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Dry Eye

Dry eye is a serious condition, yet many sufferers, as well as doctors, are in the dark on how to successfully treat it. Here are some tips on current treatments and information on innovative future treatment possibilities.

Dry eye is a potentially debilitating condition that affects millions of Americans. It can cause burning, scratching or stinging sensations in the eye due to lack of tears, which are needed to lubricate your eyes and wash away particles and foreign bodies.

In addition to burning or stinging sensations, dry eye may also cause you to have strained or tired eyes after even short periods of reading. Prolonged bouts of dry eye can eventually lead to tiny abrasions on the eye surface.

Traditional treatments for dry eye include using artificial tears in the form of drops or ointment, or simply prevention by avoiding triggers such as smoke and dry air. Restasis®, approved by the Food and Drug Administration in 2002, is the only prescription eye drop available to help increase tear production.

Part of the problem in treating dry eyes is that the cause is not always easy to pinpoint. Dry eye can be caused by a variety of factors including aging, sun exposure, smoking, eye injuries and Sjögren’s syndrome, an autoimmune disease in which the body mistakenly attacks its own moisture producing glands. Dry eye is a hallmark symptom of Sjögren’s syndrome, which typically strikes women over age 40. Therefore, before treatment can be advised, a lengthy evaluation of both the physical and environmental history of the patient must be taken.

In addition to a lack of information on the cause of dry eye, little is known about how the lacrimal gland—the part of the eye responsible for producing tears—actually works or why it stops working in patients with dry eye. However, scientists are providing a greater understanding of the inner workings of the tear producing glands and moving towards innovative treatments for dry eye.

Studies support an idea that the cells in the lacrimal gland, along with the cells that cover the surface of the eye, function as part of what scientists call the "mucosal immune system." This immune system protects and defends moist, fragile tissues—such as the linings of the respiratory, gastrointestinal, urinary and reproductive tracts, and the surface of the eye—from the external environment.

So while tears play an important role in keeping the eyes moist and comfortable, they also contain beneficial antibodies that immobilize germs and prevent them from invading the cornea or sclera (the whites of the eyes).

Knowing this, researchers have begun to study ways to trigger "normal" functioning of the immune response that causes tears. This means they may be able to treat dry eye from the inside out.

In addition, some researchers believe that the onset of dry eye may have something to do with hormones, especially in women. The results from studies of a small number of female patients with dry eye who used an established hormone-replacement therapy seem to explain why many more women than men experience dry eyes, particularly after events such as pregnancy when hormones fluctuate dramatically.

Significant advancements have been made toward the development of a bioengineered artificial lacrimal gland, designed to be implanted above the eye and beneath the skin to produce tears. The device is geared towards people who have severe cases of dry eye as a result of advanced eye disease or facial burns or trauma.