TEAR FILM ABNORMALITIES DRY EYE & CVS
Comprehensive Eye Care & Surgeries
The surface of the eye and its health have become topics of great concern over the last few years.The introduction of digital devices has made it of crucial importance.The eyes are being used for many more hours than it earlier was.
The ways the digital screens function and its properties have an impact on the ocular surface.The eye too responds in different ways. And this depends upon a lot of internal and external factors.Use of screens is inevitable and how we adapt to it has been changing as well.The screens also have been evolving over time and we certainly have better devices as opposed to their older versions.
Dry Eye has become very common these last 2 to 3 decades.First recognized as an eye condition somewhere in the 1920’s the condition started becoming common with our changing lifestyles,changing climates,changing workstyles etc.
When a term is called DRY EYE,it means that our eyes should otherwise be wet!!
Yes its extremely essential that our eyes are wet at All times. Wetness maintains the integrity of our eyes and the clarity of our vision. The Tears in ours eyes are responsible for keeping our eyes moist.But it is because of a complex mechanism and a number of factors that the tear film remains healthy.
We have the lacrimal (tear glands) that manufacture the tears.The meibomium glands that supply the fat layer that keeps it from evapourating and the mucous glands that help it slide smoothly over the eyes and stick to it.
The eyelids blink and see to it that the tear film spreads evenly over the eye surface.The blink removes the debris,clears off the contaminated tears and brings in a fresh layer of tears over the eye surface.We also have a drainage system,that drains off the excess and the used tears, so that it makes way for a fresh layer of tears.
A balance between the manufacturing of tears,its spread and stability over the eye,its evapouration from the surface and its drainage is of immense importance in maintaining a perfectly stable tear film.
UNDERSTANDING THE TEAR FILM
The tear film has three layers.
- The Mucous Layer:The innermost is the mucin layer and this helps smooth layer of tears
- The Watery Layer:The middle one is the fluid layer and makes most part of the tear film
- The oily Layer:The outermost is the oily layer and this prevents evapouration of the tears.
FUNCTIONS OF THE TEAR FILM
The tear film has many functions.It is mainly responsible for
- Lubrication:The tear film helps easy movement of the eye lids over the eye surface.
- Nourishment: The cornea receives its nutrition from the nutients and oxygen drawn from the air into the tear film
- Cleansing action: every blink brings with it a fresh new layer of tear film and cleans away the debris from the eye surface
- Optical clarity: the clear tear film keeps the cornea wet at all times and helps maintain its integrity and optical clarity
- Immune competence: a lot of immune regulators are present in the tear film and forms a sort of a defence mechanism for the ocular surface.
CAUSES OF DRY EYE
A change in composition of the tear film is the main reason we have Dry Eyes.This can happen because of various reasons.
- Computer screens: continuously watching digital screens can cause dry eyes
- Reduced formation of tears or mucous.
- Unhealthy eye lids
- Hormonal Changes: Dry eyes is more common in females especially around menopause
- The environment you are in: Dry windy,hot climates,pollution and smoke precipitates dry eyes
- Systemic conditions like thyroidrheumatoid arthritis,Sjogrens syndrome,Lupus,etc
6.Systemic medications:Diuretics,beta blockers,ant allergics,sleeping pills,anti depressants and anti anxiety medication,antacids,etc
- Eye procedures: like LASIK
- Eye medications: Long term therapies with preservatives can cause dry eyes.
- Long term contact Lens use.
- Chemical injuries and burns
SYMPTOMS OF DRY EYES
The most common symptoms are eyestrain,tiredness,discomfort,gritty sensation,watering,light intolerance,itching,stickiness, inability to see well or blurring of vision, etc. A lot of symptoms may be very vague and varied.
Dry eye can be diagnosed only by an eye doctor.A detailed examination after a detailed history taking and a battery of tests are done to diagnose a dry eye.
TREATMENT OF DRY EYE
The management of dry eye is very complex and varies from simple supplementation with tear substitutes to surgical intervention and advanced systemic medication and local immunomodulator eye drops. The plan of management is made by the eye doctor only after a complete evaluation.
Following are the ways in which a dry eye could be managed.
- Conservative Management: Taking care of surrounding environment,humidity of the room,wearing wrap around glasses etc.
- Supplementation with tear substitutes: Most common over the counter lubricating eye drops help in early and mild cases of dry eyes.
- Quality of eye drops: changing over to preservative free eye drops
- Management of co existing eye problems like meibominitis and allergies and inflammations of the eye.
- Dietary supplements: Like Omega 3 fatty acids vitamins like Vitamin A.
- Surgical management: blocking the drainage of existing tears with punctals plugs etc.
Q: What Keeps our eyes wet?
A Combination of factors keeps our eye wet
1.the tear film: its integrity,its composition,its stability,its quality,its quantity,the frequency of its change.. all are responsible for a good tear film
- The Blink rate: The frequency of blinks,the quality of the blink,does make a big difference.
Q: Is Dry eye a common condition?
A: Dry eye first became known in the 1920s.It has been a progressively common disorder with our changing lifestyles and dietary habits and use of digital screens
Q: Are Dry eye syndrome and computer vision syndrome the same?
A: Yes they are synonymous.
Q: What is the reason for dry eye with use of computers?
A: The blink rate drops down drastically causing evapourative dry eye.
Q: What is 20-20-20 rule?
A:Take a 20 second break off your computer screen and look at an object 20 feet away…every 20 minutes.This helps keep your eyes wet and comfortable, especially while working on digital screens.
Q: Is dry eye a chonic condition?
A: Yes if corrective measures aren’t taken,dry eye can be a nagging condition and becomes chronic.
Q: What should we do to prevent dry eyes?
A:Eat healthy,Blink frequently while using digital screens,adjust the heat and humidity and lighting within the room,take care of your postures,get your eye numbers corrected and visit your eye doctor annually.
I had the pleasure of experiencing her above qualities when I visited her hospital with my family few month’s back, her ever smiling face, reassuring us time and again and impeccable services before and after the treatment made us think of an angel on the earth.
I take this opportunity to thank her profusely and pray to Almighty to bless her with long life so as to serve the humanity.”
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