Many people suffer from symptoms of dry eye, including sore, gritty, and tired eyes. Sometimes, but not always, the condition occurs in conjunction with rheumatoid arthritis.
The function of tears is to keep the front of the eye moist. Healthy tears form a smooth, uninterrupted, film over the eye, which is replenished with every blink.
The chemical composition of tears is complex and there are believed to be three main components of tears. These are a mucus layer, a watery layer, and an oily layer. When we cry we produce more of the watery component. But the normal tear film that should be present throughout the day requires much more than just this watery fluid. To maintain a smooth film the chemical balance of the tears has to be just right.
If a dry eye only occurs during certain tasks, such as using a computer, then blinking exercises may help. One of the Cole Martin Tregaskis Optometrists information leaflets explains how to do these.
The commonest treatment for dry eyes is to use artificial tears. These are viscous drops which can be placed in the eye either whenever symptoms occur or at regular intervals during the day. Artificial tears can be very helpful, particularly for people whose dry eye symptoms only occur occasionally or at certain times.
There are various different types of artificial tears and research has shown that the type or make of artificial tears that is most helpful for one person may not suit another. So, it is best to try several types to find the best for you. Most people find that one of the following products gives them relief from dry eye: Optive, Celluvisc, Systane, Clarymist. All of these are available from our reception.
For some people, dry eye symptoms are too severe or too frequent for drops to be very much help. These people may be helped by punctal occlusion.
The components of tears are produced at various different glands at the front of the eye. Little can be done to aid tear production, but treatments are available to help the tears to persist for longer in the eye.
The tears drain away from the eye into four drainage ducts, called puncta (each one is called a punctum). These puncta drain into the nose and this is why, when the eyes water, the nose often runs. There are two puncta in each eye, one at the inner corner of the upper eyelid and one at the inner corner of the lower eyelid. If you look carefully into a magnifying mirror and pull down the inner corner of one lower eyelid you may be able to see the punctum, which looks like a small black hole.
Punctal occluders are “plugs” designed to obstruct these drainage ducts. This causes the tears to remain in the eye for longer and reduces the symptoms of drying.
People whose eyes water excessively can often be helped by having their tear drainage ducts irrigated. Another of our leaflets explains this painless procedure.
Not every case of dry eye is suitable for punctal occluders. They are only suitable if it is the watery component of tears that is lacking. If your eyes are sometimes dry and at other times they water a lot then you are probably not suitable.
Before fitting punctal occlusion we arrange a special appointment with Professor Evans to carry out an assessment of your tear film stability. He will then discuss with you whether you are suitable for a trial with temporary punctal occluders.
There are two types of punctal occluders. Professor Evans starts by fitting collagen plugs which are temporary. Collagen is a naturally occurring substance which dissolves after about 5 days. In this way the effect of the plugs can be investigated before deciding to proceed to more permanent, silicone, plugs.
Although silicone plugs can be removed, they do not dissolve and are a more permanent solution to dry eye problems. Professor Evans only fits silicone plugs when indicated by the findings of his tear film investigations and after a trial with collagen temporary punctal occluders. Silicone plugs are usually fitted to one punctum in each eye.
If glasses are not of the correct strength then this can cause eyestrain which can worsen the symptoms of dry eye. So, the first stage is to have a routine eye examination. If, following this, you would like to investigate the further treatment of dry eye then please ask for an appointment for a special investigation of tear film stability. If you are suitable, we may, at this appointment, fit collagen plugs.
After about a week your optometrist will see you again to assess how effective the collagen plugs have been. If both you and the optometrist agree that you are suitable, then they may fit a pair of silicone plugs. All that is then required is a brief follow-up appointment after about 3 weeks and normal examinations thereafter.
|
Fees
(inclusive of consultations & materials) |
|
|
collagen plugs |
£
75 |
|
silicone plugs |
£170 |
Return to Cole Martin Tregaskis home page.