Punctal Plugs for Dry Eye

What is Dry Eye?

  • Dry eye is a reduction in your eye’s ability to produce tolerable  natural tears.
  • Intolerable  crack production can lead to rawness and pain, and even scarring of the cornea (the gossamer part of the eye that covers the pupil and iris).
  • Many people will experience dry eye symptoms at some point in their lives.
  • Often due to surroundings al factors such as indoor heating or air conditioning, it can also be kickoff  by occupational factors such as prolonged computer use.
  • Dry eye symptoms can affect anyone.
  • Some of the symptoms of dry eye include a burning sensation or gritty feeling in the eyes. You may also experience decreased tolerance to contact lens wear or susceptibility  to light.

Patients with "dry eye": much complain of symptoms

  • feeling of drought 
  • gritty or foreign body sensation
  • burning sensation and stinging 
  • soreness
  • tired eyes 
  • paradoxically, watering eyes
  • Tearing is reflex tearing from the irritated cornea stimulating the lacrimal gland. Your eye may be red as a sign of irritation

Anatomy of the Tear Film

  • The routine crack film has three layers and several key functions. The layers are 
    • Lipid which is the top most layer. This helps tears from evaporating and is made by meibomian glands. 
    • Aqueous which is in the middle. It is made from the main and accessory lacrimal glands 
    • Mucin which is next to the cornea, and allows the crack film to spread over the ocular surface; it is made from goblet cells

  • The crack film is critical as it is the first surface that light hits as it enters your eye. It provides the cornea with nutrients, oxygen and protection from infection.


Causes of Dry Eye

Many different things can cause dry eye sickness . The routine aging of crack glands, as well as specific diseases and disorders, may cause changes in the amount and condition of tears produced.

  • Congenital (born with) - Riley-Day Syndrome (familial dysautonomia)
  • Seized 
    1. Medications
      • decongestants
      • antihistamines
      • diuretics
      • beta-blockers
      • sleeping pills
      • pain-relievers
      • alcohol
    2. Trauma to lacrimal gland

    3. Neuroparalytic hypo secretion

    4. Inflammation of the lacrimal gland due to mumps, sarcoid

    5. Contact Lens Wear

    6. Milkulcz's sickness 

    7. Smoking

    8. Eye pressure due to prolonged computer use

    9. Wearing contact lenses for long periods of time

  2. Sjögren's sickness 

    • Sjögren's sickness  is an immune system disorder which is characterized by rash and drought  of the mouth, eyes, and other mucous membranes. Tear production may be limited as the the lacrimal gland is affected. (Primary SS, young middle aged women, severe aqueous crack failing , HLA B8 association in 90% of patients
  3. Excessive evaporation of tears can also cause dry eye sickness . Such evaporation may be kickoff  by "meibomitis," which results from flu and rash of the meibomian glands in the eyelids. Patients with thyroid disease (Thyroid or Grave's disease results from overative thyroid which affects the eyes, may cause proptosis, loss of vision and dry eye. Please see the Thryoid page for more details), may also experience dry eye sickness  kickoff  by excessive evaporation.

  4. Decreased susceptibility  of the cornea can also lead to intolerable  production of tears.

  5. Hormonal changes can also affect secretions from the crack glands.

What You Can Do to Prevent or Minimize Dry Eye Symptoms

  • Shun drafts from heating or air conditioning vents, especially in cars and airplanes.
  • Take frequent breaks to relieve eye pressure during periods of prolonged computer use.
  • Remove your contact lenses and keep them especially clean when your eyes are feeling dry.
  • After LASIK surgery, use artificial eye drops to soothe and comfort your dry eyes during recovery.
  • Be aware that certain over-the-counter medications and prescript drugs can contribute to dry eye symptoms.
  • Use a humidifier at home and in your workplace.