Restasis is the most widely prescribed eye drop used for the treatment for dry eyes. Unlike artificial tears which lubricate the eye, Restasis works by facilitating the production of tears. Bottom line: Restasis treats the cause of the dry eye rather than the symptoms of dry eye.

As a part of normal degenerative processes of aging, the tear production glands in the eyelids and on the surface of the eye become inflamed and lose their ability to produce oil, water and mucous. If this inflammatory process is allowed to progress, these cells ultimately die and lose their ability to produce the lubricants so vital to the health and comfort of the eye. Certain ocular conditions like chronic blepharitis and conjunctivitis and certain medical conditions like autoimmune diseases all tend to be inflammatory in nature and further accelerate the more subtle inflammatory processes of aging.

Restasis is an immuno-suppressive agent and works to relieve dry eyes by virtue of its anti-inflammatory properties. Chronic inflammation of the oil producing tear glands results in diminished oil and mucous production. Ultimately this process can progress to essentially no tear production what-so-ever. Reduced tear production results in extremely uncomfortable and unhealthy eyes. Simply speaking, chronic inflammation damages the tear producing glands and prevents them from functioning. Restasis, by suppressing the inflammation in the tear glands at the molecular level, allows the tear producing cells to return to normal and start producing “good tears” again.

All good things come with time:
Because it takes a while for this entire process to work, relief from Restasis is not a “quick-fix”. It takes about 3 to 4 months to significantly alter the tear production process. Consequently it takes that long to really observe and feel the effects of Restasis. For this reason, the eye doctor generally will see the patient at one-month intervals during the start-up period in order to assess the physical signs of improvement that generally precede the symptomatic relief that the patient is waiting for. Because it takes so long to work, these visits often provide a “up-lift’ to the patients who very quickly can become discouraged and disheartened by their dry eye symptoms.

What the doctor sees:
The eye doctor can actually observe the effects of dry eyes on the surface of the cornea. By using a yellow anesthetic dye, the doctor is able to assess and measure the degree of dryness. The doctor sees this dryness as superficial punctuate staining (SPK) on the cornea. This actually represents areas where the normal cells have died and literally fallen off. It is analogous to chapped skin, but on the front of the eye (conjunctiva and cornea). And just as chapped skin is uncomfortable, dry eyes (chapped skin of the cornea) can be miserable.

What the patient feels:
Once the surface protective cells have fallen off the cornea and the nerves are exposed, the patient experiences symptoms of grittiness, a sandy feeling, itching, burning, redness and fatigue. It often feels like something has fallen into the eye and is moving around. This sensation occurs because your upper lid is actually rubbing against the exposed nerves of the cornea. Often the patient complains that there is something in the eye and that it is moving around. This occurs because it is your eye that is moving relative to the eye lid. As you look up-and-down or left-and-right the eye lid keeps rubbing against the exposed nerves from a different direction. Tear film dysfunction is generally referred to by the symptom it creates, “dry eye”. The tear film not only cleanses, moistens, feeds and protects the eye, but it also has the greatest effect on the light/images that pass through it for focusing as compared to any other part of the eye. Dysfunction of any part of the tear film can thus cause infection, pain and discomfort and can compromise daily activity and quality of life, including decreased vision. Just as a dirty automobile windshield greatly reduces clarity and causes glare, so too a dry cornea can cause blurry vision and glare.Can dry eye symptoms be cured?The short answer is, No! Like any condition of aging, dry eyes can be controlled, but not cured. Restasis along with other dry eye treatments can keep a patient feeling healthy and normal.

What else can I do for dry eyes:
There are a number of effective treatments for the symptomatic relief of dry eyes both systemic and topical. Nutritional oil supplements and artificial tears are the mainstay of dry eye treatment.

It has become apparent that omega fatty acids are exerting an anti-inflammatory effect upon the tear glands.

Nutritional Supplements:
Fish Oil - Flaxseed Oil – Borage = Omega 3-6-9 The benefits of omega fatty acids as nutritional supplements have been touted for many years as being good for your heart and overall wellbeing. Their use in dry eye was initially thought to be related to the lubricating benefits of these natural oils. Most recently, it has become apparent that they are also exerting an anti-inflammatory effect upon the tear glands as well. So, once again, as with Restasis, the basic inflammatory abnormality causing dry eyes is being treated. You should consult one of our doctors as to which of these nutritional supplements would be best for you and which may be contraindicated because of certain systemic medications that you may be taking.

Artificial Tears:
Artificial tears work on the eye in much the same fashion as lubricating creams work on dry skin. They are made up of various lubricants that attempt to mimic the oil and mucous components of your normal tear film. Depending upon an individual patient’s deficiency (oil or mucous) one particular artificial tear may provide better symptomatic relief than another. Often it is a matter of trial and error before the appropriate tear match is made for the patient. If you are taking tears more than 3-4 times a day, you probably would benefit from Restasis and should be evaluated. Ocular Decongestants: There are many eye drops that work by constricting or “bleach” the blood vessels in the conjunctiva (skin of the eye). These are not an effective way to treat dry eyes. A lubricant (artificial tear) is what is needed, not a decongestant. Decongestants have a roll in the treatment of allergic eye conditions, but are generally are not helpful in treating dry eyes.