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1. What is dry eye syndrome?

   Dry eye syndrome is a group of disorders affecting the film of tears over the eye. When you have dry eye syndrome, either you don't produce enough tears, or you have unstable tears and excessive tear evaporation.

2. What causes or contributes to dry eye syndrome?

   Dry eye disproportionately affects more women than men and is often caused by hormonal changes due to aging and menopause. Dry eye also can be triggered by certain medications such as antihistamines, antidepressants, diuretics, oral contraceptives or hormone replacement therapy. Additionally, dry eye can be caused by autoimmune disorders such as rheumatoid arthritis, lupus, sarcoidosis, Sjögren's syndrome, or it may a side effect of other medical conditions such as thyroid conditions, rosacea, vitamin A deficiency and diseases such as Parkinson's disease.

   Dry eye can be aggravated by a number of external factors, many of which are common in workplace environments, including computer use, heating and air conditioning, reading, exposure to dust and allergens, hot, dry or windy environments, high altitude, contact lens use and driving.

3. Who is at risk for dry eye syndrome?

   Dry eye occurs most often in people older than 40, and an estimated 75 percent of people over age 65 may experience dry eye symptoms. Although the cause of dry eye syndrome is unknown, it tends to occur more often in women, especially those who are pregnant or postmenopausal. An estimated six million women and three million men in the U.S. have moderate to severe dry eye syndrome, and scientists estimate that an additional 20 to 30 million people have mild cases. The condition affects women two to three times more than men.

4. How do I know if I have dry eye syndrome?

   The early symptoms of dry eye syndrome include eye redness; a burning, stinging, and/or gritty sensation in the eye, especially in an environment with low humidity; a feeling that something is in the eye; trouble wearing contact lenses; a gritty feeling that is persistent and painful; eye dryness and excessive tearing. In mild cases, these symptoms may come and go. As dry eye syndrome worsens, the symptoms become more persistent. Severe cases of dry eye may also have eyes that are unusually sensitive to light, and may experience severe eye pain or notice changing vision. Anyone experiencing these symptoms, or using artificial tears more than two to three times a day should visit their eye care professional for a diagnosis.

5. What's a Schirmer test? Will it hurt?

   A Schirmer test measures your tear production. It is often conducted when your health care professional sees a lack of a tear pool during the initial slit lamp examination, and finds dry areas in one of the stain tests. Your health care professional will take a special strip of filter paper, put a tiny fold in it, and place it on the tear pool on the edge of the lower eyelid. The paper remains in place for five minutes, absorbing the tears. The test produces no pain, but some patients find it slightly uncomfortable. It does not affect vision. After the five-minute time period, the paper strip is removed and the area of wetness measured in millimeters (mm). A wetness area of 15 mm is normal. A reading of 10 mm is below normal, but most patients can tolerate it, and may have a few symptoms. A reading of 5 mm is low, and most patients at this level do have some symptoms. Patients with many dry eye symptoms may have a reading of 2 mm or lower.

6. Can dry eye syndrome be cured?

   No, but it can be treated. The cause of dry eye at this time is unknown. Dry eye can be associated with rheumatoid arthritis. It also is a symptom of Sjogren's syndrome, an autoimmune disease that attacks the body's lubricating glands, such as the tear and salivary glands. And, it can be a side effect of a variety of over-the-counter and prescription medications. Because there is no cure, health care professionals direct treatment at managing symptoms.

7. What is the most common treatment for dry eye?

   Over-the-counter artificial tears in the form of eye drops are the mainstays of dry eye treatment. Most health care professionals recommend you take the drops as often as you need them to relieve symptoms. Your health care professional can recommend what brands may be best for you. As a general rule, if you use artificial tears more than two to three times a day for dry eye symptoms, you should visit your health care professional to discuss additional treatments.

8. Artificial tears don't seem to be relieving my dry eye symptoms. Will punctal plugs help me?

   Possibly, but talk to your health care professional about what treatment might be right for you. In cases of moderate to severe dry eye, a temporary or permanent plug about the size of a sesame seed can be inserted into some of the channels, or puncta, at the inner corner of the eyelid where tears drain into the nose and back of the throat. This helps conserve tears. Plugs are inserted by your health care professional in the office in minutes using a magnifying instrument to best see the punctum. Collagen punctal plugs eventually dissolve, and often are used to see whether permanent plugs will help the eye retain tears and can be tolerated by the patient. Silicone punctal plugs are considered permanent, although your health care professional can remove them.

9. How can I prevent dry eye syndrome?

   There is no way to prevent dry eye syndrome. But, you can help preserve your tears by avoiding anything that can cause dryness, such as hair dryers, rooms with low humidity, and wind. Placing a humidifier in the room when indoor heat is used, and wearing wrap-around glasses when outside may provide some relief from dry eye. Smoking is especially bothersome to dry eye sufferers, and should be avoided.