Boulder Eye Surgeons
Donald J. Keller, MD & Brian E. Nichols, MD PhD

Dry Eyes

The surface of the eye is normally covered with a healthy tear film. However, many people - especially in arid climates like Colorado - suffer from dry eye syndrome. When the tear production cannot keep up with the rate of tear loss, a number of symptoms can result. Patients with dry eyes complain of red, scratchy, irritated, burning, painful eyes. Often, patients who suffer from dry eye syndrome complain that their eyes water frequently. This is due to progressive dryness on the surface of the eye that eventually leads to irritation and reflex tearing. Often, the symptoms are better for some time until this vicious cycle starts again with progressive dryness. Because the tear film is an important component of good vision, patients with dry eye syndrome frequently complain of variable vision, especially when doing activities in which we do not blink frequently, such as reading, working on the computer, watching television, and driving. Typically, the longer one does these activities, the more variable and "blurry" the vision becomes.

Dry eye syndrome has many causes. High altitude and dry conditions are a major contributor here in Colorado. Tear production normally decreases with age. Contact lens wear can make dry eye symptoms worse. Dry eye syndrome is the leading cause of contact lens intolerance. Finally, there are several diseases and medications which adversely affect your tear production.

The diagnosis of dry eye syndrome usually relies on the symptoms and physical examination and can also include a mesurement of the tear film with a Schirmer's test or a lactoferrin assay.

Treatment of dry eye syndrome focuses on improving the quality and quantity of tears on the surface of the eyes. Many patients with mild symptoms benefit from using artificial tear drops a few times a day. Patients with worse symptoms may require a simple non-surgical procedure called "punctal occlusion". In this procedure, tiny silicone plugs are placed in the drainage ducts of the eye (located in the upper and lower eyelids). Insertion of the plugs are done in the office and is safe, quick, painless, and totally reversible. This can be compared to putting a stopper in a sink drain. Blocking the drainage ducts prevents tears from draining away too quickly, keeping them on the surface of the eye and relieving the dry eye symptoms.

Insertion of Punctal Plugs

punctal plugs
Plugs are inserted into the punctal ducts, effectively blocking tear drainage and improving the tear film on the surface of the eye.