Everything You Need To Know About Dry Eyes

If you are suffering from dry eyes, you are likely experiencing itching and burning of one or both eyes. These side effects are a nuisance and they can be very uncomfortable. The good news is that there are treatments available to both target the cause of your dry eyes and alleviate your symptoms.

Dry eyes are a common occurrence affecting almost 20 million Americans, per year. While most dry eye sufferers begin having symptoms as early 6-13 years of age, seniors are affected most, with 3 million new cases every year. A visit to an allergist, optometrist or ophthalmologist will help you to get a proper diagnosis and treatment for your condition.

Most Common Causes of Dry Eyes

  • Allergies-Seasonal allergies are the primary cause of dry eyes, as a release of histamine causes the eyes to become inflamed. Allergy medications may exacerbate the problem by drying tear ducts and making the problem worse. Therefore you doctor may recommend eye drops to be taken with allergy medication.

  • Environmental Triggers-Chemicals, wind and dry heat can dry eyes due to a lack of moisture in the air. This happens when the eyes cannot produce enough lacrimal fluid to keep up with environmental demands.

  • Autoimmune Conditions-Due to glandular destruction many autoimmune disorders can cause eye and mouth dryness including: Lupus, Multiple Sclerosis, Psoriasis, Rheumatoid arthritis, and Sjogren’s syndrome.

  • Medication-Medication can reduce tear production and cause dry eye including: antihistamines, antidepressants, heart medications, and pain medicines.

  • Aging & hormonal changes-Due to hormonal changes, women & seniors 55+ have an increased chance of dry eye. Women taking birth control pills or entering menopause have an increased risk of dry eyes. 

Treatment for Dry Eyes

  • Self-care-In most cases eye drops are enough to treat dry eyes. Eye drops mimic tears lubricating the eyes, and can be purchased over the counter (OTC) or by prescription. Popular brands of OTC eye drops include: Genteal Tears, Thera Tears, Bausch & Lomb, Ocusoft and Systane Products. The price range for these eye drops is $13-$15 and are not covered by insurance. Medicated eye drops are prescribed by a doctor and include Restasis and Xiidra. Most Medicare and insurances pay for these medicated eye drops but if uninsured, medicated eye drops can run around $750. Ophthalmic corticosteroid drops are used to prevent permanent eye damage and to treat symptoms, these cost approximately $50.

  • Devices & Plugs-Devices & plugs are used in conjunction with eye drops when eye drops alone are not sufficient. Lacrisert is a once a day device placed under the eyelid. This insert is used when artificial eye drops are not successful. The cost of Lacrisert without insurance is around $630 for 60 doses. Temporary/permanent plugs called a Punctal Occlusion are used to solve a drainage issue. Your doctor will first try temporary plugs to determine if plugs work for you. Most insurances cover this procedure, but the cost for the uninsured is around $630. Scleral Contact Lenses are used to keep the eye moistened and work much like a reservoir, trapping moisture on the eye. Scleral Contact Lenses are not covered by insurance and cost $4000+ per lens.

  • Therapies-There are a number of therapies used when the meibomian gland cannot function properly, this is when lubricating oils are hardened and clogged, and lubricating oil is not able to flow. Your doctor will squeeze the hardened contents performing a Meibomian Gland Expression (MGE), Lipiflow or Intense Pulsed Light (IPL). All of these therapies are approved by the FDA, but none are covered by insurance. The cost of an MGE is $450-$500 per eye, a Lipiflow also ranges between $450-$500 per eye, and IPL costs $1200 per eye.


Dangers of Leaving Dry Eyes Untreated

Leaving dry eyes untreated can be more than irritating, untreated dry eyes can lead to serious and permanent damage. Tears perform more tasks than just overall comfort. Your tears protect the surface of your eyes from getting scratched. This area of the eye is your cornea and once damaged, the cornea will not be able to perform its job of protecting your eyes or to focus light. This could mean vision impairment due to scratches or eye infections from irritants penetrating your eye. 

If the epithelium of the cornea is permanently damaged or infected due to excessive and untreated dry eyes, Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) may be necessary to fix the damage. This is the removal of cornea damage and a partial transplanting of a cadaver’s corneal tissue. When cadaver corneal tissue transplanting is not a viable option due to several unsuccessful grafts, an artificial cornea is used called the Boston Keratroprosthesis (Kpro). Both of these procedures are usually covered by insurance but can cost between $13,000-$27,000 per eye, for the uninsured. The DSAEK has a higher success rate at 91% with the Kpro at a 56.5% success rate.