Dry eye is a very common condition that occurs from a deficiency in the quantity and/or quality of the tear film.  The tears are produced by glands in the upper and lower eyelids.  Tears function to keep the surface of the eye lubricated and comfortable.  Tears also protect the eye from harmful irritants and from infection. www.mayoclinic.com/health/dry-eyes/DS00463

Symptoms of dry eye include an uncomfortable sensation, scratchy or gritty feeling, burning, itching, redness, and tearing or watering of the eyes.  There are two different types of tear production, a baseline lubricating production, and a reflex production.  The baseline lubricating production of tears occurs continuously and helps to keep the eyes healthy and comfortable.  Reflex production of tears occurs when the eyes are irritated or in response to emotion.  When the eyes are irritated, as from dryness, the eyes respond by producing reflex tears.  This is why our eyes water, even when they are dry. 

Dry eye is treated several ways, depending on the severity of the dry eye.  Usually, dry eye is treated with artificial tears, which are over-the-counter drops that supplement the body’s own tears.  Artificial tears come in many different brands, in both bottle form or in preservative-free vials.  Artificial tears even come in a gel form, which is usually used at bedtime. The artificial tears can be used anywhere from a few times a day to as often as every hour, depending on the severity of the dry eye and the type of artificial tear preparation used. 

In more severe cases, dry eye can be treated with prescription medication drops, and/or with punctual plugs.  One prescription medication works by increasing the body’s own natural tear production.  Other prescription medications treat dry eye by combating the inflammation that is associated with dry eye, or by treating eyelid conditions that can contribute to dry eye.  Treatments of the eyelid conditions that contribute to dry eye can also involve eyelid hygiene measures such as lid scrubs with baby shampoo and warm compresses. 

Punctal plugs work by occluding the drainage duct in the eyelid that carries the tears out of the eye.  There are two drainage ducts for each eye, one in the upper eyelid and one in the lower eyelid.  A plug can be placed in the drainage duct opening of the lower eyelid.  This placement of a punctal plug can be compared to placing a stopper in a sink drain.  This results in the tears staying longer on the surface of the eye. This procedure is quick, painless, and done in the office.   The results are immediate.