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Johns Hopkins Health - A Dry Eye in the House

Spring 2014
Issue No. 24

A Dry Eye in the House

Date: April 1, 2014

When eyedrops don’t provide relief, it’s time to look to a medical professional

dry eye

After a long day of staring at your computer screen, your eyes are shot. Maybe you find your vision is blurry or your eyes are burning. Or perhaps in the course of your normal routine you experience a sharp pain in your eye or have excessive watering.

These are symptoms of dry eye syndrome, which can damage the surface of the eyes and impair vision if not treated. For many people, over-the-counter (OTC) eyedrops do the trick. But not always.

Michelle Hessen, O.D., an optometrist at the Johns Hopkins Wilmer Eye Institute, says that although there is no cure for dry eyes, with effective management “our patients have been getting a significant reduction in their symptoms.”

There are two main categories of dry eyes, Hessen explains. One is a lipid deficiency, which causes tears to evaporate too quickly. The other is an aqueous deficiency, meaning not enough tears are produced. “It’s a quantity issue or a quality issue,” she says, “and very often it’s both.”

Sometimes switching to a preservative-free eyedrop is effective, she says. (Preservatives are added to most bottled eyedrops to inhibit bacteria growth, but they can also aggravate dry eyes.) Other times, a thick ointment can be applied at night. Beyond these OTC remedies, outpatient treatments might include topical medications, a procedure that seals the drains where tears leave the eye, and intense pulsed light therapy.

The risk of developing dry eye syndrome increases with age, Hessen says. Certain medications (antihistamines, decongestants), medical conditions (rheumatoid arthritis, diabetes) and environments (smoke, wind) are also factors. Staring at a computer screen or poring over printed documents for long periods can worsen symptoms, she says, though they don’t cause the condition.

Watch for These Symptoms
Dry, itchy eyes can be more than a nuisance.

When people come to the Johns Hopkins Wilmer Eye Institute for dry eye treatments, “I want to know what other symptoms they may be experiencing,” says Michelle Hessen, O.D., an optometrist at the institute. If they are also suffering from dry mouth, fatigue, achy joints or digestive difficulties, they might have Sjögren’s syndrome, a degenerative autoimmune disease that damages the glands that create moisture.

Sjögren’s affects more than 4 million Americans, 90 percent of whom are women (it’s not fully known why women are more likely to have autoimmune diseases). Yet Sjögren’s is often overlooked or misdiagnosed because its symptoms are so common.

To discover more about dry eye syndrome and Sjögren’s syndrome, including diagnosis and treatment, visit For more information, appointments or consultations, call 877-546-1872.

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