Q: I've been diagnosed with recurrent corneal erosion. My eyes are dry all the time. One eye doctor suggests putting small plugs in the ducts that drain tears from my eyes, which should make the tears stay in my eye longer and make my eyes moister. I use artificial tears all day long and an ointment at night. Will the plugs help prevent further eye damage? Also, I have a dry mouth and wonder if I have Sjogren's syndrome. If I have it, would the plugs still help?
A: Placing "punctal plugs" has become a common procedure for patients with severe dryness of the eyes. These plugs block your tears from draining. So the tears you make last longer in the eye. Your condition sounds severe enough that this approach seems appropriate to consider.
Other ways to help avoid dry eye include:
--Using artificial tears frequently
--Steering clear of low-humidity environments
--If possible, avoiding medicine that makes dryness worse (such as diuretics, antihistamines and certain antidepressants)
There are a variety of eye drops that may reduce irritation and help prevent corneal damage from not making enough tears. Doctors commonly recommend artificial tears and cyclosporine (RESTASIS). Your ophthalmologist can determine the best care for your eyes after a full evaluation.
Sjogren's syndrome is an autoimmune disease. That's a condition in which the immune system mistakenly attacks its host. People with Sjogren's syndrome have dry eyes and mouth and inflammation in multiple organs, including the eyes, joints and skin.
Antibody tests can help diagnose this condition. Diagnosis is important because you may need more than just eye drops. For example, drugs that stimulate saliva production or drugs that suppress the immune system may be helpful.
Dry mouth increases the risk of cavities. So your dentist may recommend frequent dental cleaning and an oral rinse with fluoride.
Based on the symptoms you describe, I would suggest you see an ophthalmologist, dentist and rheumatologist for evaluation.
(Robert H. Shmerling, M.D. is a practicing physician in rheumatology at Beth Israel Deaconess Medical Center, Boston, Mass., and an Associate Professor in Medicine at Harvard Medical School.)
(For additional consumer health information, please visit http://www.health.harvard.edu.)