The following report by medical editor Marilyn Brooks first aired Oct. 20, 2004, on Channel 4 Action News at 5 p.m.

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A lot of people don't know they have dry eye syndrome until they see their doctor for glasses, because they don't always get that sandy, gritty feeling right away. Sometimes, the eyes are just red.

It wasn't even redness or grittiness that shocked Wendy Kramer. It was pain and swelling.

Kramer, dry eye patient: "I woke up and my eyes were red, huge, big. It looked like someone took a spoon and burned my eyelids and underneath."

The diagnosis was dry eye syndrome. An estimated 20 million people have the problem, and most are women over 50. Some believe it's related to hormones.

Causes include trauma; corneal laser surgery, such as lasik; allergy, heart and blood pressure medications; soft contacts; and rheumatoid arthritis.

At 47, Kramer has none of those problems, but dry eye syndrome can be linked to rosacea.

Kramer: "They diagnosed I have rosacea."

Though there are many causes of dry eye, lubricating eye drops are usually the solution. There is also Restasis, which is actually cyclosporine -- the same drug that holds the immune system down for transplant patients.

Dr. Reshma Paranjpe, Allegheny General Hospital: "It has a very powerful effect. It suppresses inflammation."

That's why one drop, twice a day, is used only as a last resort. It alleviates the symptoms, helps patients produce more natural tears and removes the threat of corneal damage and blindess.

Paranjpe: "As you improve the quality of the occular surface, the vision will improve, and that sandpaper look that I see under the microscope goes away."

Restasis is not a cure for dry eye. It takes 3 months to begin working and costs $80 a month. Some insurance will pay, and some will not.