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Los Gatos Eye Care
A Professional Optometric Corporation
15563 Union Ave.
Los Gatos, CA 95032

(408) 377-2020
fax: (408) 377-2022

Dry Eye Syndrome/Tear Film Insufficiency


Dry Eye Syndrome affects more than 10 million people, primarily women, in the United States alone. It is one of the most common conditions for which patients see eye care.

Dry eye syndrome results primarily from compromise to either the quantity or quality of the tear film. Tears are composed of three layers. Deficiencies in any one of the components may create a tear film which is incapable of properly moistening the eye, resulting in drying out and symptomatic complaints. In addition, irregularities in the blink mechanism or conditions affecting the regularity of the ocular surface may further interfere with proper wetting of the cornea.

Dry Eye Syndrome can cause lots of suffering. It can also impair functional visual acuity, leading to a decreased ability to read and to drive, especially at night. Furthermore, it increases the risk of eye infection.

As is the case with other diseases involving chronic pain, the constant pain of severe dry eye. It is essential to treat this condition to improve your eye health.

The typical symptoms of chronic dry eye syndrome (other than dryness) are:
  1. Foreign body sensation: The irritation caused by the eyelid rubbing on a dry surface produces a feeling similar to having sand in the eyes and patients will often complain of feeling like something is in the eyes.
  2. Excessive watering: There is a feedback loop from the brain to the eye that tells the lacrimal gland to produce more tears when the eye is dry. But, unfortunately, unless the eye also produces more of the other two layers (mucous and oil), the eye will never be “satisfied” and will continue to produce more and more water causing excessive tearing.
  3. Headaches: The brain doesn't know the difference between the front of the eye and the back of the eye when it comes to pain. If the eyes are dry and the eyelid rubbing on the dry surface causes irritation, often times the patient will complain of pain behind the eye or radiating back from the eye or a headache above or behind the eyes.
The tear film is made up of three distinct layers. If any one of the layers is somehow disrupted (either too much or too little), the ENTIRE tear film will become unstable and will start to break down.
  1. Mucous: This is the layer directly over the front surface of the eye (the cornea & conjunctiva). It is produced from cells called “Goblet cells” and its purpose is to create a “cushion” between the tear film and the delicate surface of the eye.
  2. Water: This is the middle layer and is much thicker than the other two layers. It is produced by the lacrimal gland which actually sits underneath the brow bone toward the temple(s). The water from the lacrimal gland enters the eye(s), travels across the eye, and drains through two openings (one on the upper lid and one on the lower lid) near the nose called the puncta. The puncta ultimately drain into the nasal cavity which is why the nose runs when crying or excessively tearing.
  3. Oil: This is the top layer; it is produced from oil glands which run vertically across the eyelids and empty out at the base of the eyelashes. The oil layer on top of the tear film help to keep the tears from evaporating.
The treatment for Dry Eye Syndrome is designed depending on many factors such as age, gender, profession, severity, environmental factors, social history and others. Treatment might include pharmaceutical grade artificial tears, nutritional supplements, oral or topical antibiotics, topical steroids or Restasis.

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