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Frequently Asked Questions About Dry Eyes and Blepharitis

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What are the Symptoms of Dry Eyes and Blepharitis?
If my eyes are dry, why do they water so much?
How can I treat this condition?


Q. What are the Symptoms of Dry Eyes and Blepharitis?

Chronic tearing, and watery eyes, ocular irritation (gritty/sandy feeling in eyes), blurry vision, especially when reading, working on the computer, watching TV, or in the evening.  Patients with Blepharitis may also have crusty eyelids in the morning.

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Q. If my eyes are dry, why do they water so much?

There are two types of tears – an oily tear and a watery tear.  As we age, the oily portion of tear gets thicker and can block the tear ducts in the eyelids.  When the oily part of the tears are not present, the eye makes too much of the watery tear – and your eyes water.  We need the oily part of the tears to reduce evaporation of the watery tears and to keep the eye comfortable.

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Q. How can I treat this condition?

Dry eyes and Blepaharitis are chronic conditions and often require long-term therapy; below are some examples.

Warm Compresses in the Morning and Evening 

        • Instructions – take a clean washcloth and heat it with warm to hot water.  (Do not burn yourself.)  Ring out the water and fold the washcloth in half.  Lay the compress over your closed eyes for 2-3 minutes, reheat the washcloth, and repeat for 2-3 minutes.  Do this at least twice a day (morning and night.) Another option is the Thermoeyes heating packs.

Artificial Tears (Systane Ultra, Systane Balance, Optive, Optive Refresh Advanced)

        • Instructions - use between 2-5 times a day.  Use when your eyes feel dry or irritated and before reading and close work.  Wait 1-2 minutes before reading, as these drops may momentarily blur your vision.

Prednisolone/ Lotemax / Durezol

This is a steroid drop, which will help reduce the inflammation (swelling) of your eyelids amd make your eyes feel better.

        • Instructions - Use one drop 3 time a day for two weeks, then 2 times a day for 2 weeks.

Restasis

        • Instructions: Use one drop in the morning and one drop at night in each eye.  Each vial should last one day. This drop may burn.  Keep in Refrigerator to reduce the stinging.  This medicine needs 8-12 weeks for maximum effect.

Omega 3 Fatty Acids (Fish Oil Pills)

Omega 3 Fatty Acids are beneficial for the entire body.  Fish oil has been shown to lower cholesterol, decrease arthritis, improve the health of the skin, maintains brain function, and reduces the risk for macular degeneration.  Fish oil is excellent at improving the quality of the tear film and reducing dry eyes.

        • Instructions - Start with 1 fish oil pill (800-1200 mg) with lunch and one with dinner. (Fish oil is absorbed better in the body when eaten with some fat in your diet.)  You can increase the dose to 2 pills with lunch and 2 with dinner after 2-3 weeks.

Azasite

This is a thick medicine that you apply to your eyelids at night.

        • Instructions - You can place the medicine on you finger, and massage it into your eyelid, or you can put the drop in your eye, and then rub your lower eyelids.  The medicine can come out of the bottle quickly, so turn the bottle over, and let the medicine drip out.

Ointment at Night

(Erythromycin or Bacitracin – mild antibiotics and lubricants) and/or Tobradex – mild combination steroid and antibiotic ointment)

        • Instructions - Pull down your lower lid and place the ointment into the “pocket” created between the eyelid and the eye.  Use the ointment immediately before going to sleep – this will blur your vision.  You can rinse your eyes with lukewarm water in the morning if your eyes are still blurry.

Lid Scrubs

These are also known as OCuSoft pads or OCuSoft foam

        • Instructions - After using the warm compress, take the lid scrub pad and gently rub your upper eyelashes (with your eyes closed.) Next, open your eyes, and gently clean your lower eyelids.  Avoid touching your eye with the lid scrub.  You may prefer the lid foam, which you can apply to your eyelids with clean fingers.  (You can also use dilute Baby Shampoo on a Q-tip).

Doxycycline

This is an antibiotic used to reduce inflammation of the eyelids.

        • Instructions - It is OK to take with food or on an empty stomach, but avoid taking with milk products, or antacids, such as Rolaids, Tums or Pepto Bismol.  Avoid prolonged sun exposure on this medicine as there is an increased risk for sunburn.  Do not take if you may be pregnant.

Lacrisert

This is a small tablet slowly dissolves and releases tears all day.

        • Instructions - You can use the applicator or a clean finger to place the tablet in the lower “pocket” between your eyelid and your eyeball.  You can use the lacrisert tablets in the morning and it will provide lubrication all day.  Some people like to use lacrisert before bedtime to prevent overnight ocular dryness.

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