Dry Eyes


Dry eye syndrome (DES), also known as dry eye disease (DED), keratoconjunctivitis sicca (KCS), and keratitis sicca, is a multifactorial disease of the tears and the ocular surface that results in discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface.

Ophthalmologe. 1997 Aug;94(8):591-4.

[Acute Borrelia infection. Unilateral papillitis as isolated clinical manifestation].

[Article in German]

Pradella SP1, Krause A, Müller A.

Author information



Borrelia burgdorferi is the cause of erythema chronicum migrans and Lyme disease. Ticks like Ixodes ricinus are responsible for transmission. Frequently, the tick bite is not noticed by the patient. Eye manifestations, such as keratoconjunctivitis, scleritis, chronic uveitis, vitritis, chorioretinitis, optic nerve disease, orbital myositis and paresis of the eye muscles, often occur after a long period of time and vary greatly.


We present below the case reports of a man 38 years old and a woman of 31, each with manifestation of an ocular Borrelia infection (papillitis and panuveitis, respectively).


By antibody-screening with the ELISA technique and Western Blot analysis we were able to prove the serological infection. After specific antibiotic therapy, ocular inflammation improved rapidly, as did visual acuity. The papillitis only healed partially.


In case of therapy-resistant inflammation of the eye we have to exclude general infections because cortisone therapy alone may result in worsening the condition. VECP can be used effectively in the differential diagnosis of papilloedemas. Early diagnosis and therapy of an acute Borrelia infection restrict the extent of the lesions and prevent ocular and general late manifestations. Seronegative values in subjects strongly suspected of having Lyme disease do not necessarily exclude the diagnosis of Lyme disease.

PMID: 9376700 [PubMed - indexed for MEDLINE]



Dry Eye Treatment

Dry Eye is a medical condition of the ocular surface that affects tear production and the quality of your tears. It is one of the most common disorders seen in any eye doctor’s office.

Do you use artificial tears or lubrication eye drops?

Do overhead fans bother you?

Do you suffer from dryness in your eyes?

Red or burning eyes?

Blurry vision that changes when you blink?

A sandy, scratchy or gritty feeling in your eyes?

Watering or excessive tearing?

Sore or tired eyes?

Contact lens discomfort?

Light sensitivity?

Mucous secretions?

A dry mouth?

Excessive blinking?

If you answered YES to one or more of these questions, you may benefit from IPL Dry Eye Treatment.

Patients with Dry Eye may complain of eye stinging, burning, itching, redness, irritation or discomfort. Vision may be blurred, causing difficulty reading, viewing a computer, watching television, or seeing clearly while driving. Symptoms may be worse later in the day.

In the past, this condition has often gone unrecognized and undiagnosed. Patients may have been advised to “home-treat” their uncomfortable symptoms with measures such as artificial tears, warm compresses, lid scrubs, or medicated drops. All of these remedies treat symptoms, but do not treat the problem.

Recently a treatment known as IPL (Intense Pulsed Light) has become available to target the cause of Dry Eye and to reduce or eliminate symptoms. Developed by Dr. Toyos, IPL has helped many patients with Dry Eye to reduce their discomfort and improve their quality of life.

To schedule an evaluation online to determine if IPL can help relieve your dry eye symptoms, click here.

For more information or to schedule an evaluation by phone, please call 888.329.0317 and one of our Patient Care Representatives will be happy to help answer any questions you may have.

Link to article:


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Guide To Dry Eyes

Part 1 of 2 - Symptoms of Dry Eyes / Common Causes of Dry Eyes

By Carol Eustice, About.com Guide

Updated May 27, 2006

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Dealing With Dry Eyes

Tears serve as a protective coating for the eyes. They keep the eyes moist, provide essential nutrients, and wash away dust and other particles. When the eyes don't produce enough tears or the right quality of tears, the result is a condition that doctors may call:

Symptoms of Dry Eyes

Just as the name suggests, this condition makes the eyes feel dry, scratchy, and gritty. Other symptoms may include:

  • burning
  • stinging
  • itching
  • pain
  • sensitivity to light
  • redness
  • blurry vision
  • a feeling that there is a speck of dirt in the eyes
  • a stringy discharge from the eyes

What are Reflex Tears?

Though it may seem strange, dry eye can cause the eyes to water. This can happen because the eyes are irritated. You may experience excessive tearing the same way you would if something got in your eye.

But these tears won't necessarily make the eyes feel better. Reflex tears -the watery type that are produced in response to injury, irritation, or emotion -don't have the lubricating qualities necessary to prevent dry eyes. Tear film is made of water, oil, and mucus, all of which are important for maintaining good eye health. The cornea, which covers the front of the eye, needs these tears continuously to protect it against infection.

External And Internal Eye Anatomy (Image)

Eye Anatomy (Image)

Most people who have dry eyes experience mild irritation with no long-term effects. But if the condition is left untreated or becomes severe, eye damage and vision loss can occur. Severe problems with dry eyes can cause:

  • eye inflammation
  • corneal infection
  • scarring

When dry eye symptoms are severe, they can interfere with quality of life. Some people may have trouble keeping their eyes open or they may not be able to work or drive. Fortunately, identifying the cause of the problem and seeking treatment early can make a big difference in easing the discomfort.

Common Causes of Dry Eyes


Aging is one of the most common causes of dry eyes because tear production decreases as we get older.

Hormonal Changes:

Dry eye affects more women than men because hormonal changes, such as those that occur in pregnancy, menstruation, and menopause, can decrease tear production.

Environmental Factors:

Environmental conditions also can play a role in making the eyes dry, these include:

  • wind
  • heat
  • dust
  • air conditioning
  • cigarette smoke
  • even hair dryers can make the eyes dry

Some people benefit from avoiding dusty, smoky areas, wearing sunglasses, and using a humidifier to moisten the surrounding air.

Not Blinking Enough:

Another common culprit is not blinking enough, which happens during activities such as watching TV and computer use. Each time you blink, it coats the eye with tears. You normally blink about every 12 seconds. Studies have been conducted on people playing computer games, and it was found that some people blinked once or twice in three minutes.

Contact Lenses:

Experts believe, about half of all people who wear contact lenses complain of dry eyes. That's because soft contact lenses, which float on the tear film that covers the cornea, absorb the tears in the eyes.

Laser Vision Correction and Other Procedures:

Dry eye also occurs or gets worse after LASIK and other refractive surgeries, in which the corneal nerves are cut during creation of a corneal flap. The corneal nerves stimulate tear secretion. If you've had dry eyes from wearing contact lenses or for any other reason and you are thinking about refractive surgery, this is something to consider.

Certain Medications:

Dry eyes also can be caused by certain medications, including:

  • antihistamines
  • some antidepressants
  • birth control pills
  • nasal decongestants
  • the prescription acne drug Accutane

Autoimmune Diseases:

Some autoimmune diseases, can attack the tear glands such as:

Lupus, an autoimmune disease that can affect many parts of the body.

Lupus Screening Quiz

Rheumatoid Arthritis, an inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. It can also affect other parts of the body besides the joints.

Rheumatoid Arthritis Screening Quiz

Sjogren's Syndrome, an autoimmune disease in which the immune system targets moisture-producing glands and causes dryness in the mouth and eyes.

Sjogren's Syndrome Screening Quiz

Other Diseases:

Other diseases can also cause dry eyes. For example, certain types of thyroid disease can interfere with blinking. Blepharitis, an inflammation of the eyelids, can interfere with the oil glands in the eyes.

See Your Doctor

Even though many treatments for dry eyes are available without a prescription, it's wise to see a health care professional to evaluate the cause of the condition and to help you pick the best treatment.

Diagnosis of Dry Eyes

Eye doctors use a combination of routine clinical exams and other specific tests for dry eyes. For example, the Schirmer test uses a tiny strip of paper placed on the edge of the lower eyelids. This measures how much moisture is in the eye, and it's also useful for determining the severity of the problem. Doctors may also use dye, such as fluorescein or rose bengal, which is placed on the eye to stain the surface. This is to see how much the surface of the eye has been affected by dryness. Another test, tear break-up time (TBUT), measures the time it takes for tears to break up in the eye.

What Are Artificial Tears?

The first line of treatment for dry eyes is usually over-the-counter demulcent drops, also known as artificial tears. These lubricate the eye and ease symptoms. Commonly found ingredients in these products includehydroxypropyl methylcellulose, the ingredient in Bion Tears and GenTeal, and carboxymethylcellulose, contained in Refresh Plus and Thera Tears. Always read the directions, but these products can generally be used as often as needed throughout the day.

Your health care professional can guide you in choosing the right one for you. Some people use drops for red eyes, but that can make the eyes even more dry. Red eyes could be caused by numerous factors, from allergies to an eye infection, which is why a proper diagnosis is important. If you wear contact lenses, use rewetting drops specifically for contact lenses. Other types of drops may contain ingredients that damage the lens.

What Is Restasis?

Restasis (cyclosporine ophthalmic emulsion) is the only prescription product for chronic dry eyes. Approved by the Food and Drug Administration in 2002, the drug increases tear production, which may be reduced because of inflammation on the eye surface. In a clinical trial involving 1,200 people, Restasis increased tear production in 15 percent of patients, compared with 5 percent of patients in the placebo group.

Restasis is usually given twice a day, 12 hours apart. It should not be used by people with eye infections or hypersensitivity to the ingredients. It has not been tested in people with herpes viral infections of the eye. The most common side effect is a burning sensation. Other side effects may include:

  • eye redness
  • discharge
  • watery eyes
  • eye pain
  • foreign body sensation
  • itching
  • stinging
  • blurred vision

For More Information On Drugs Used To Treat Dryness

Sjogren's Syndrome Medications (Drugs to Treat Dry Eyes and Dry Mouth)

Restasis (Cyclosporine Ophthalmic Emulsion)

Hydroxypropyl Cellulose (Eye Drops & Pellets)

What Are Punctal Plugs?

For people who have not found dry eye relief with drugs, punctal plugs may help. These are reserved for people with moderate or severe dry eye when other medical treatment hasn't been adequate.

In each eye, there are four puncta, little openings that drain tears into the tear ducts. Punctal plugs are inserted into the puncta to block tear drainage. Some doctors try out temporary ones made of collagen first to make sure that permanent ones will not cause excessive tearing. Permanent plugs are usually made of silicone. In recent years, some plugs have been approved that are made of thermally reactive material. Some of these are inserted into the punctum as a liquid and then they harden and conform to the individual's drainage system. Others start out rigid and become soft and flexible, adapting to the individual's punctal size after they are inserted. Artificial tears are usually still required after punctal plug insertion.

Experts stress, the risks of punctal plugs are fairly minimal, but there is a risk of eye irritation, excessive tearing, and, in rare cases, infection.

Related Resources - Dry Eyes

Sjogren's Syndrome


Rheumatoid Arthritis

Vision at About

Source: Dealing with Dry Eye, by Michelle Meadows, FDA Office of Public Affairs, FDA Consumer Magazine, May-June 2005 Issue

Dry Eyes- Symptoms

By Mayo Clinic staff

Signs and symptoms of dry eyes, which usually affect both eyes, may include:

  • A stinging, burning or scratchy sensation in your eyes
  • Stringy mucus in or around your eyes
  • Increased eye irritation from smoke or wind
  • Eye fatigue after short periods of reading
  • Sensitivity to light
  • Difficulty wearing contact lenses
  • Periods of excessive tearing
  • Blurred vision, often worsening at the end of the day or after focusing for a prolonged period

When to see a doctor

See your doctor if you've had prolonged signs and symptoms of dry eyes, including red, irritated, tired or painful eyes. Your doctor can take steps to determine what's bothering your eyes or refer you to a specialist.

Link to article: http://www.mayoclinic.com/health/dry-eyes/DS00463/DSECTION=symptoms