Dry Eye Syndrome

The doctors at Tucker-Kudrna-Holec-Young Eye Care Centre are trained in the area of Dry Eye Syndrome (DES) as it affects over 60% of our population on a continued basis or as an episodel condition associated with environment or working conditions. The tears of the eye are made up of three layers and any one layer that has an associated condition can cause the tear chemistry to change and cause a dry eye condition.

The Mucus Layer – The closest layer to the corneal epithelium is produced by the conjunctival goblet cells, and is absorbed by the corneal surface, creating a hydrophilic surface. This is the base layer for the stability of tears on the eye. If this layer is disrupted through an infection or other conditions, it can lead to extreme dry eye conditions.

The Aqueous Layer – the layer between the mucous and lipid layers is produced from tears secreted by the lacrimal tear glands found at the lid margins in the upper and lower lids. The tears from this layer incorporate all water-soluble components of the tear film. It also comprises 90% of the tear thickness. The aqueous layer provides moisture and supplies oxygen and important nutrients to the cornea. Again, this layer is very important to nourish the cornea and keep it moist and comfortable.

The Lipid Layer – the outermost layer is produced by the Meibomian glands within the lid area and contributions from the glands of Zeis and Moll of the eyelids. The secretion is an oily material, which is fluid at body temperature and retards evaporation of the aqueous layer and lowers surface tension, thereby allowing the tear-film to adhere to the eye’s surface. This layer keeps the tear film from leaving the surface of the cornea and also helps keep comfortable lid blink movements adding lubrication.

The Blink Reflex renews the tear film by delivering aqueous and lipid to the tear film and sweeping away debris. The normal blink interval is about 5 seconds under normal conditions. The tear film is typically stable for about 10 seconds. Tears are normally evaporated or forced out through the tear ducts in the inner corner of the eyes on blinking.

Many different things cause dry eye syndrome. The normal aging of tear glands, as well as extended use of contact lens, environmental pollutants, prescription drugs, refractive surgery, autoimmune diseases, nutrient deficiencies and other disorders can cause disruption in the tear production and retention process.


The typical symptoms of the dry eye syndrome include dryness, grittiness, and irritation. Difficulty in reading for long periods of time, burning and even the apparent contradiction of excessive tearing or watering can all be signs for dry eye syndrome. In extreme cases of dry eye, patients may become unusually sensitive to light, experience severe eye pain, and start to notice diminished vision.

Extended Contact Lens Wear can result in dry eye from corneal oxygen and nutrient deficiency. Protein build-up on contact lens can produce a breeding ground for bacterial growth and surface roughness, further contributing to inflammatory changes. Some contact lens solutions contain preservatives that can also cause chemical irritation of the corneal surface and result in dry eye symptoms.

Diseases that may be associated with dry eyes include Rheumatoid Arthritis, Sjogren’s Syndrome, Diabetes, Asthma, Thyroid disease, Lupus, and possibly Glaucoma.

Dry eye syndrome affects 75% of people over age 65. Tear volume decreases from age 18 as much as 60% by age 65. Treatment options vary and can be determined based upon the type of dry eye and the age of the patient.

Hormonal changes cause decreased tear production brought on by pregnancy, lactation, menstruation, and menopause.

Medications that can cause dry eyes are antibiotics, blood pressure medications, antidepressants, diuretics, over-the-counter vasoconstrictors such as Visine, antihistamines, birth control pills, appetite suppressants, and ulcer medications.

Computer Use causes most people to blink less frequently (about 7 times per minute vs. a normal rate of around 22 times/minute). This leads to increased evaporation along with the fatigue and eye-strain associated with staring at a computer monitor. Any task requiring a great deal of concentration can result in decreased blink rate.

If your eyes are constantly itchy or dry, you may have dry eye syndrome (DES). The doctors at Tucker-Kudrna-Holec-Young Eye Care Centre are specialists in DES and have many different treatment options to consider.

The first step is to have a dry eye examination and diagnostic test to determine the amount of tear deficiency and possibly the inflammatory issues associated with your condition. The doctor will also review your environment issues associate with your dry eye condition through an office visit with our patient counselors and doctors.

Because DES affects so many people, the doctors at Tucker-Kudrna-Holec-Young Eye Care Centre take the condition very seriously. We have been trained in diagnosis and many treatment options for DES and provide the latest in dry eye treatment technologies for diagnosis and for treatment options. In many cases, the patients with DES can find comfort and relieve from this condition with a nutrient designed to treat the inflammatory issues associated with DES. In some cases, our doctors may recommend punctal occlusion. In this situation, the patient is treated with a punctal plug implant that helps keep tears on the surface of the eye and reduces the evaporation of the tear film that is important for eye health.