How we treat dry eye depends on the severity. A healthy tear is like alphabet soup with all sorts of nutrients in it to keep the eye healthy. When you use artificial tears it’s like adding broth, which is a start but incomplete. Oral flaxseed oil capsules (2000-4000mg/day) helps the tears spread better and be more stable between blinks. Restasis helps you make more healthy, natural tears, Xiidra does some of that, too, but they are both medicines, not tears, and expect some burning when you put them in because your surface is so roughed up from dryness.
The other thing we can do is try to keep tears in your eye longer by putting plugs in the drain (puncta). It's like putting a plug in the sink and keeps the water in the sink longer, but it doesn't work on the faucet. You still need to add tears, etc.
We like to start with tears 4x a day and flaxseed oil so you get some improvement before putting the medicine on your surface. It takes two weeks for the flaxseed oil to kick in, so we will see you back in2-3 weeks, and then we usually will add a medicine (Restasis or Xiidra) to help make healthy tears.
We usually try to get the tears healthier first, and if there are still symptoms or signs we will try plugs (a simple painless procedure done right in the office). But if you can't get or tolerate the meds, we still do plugs.
There are many types of artificial tears, different thicknesses, and some with lipid in them. If you use drops very frequently we like to use non-preserved tears. If you try a brand of tears in one eye you can compare to a different brand in the other eye and see which works best for you.
If you judge yourself on a 1-10 scale, 10 being the worst dryness, where are you now? Then we will compare each step as to how you do. This is a process of improvement, not a full cure.
Dry eye is also made worse by allergies, and you are exposed to more allergens when you are outside.It is best to get a full examination to see what is going on with your eyes.
Lisa S. Bunin, M.D.
1) the manufacturer's suggestion (i.e., are they daily, biweekly, or monthly contact lenses)
2) the health of the surface of your eye. If you have dry eyes, allergies, or have developed surface issues such as bumps under your upper eyelid (Giant papillary conjunctivitis), which is checked by having your doctor look under your upper lids, then you should replace your contact lens more frequently.
A contact lens is a prosthesis fitted to your eye, and you need to have regular eye health check-ups to be sure you are not damaging your eye by over-wearing them.
Depending on the amount of crossing, strabismus is treated with patching, glasses or surgery. It is important that children with strabismus be seen as early as possible to prevent loss of vision, because the eye will be become "lazy" if it isn't corrected and realigned. Please see an ophthalmologist as soon as possible, because after age 7 it is less likely that vision can be restored if it has been lost.
He should see an ophthalmologist specializing in strabismus.
This should not be ignored. Please see an ophthalmologist ("MD") to get checked right away in case it is an infection or foreign body so it can be treated.
Start with warm compresses to liquefy and soften the center, and then use an eyelid scrub such as Ocusoft to clean the lids, and get to an eye MD so they can prescribe an antibiotic as needed.
If you are near my area, I would be happy to see her and thoroughly evaluate her. I see lots of patients with these complaints and it takes a careful history and examination to figure things out, but we can defintely make things better.
Every time you sleep in your contact lenses you run the risk of getting a serious infection, microabrasions, and a corneal ulcer with scarring -- or worse. The cornea does not have blood vessels in it and only gets oxygen and nutrients through the tear film. When you sleep in a contact lens it can suck on to the cornea and not allow exchange of nutrients and oxygen because the tear film doesn't get to the cornea. Even without a contact lens, the normal oxygen content drops from about 96% to 53% while you're sleeping, so imagine how much lower it is with the contact lens in place. Although people get away with it, it is sort of like the chances you take when you ride a motorcycle in a dangerous place without a helmet; you may get away with it sometimes but the one time you're in an accident it's often fatal.
If you wake up with your eyes swollen or red, that indicates that something is wrong, even if it's not painful. (Swelling around the cornea can numb the sensation). If there is any blurred vision, redness around the cornea, or pain, you should definitely seek professional help immediately. If there is just a little swelling then try using a lot of artificial tears and keep the contacts out and see if you get better in an hour or two. If not, you should definitely seek professional attention because the earlier and infection is caught the better the outcome.
In general, with contact lenses, if there is any irritation blurred vision excessive tearing or any other issue, it is best to follow the adage "if in doubt, take it out".
I hope this is helpful.
WE HAVE TWO TEAR systems in the eye. Thebaseline tear system is the one that keeps the eye moist and comfortable, keepsthe window of the eye nice and clear, and keeps out the dirt and debris. Whenyou don't make enough of these the eye can feel dry, gritty, itchy and burning,and you get blurred vision from dry spots because the tears break up,especially when you use your eyes to read, use the computer or stare atthings, and you don't blink as often.
The back up tear system is the one everyone knowsabout, the one you use to cry for emotional reasons, or if you peel onions.That comes from the lacrimal gland, and is all or nothing. It doesn't give youthe one or two tears you need, it dumps out a bucketful. So then you aretearing.! Thenumber one cause if a tearing eye is a dry eye kicking in the backup system.
Dry eye is also made worse by allergies, and you are exposed to more allergens when you are outside.It is best to come in and get a full examination to see what is going on with your eyes. I'd be happy to see you if you are in my area. Call 610-435-5333 for an appointment.
Lisa S. Bunin, M.D.
Eye, Eyelid, Skin & Laser Surgeon
Custom Cataract Surgery,Multifocal Lenses, Complete Eye Exams