The lack of tear production (dry eye) is very common and makes up 15-20% of the cases presented to Dr. Gwin. In general the most common signs associated with dry eye include red irritated eyes, thick mucoid discharge, squinting, and discomfort. In severe cases, loss of vision or decreasing vision associated with advancing corneal disease. Aqueous tears provide nutrients and lubrication to the surface of the avascular cornea. Bilateral involvement is common.
As you would expect, therapy for dry eye is quite variable depending on the nature/severity of the problem, and the underlying causes. Medical therapy is somewhat complex and may involve several medications given several times a day. In addition to increasing tear production, resolving secondary corneal disease, infectious and inflammatory components, can be challenging. The lower the initial tear production and the longer the disease has been present the more difficult these cases tend to be.
Medical therapy involves topical antibiotics, non-steroidal anti-inflammatories (t-lymphocyte blockers) and in select cases topical cortisone. Artificial tears and over the counter lubricants are of almost no value in treating the underlying disease.