Myth: Dry eyes is a problem that only can be helped and not prevented.

Fact: Dry eyes is a condition of the eyes and whole body that can be treated holistically.

The most frequent patient complaint to eye doctors is dry eyes, known technically as aqueous insufficiency. About 33 million Americans in all age groups experience varying degrees of dry eye symptoms. The symptoms may include dryness, grittiness, irritation, burning and even the seeming contradiction of excessive watering or tearing.

Any condition that reduces the production, alters the composition or impedes with the distribution of the tear film may result in dry eyes. Like most eye conditions, dry eye syndrome is often related to other health conditions in the rest of the body. It is commonly associated with dryness of other mucous membranes, interior body surfaces such as joints and brittle nails. It also can be a sign of digestive imbalances or of more serious autoimmune diseases, such as rheumatoid arthritis, Sjogren's syndrome or lupus erythematosus.

These diseases trigger an immune response generating lymphocytes that slowly destroy the cells responsible for tear production and secretion. As a result, tear volume decreases, cells in the conjunctiva decrease and corneal cells can be lost, creating dry spots. In Sjogren's syndrome, for instance, the entire lacrimal gland, responsible for 90 percent of tear production, may be destroyed by the invasion of inflammatory lymphocytes.

Dry eyes are mostly a health problem for women and seems to be a result of fluctuations in hormonal levels, particularly estrogen and androgens. Pregnant women, women who use birth control pills and post-menopausal women on hormone replacement therapy frequently report dry eyes.

Dry eyes in post- menopausal women also can be a sign of Sjogren's Syndrome. This condition, which afflicts four million American women, is considered the most commonly misdiagnosed of all health conditions over the age of 40. In Sjogren's syndrome, dry eyes are accompanied by dryness in other parts of the body: dry mouth, dry joints(arthritis), sore throat, dry skin, dry cracked lips, dry scalp (dandruff) and brittle nails. This pattern of symptoms is produced by an auto-immune process in which antibodies attack fluid secreting cells. Fatigue and dental cavities are often present.

Dry eyes can also be an isolated problem. Older people naturally have drier eyes, because as we get older, our eyes produce on average 40 percent less lubrication. Free radicals are partly to blame; they take their toll over time, damaging body tissues and increasing the prevalence of dry eye symptoms. Some people lack a sufficient amount of tears, or their tears might have the wrong composition. In addition, a problem with the eyelid can prevent the tears from distributing over the eyes properly.

Long term contact lens use can also contribute to dry eyes, because, over time, contact lenses can reduce corneal sensitivity. The sensitivity of the cornea and the entire ocular surface determines how many tears the lacrimal gland will secrete. The less sensitive the cornea, the fewer tears you will have.

Forty percent of dry eye patients are smokers, so tobacco smoke, environmental allergens, air conditioning and wind may also cause dry eyes. Many medications trigger dry eyes, most commonly antihistamines, codeine, decongestants, diuretics, morphine, oral contraceptives and even eye drops such as Visine and Murine.

Standard medical treatment for dry eyes includes two options: artificial tear preparations in the form of eye drops or punctal occlusion:

ARTIFICIAL TEARS
Although many people find temporary relief with artificial tear preparations, they merely palliate the symptoms. Worse, the preservatives in many of these products can aggravate the condition. In fact, they can even kill corneal cells. Eye drops called vasoconstrictors, that promise to "get the red out", will reduce circulation in the eye, decrease production of the tear film, and worse, eventually make your eyes even drier.

Always use eye drops without preservatives. These have been shown to enhance corneal healing and improve dry eye problems.

PUNCTAL OCCLUSION
Many patients tire of using eye drops and turn to punctal occlusion, which may provide longer term relief.

Punctal occlusion is a procedure used to help dry eye patients. It is based on the theory that if the tear outflow is limited by occluding the area from which the tears flow, the amount of tears will increase so that the overall length of time that tears are in contact with the cornea will increase. This may help dry eye patients to be more comfortable.

Punctal occlusion closes the drain that draws away excess fluids from the eyes. Here is how it works: there are tear drainage canals on the margins of the upper and lower eyelids near the nose. Inside the drainage opening are tiny pumps that suck away fluid from the surface of the eyes.

In punctal occlusion, the doctor closes the drain with silicone plugs, which keeps most of the fluids from being pumped away. In one study, 85 percent of patients with dry eyes were able to reduce their need for artificial tears to occasional use.

DIET:
One of the most important aspects for people who suffer from dry eyes is the prohibition against sugar and/or artificial sweeteners. Sugar increases the risk for dry eyes. Consumption of more than 11 teaspoons of sugar per day (most of which is hidden in processed foods) has been linked to dry eye syndrome. A single can of soda contains about nine teaspoons of sugar and sugar is hidden throughout processed and refined foods in cereals, including a substantial amount of sugar in ketchup and salad dressings.

Avoid the toxic fats in commercial red meats, dairy products, fried foods and hydrogenated oils (such as margarine and shortening). These fats interfere with the proper metabolism of essential fatty acids in the body and are indirect causes of dry eye syndrome.

If you suffer from Sjogren's syndrome, you are deficient in gastric acids, particularly hydrochloric acid and pepsin. Acidophilus, bifidus and other friendly bacterial flora supplements are recommended to improve the function of the gastrointestinal tract. We recommend about six billion viable organisms (in a probiotic supplement) three times a day.

VITAMINS AND MINERALS
The following are some of the essential nutrients for treating dry eyes:

• Vitamin A: In parts of the world where vitamin A deficiency is widespread, severe dry eye syndrome is a leading cause of blindness. Vitamin A is needed for the health of all epithelial (surface) tissues; it is actually found in the tear film of healthy eyes, and is fundamental to the production of the mucous layer of the tears.

  We recommend eye drops containing vitamin A because they protect the eyes from free radicals, such as toxins, irritants, allergens and inflammation. In addition, take a daily dose of 10,000 I.U. of vitamin A and 25,000 I.U. of beta-carotene (also called pro-vitamin A because it converts to vitamin a in the body).

  Note: before beginning a regimen of vitamin A or beta-carotene, have your thyroid activity checked by your doctor. Hypothyroid patients - people with underactive thyroids - are always vitamin A deficient. They cannot convert beta-carotene to vitamin A, nor can they convert vitamin A to the form usable by the eyes. One way to check this yourself is to take your temperature under your arm when you wake up in the morning, but before you get out of bed. If it is regularly below 97.8 F degrees , you might have any underactive thyroid.

• Vitamin B6: All of the B vitamins are important in treating dry eyes, but vitamin B6 aids in the proper absorption of magnesium. Magnesium helps the body produce a hormone called prostaglandin E-7, which is necessary for tear production.
• Vitamin C: Vitamin C is concentrated in the tear film to a higher level than that found in the blood.
• Potassium: Probably the most important mineral for dry eye symptoms, potassium is usually very low in dry eye patients. This is usually linked to low intakes of folic acid, vitamin C and vitamin B6 along with high sugar consumption. You can take in at least 500 mg per day by increasing your consumption of fruits and vegetables (one banana contains 400 mg).
• Essential Fatty Acids: These are important for the production of both the oily, lipid and the watery aqueous layers of the tear film. After only ten days of taking essential fatty acids plus vitamins B6 and vitamin C, dry eye sufferers have seen an increase in tear production.

In Traditional Chinese Medicine, we view dry eyes as a deficiency in the kidney and liver meridians. The flow of tears is controlled by the liver, and the kidneys play an important role in whether dryness is present anywhere in the body. The Chinese formula we recommend is called Lycii-Rehmannia.

One researcher found that the level of a stress chemical found in tears (called prolactin) may play a role in determining why women cry four times more easily then men. Prolactin is a hormone that helps stimulate the production of milk. Might women cry more often because they have naturally higher levels of this hormone?

This research suggests that one reason we cry might be to decrease the level of stress chemicals that can eventually affect our health. According to this theory the willingness to cry when under emotional pressure may help prevent stress-related disease.