Dry Eyes, Dry Eye Syndrome, Keratoconjunctivitis Sicca are all synonymous with a disease of the ocular surface attributable to different disturbances of the natural tear production and function as well as interfering with the protective mechanisms of the  eye surface.  Ultimately it leads to a breakdown or inadequate tear film when the eyes are open.

The symptoms of Dry Eyes, Dry Eye Syndrome, Keratoconjunctivitis Sicca may include:

■ Burning and Red eyes

■ Itching

■ Foreign Body Sensation

■ Sandy Or Gritty Feeling

■ Light Sensitivity

■ Watery Eyes

■ Pain Or Soreness In Or Around Eyes

■ Tired Eyes

■ Contact Lens Discomfort

What are Dry Eyes, Dry Eye Syndrome, Keratoconjunctivitis Sicca

Your tears function to protect the eyes and keep them lubricated and comfortable. Dry Eye Syndrome (DES) is the decline of the quantity and/or quality of the tears produced. It is caused when the tear glands in the upper and lower eyelids do not produce enough tears, or they don’t produce the right kind of tears. This phenomenon causes the eyes to feel irritated, scratchy, burning, red, and uncomfortable.

Dry Eye Syndrome is the most common of all eye disorders, affecting approximately 20% of our population.

Increasing prevalence of dry eye

  • Normal tear flow decline with age
  • Increasing life-span of the population
  • Expansion of consumption of medications
  • Increase in number of people wearing contact lenses
  • Increase in computer usage.
  • Increase in number of patients undergoing LASIK.
  • Increase in pollution


Your eyes are moistened by two different types of tears:

  • Lubricating tears
  • Reflex tears.


Lubricating tears are produced continuously to moisturize the eye and contain natural infection fighting antibiotics.

Reflex tears are produced in response to sudden irritation (smoke, onions, foreign particles), injury, or emotion. Ironically, the irritation from dry eyes can trigger reflex tears, which flood the eye. But because reflex tears do not have the proper lubricating composition, the discomfort persists. Thus, “watery eyes” can actually be a symptom of DES.


  1. Tear Deficiency States
  2. Increased Tear Evaporation

Tear deficient dry eye Keratoconjunctivitis sicca (KCS)

  • Sjogrens: Autoimmune disorder with a triad of dry mouth, dry eye and arthritis
  • Non-Sjogrens
    • Aging – Gradual deterioration of lacrimal gland tissue occurs with aging
    • Menopause – At the time of menopause, levels of androgens drop down
    • Neurotrophic keratitis – Corneal sensitivity decreases after LASIK, PRK, contact lens wear and diabetes
    • Medicamentosa – Anti histamines, anti-depressants,
    • beta blockers
    • Cicatricial Diseases – Trachoma, chemical burns, Stevens Johnson syndrome



  • Meibomian gland disease: Most prevalent (65%). Obstruction of meibomian gland
  • Lid surfacing anomalies: Lid closure affected, blinking affected
  • Ocular surface toxicity: Long term use of topical antiglaucoma medications, preservatives like BAK
  • Contact lens wear can dramatically increase tear evaporation, causing discomfort, infection, and/or protein deposits. Research shows that DES is the leading cause of contact lens intolerance.
  • Allergy
  • Extensions of interblink period due to intense concentration due to close work and computer work concentration leads to drying of ocular surface.
  • Normal blink rate : 15 times/min
  • Working on computer: 5 times/min

Many causes, which explains why millions are affected.

Can Dryness Damage Your Eyes?

 Yes. When left untreated, severely dry eyes may lead to chronic infection of your eye and eyelids, corneal ulceration, scarring, permanent vision loss.

 Tear related problems are the most common medical reason people visit eye doctors.


Eye Drops can be of great help. Tear substitutes are the mainstay of therapy for dry eye.

  • Provide adequate relief
  • Increase humidity at the ocular surface and improve lubrication.
  • Smooth the ocular surface leading to improved vision.
  • Intra/post-operative use has shown to help restore ocular surface after refractive surgery.
  • Improve patients’ quality of life.

Thicker eye drops are preferred because they stay around longer.

Tears and ointments are available both with and without preservatives. If you are using them more than 4X a day, it is best to use preservative free drops.


Lacrimal Occlusion for Long Term Relief

In more persistent cases a simple non-surgical procedure is available that provides long-term relief


Lacrimal Occlusion for Long Term Relief

“Lacrimal occlusion” is the partial blockage of your tear ducts to preserve lubricating natural tears on the surface of the eyes.  Punctal occlusion can be compared to putting a stopper in a sink drain, keeping the tears on the eye’s surface for longer periods. This widely performed procedure is safe, quick, painless, and totally reversible.

This procedure may provide you with long-term relief from dry eye symptoms. For many people, lacrimal occlusion can reduce or even eliminate the need for lubricating eye drops.