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Green Swirls & Green Dots: the Face of Dry Eye

Dry Eye is much more than a symptom or a feeling.   For many people, it's an actual syndrome.   What does Dry Eye Syndrome look like?   Green Swirls and Green dots of course!

abnormal evaporation of tear layer

Before you go asking your friend of family member if they see any green dots or swirls in your eye, let me first say that's estimated Dry Eye Syndrome affects millions of people in the United States.   The symptoms may range from mild dryness all the way to severe redness, irritation, itching and sandy feeling.  The dryness may go beyond a simple lack of moisture to actually causing damage to the front surface of the eye.

When patients come to our practice with complaints related to dry eyes, we instill a temporary dye made of sodium-flouroscein.   The dye lasts for about 10 minutes,during which time we use a special cobalt blue light to excite the dye.   Doing so allows us to physically see the patient's ocular dryness and its effect on the eye.   This is where  the green swirls and green dots come in.

When ocular dryness isn't a problem, the tear layer forms an even coat across the surface of the eye.  However, the green swirls in the top picture show the tear layer evaporating off the surface of the eye unevenly.   Normally, this tear layer should last for 10 seconds. In patients with dry eye, it may only last 2 or 3 seconds before evaporating and typically looks just like the top picture.

staining of damaged surface cells

When the dryness is chronic, it can physically damage the surface layer of the eye.   The bottom picture with the green dots shows the sodium flourescein staining these damaged cells.   There are a lot of sensory nerves in this area, so when this damage occurs the person will typically experience irritation, discomfort,or a sandy feeling.

The good news is there are treatments available.  Artificial tears are just one way to treat Dry Eye Syndrome.   When the green swirls and dots show, it may be time for prescription medications or tear saver plugs.

As always, we'd love to hear from you.    Post a question or give us a shout out on our Facebook page!

Dr. Beach


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