:

  • Dry, itchy eyes
  • Burning or stinging
  • Irritation
  • Watery eyes
  • Blurred vision
  • Pain
  • Foreign body sensation

The main function of tears is to maintain the health of the cornea of your eye by washing away foreign matter and ensuring that the surface of your eye remains moist, smooth and clear. Tears also rinse away dust particles from your eyes and contain enzymes that protect your eyes from bacteria that can cause infections. Dry eyes is a condition that develops when the amount of tears produced is not sufficient to maintain the moisture balance in your eye. This can result in that scratchy sensation, a continuous feeling of dryness, stinging and a sensation of a foreign body in your eye. Ironically in an effort to fight off the condition, dry eyes can cause you to produce excessive tears, which is why some people experience watery eyes.

Causes of Dry Eye Disease

Dry eyes can occur naturally as a result of aging or hormonal changes, typically in women who are pregnant, taking oral contraceptives or going through menopause. In fact, women over 50 have a 50% greater risk of dry eye disease than men do of the same age. It can also result from taking certain medications that reduce tear production such as antihistamines, blood pressure medications and antidepressants. Environmental factors can also play a role in drying out the eyes and DED is common in areas where the climate is dry, dusty and windy. Home air conditioners or heating systems and excessive time spent staring at a computer or television screen can also dry out eyes and exacerbate symptoms due to the lack of blinking while staring at our screens.

Individuals that suffer from certain medical conditions such as diabetes, blepharitis, lupus, arthritis and thyroid problems are more vulnerable to developing DED. Other causes can be due to eye surgery including LASIK, certain conditions in which the eyelids don’t close properly or extended contact lens use.

Diagnosis of Dry Eye Disease

Typically, dry eye disease can be diagnosed through a comprehensive eye exam and a description of your symptoms. On some occasions the eye doctor might decide to do a test that measures how quickly your tears evaporate from the surface of your eye. By instilling a simple dye called fluorescein (much like food coloring) the doctor is able to watch and count how long it takes the tears to start to break up after they’ve asked you to hold your eyes open after a blink. This is called TBUT or a Tear Break Up Time test. A low TBUT generally indicates a lipid (aka oil) deficiency in the tears resulting from oil glands in the eyelids not functioning properly. In another type of test, called a Schirmer test, a strip of filter paper is placed under the lid of the eye and you will be asked to close your eye for five minutes. Following the test the amount of moisture on the strip will be measured. Schirmer tests are performed less frequently than a TBUT test.

Treatment for Dry Eyes

There are many treatment options for dry eyes which are highly dependant upon the cause and severity of the condition. Many mild forms of DED can be alleviated using artificial tears or lubricant eye drops to make up for the lack of natural tears usually produced by your eyes. If over-the-counter drops don’t alleviate your symptoms, your doctor might prescribe prescription drops that actually stimulate tear production or steroids for short-term relief.

More severe cases of dry eyes might be treated with a punctal insert which is a tiny insert containing a slow-release lubricating substance that is placed inside the lower eyelid. Since DED is often related to eyelid inflammation known as blepharitis your doctor may prescribe a heated hot compress mask, specialty eyelid scrubs and sometimes an antibiotic ointment. Finally, punctal plugs might be recommended for severe cases which would be inserted into the tear ducts to reduce the tear drainage in your eyes to keep them from drying out.

If the cause of your dry eyes is something external or environmental, eliminating that cause may solve the problem and resolve the symptoms. Avoid dry environments, hair dryers, heaters and fans, (particularly directed toward the eyes) and smoky environments and wear eye protection such as wrap around glasses or goggles when in dusty or windy areas. Use a humidifier to add moisture to dry indoor air. If working on computer or watching television, make sure to blink purposefully as our natural tendency is to reduce our blink rate when staring at a screen. Also avoid rubbing your eyes as this can further irritate them. Staying hydrated by drinking at least 8 to 10 glasses of water per day can also help.

In cases where discontinuation or switching to different medications is possible this can eradicate symptoms. Your doctor may also recommend that you limit or refrain from contact lens use for a certain amount of time or switch to a different brand or type of contact lens which will reduce dehydration.

Dry eye disease won’t have a permanent effect on your vision, but there is no reason to endure dry, itchy and uncomfortable eyes, especially since there are so many treatment options to increase moisture and comfort. It’s also important to realize that this is a chronic disease that needs consistent treatment. Your doctor will work with you to create a long term strategy to keep your eyes as comfortable as possible.

Dear Patients,

We will be reopening our office Monday, May 18, 2020, and would like to bring you up to date with the many very important physical and procedural changes we have made to our office to assure the highest level of health and safety for our patients and staff during these very challenging times.

We have consulted with our county, state and federal officials, as well as the CDC and other healthcare professionals, to incorporate the recommended and required safety measures throughout our office.

We sincerely apologize for any inconvenience we may have caused by rescheduling or postponing your earlier appointments.

To assure the health and safety of our staff and patients, as well as minimize any exposure, we have instituted the following changes. Please read through this entire document and print a copy so you are familiar with them.

1. Any and ALL appointments and visits will need to be scheduled. This includes the pickup of eyeglasses or trial contact lenses, frame selection, eyeglass repairs, and eyeglass adjustments.

2. Contact lenses will be shipped to all patients at no charge

3. To maintain social distancing and minimize any possible exposure, we have spread out our patient schedule.

4. 24-48 hours before your appointment, one of our staff will be calling to remind you of your appointment and discuss your ocular and medical history. In addition, they will ask you standard COVID19 screening questions and answer any questions regarding your upcoming exam. This will take 5 – 10 minutes but this initial call is important to allow you ample time in our office.

Please look for and answer this call.

5. In order to save time and keep everyone on schedule, any and all medications you are taking should be listed in as much detail as possible on a separate piece of paper, emailed to our secure site: DROXENBERG@COMCAST.NET, or entered on the patient registration form on our website: WWW.DROXENBERG.COM. This needs to be completed prior to your appointment and should include all systemic medications (diabetes, hypertension, etc.) and ocular medications (eye drops, glaucoma medicine, etc.).

6. On the day of your appointment please plan to arrive 15 minutes early and call us at (717) 394-3798 when you arrive. We will return your call when you will be allowed to enter. Entry will be through the front door only unless previously discussed with our staff. Only the person with the appointment will be allowed in the office with the exception of minor children who have the appointment. NOTE: Family members and/or friends will need to wait outside.

7. We will be taking your temperature in the vestibule and anyone with a temperature of 100 degrees or higher or who is sick will be rescheduled. If you feel ill, please reschedule your appointment.

8. All staff will have their temperatures checked 2 times daily for your safety.

9. All staff will wear a facemask while in the office. In addition, all patients must wear a facemask while in the office as mandated by Governor Wolf for all PA businesses. If you do not wear a facemask, one will be provided to you.

10. There are hand sanitizing stations strategically placed throughout the office. Please use them.

11. All frames will be disinfected before and after being handled by patients and staff. Frames will not be returned to the frame display until they are appropriately disinfected.

12. All exam room equipment will be cleaned and disinfected before and after each use according to the CDC guidelines.

13. Cleaning and disinfection of our office have always been a priority and this will continue in earnest.

14. Preferred payment is by credit card or checks at the time of services but cash will be accepted.

15. We have installed a plexiglass barrier on our front desk to comply with the CDC and state guidance.

16. Reception area chairs have been separated to maintain social distancing.

17. Patients who are physically disabled will be allowed entry through the rear door, with prior approval, following a temperature check and COVID19 screening. All other patients must enter through the front door and screening vestibule.

18. Above all else, your safety and health are our top priorities. We take this responsibility very seriously and have implemented these changes in procedures to achieve this.

Dr. Oxenberg has been providing eye care to you and your family since 1990 and expects to continue for many years to come.

If you have any questions and /or concerns, please feel free to email our office at droxenberg@comcast.net or call (717) 394-3798.

We look forward to seeing you all again!

Sincerely,

Dr. Larry Oxenberg