Dry eye is a common, often chronic problem, that occurs when your tears don’t properly lubricate your eyes. You don’t make enough tears or the quality of tears to keep the eye moist and comfortable. Tears provide clear vision, reduce the risk of eye infection, wash away foreign matter in the eye and keep the surface of the eyes smooth and clear.
When you blink, tears spread across the front surface of the eye. Excess tears in the eyes flow into small drainage ducts in the inner corners of the eyelids, which drain into the back the nose and to the back of the throat. Dry eyes can occur when tear production and drainage are not in balance. A chronic condition has a big impact on your life.
Causes & risk factors
People with dry eyes either do not produce enough tears or their tears are of a poor quality:
- Inadequate amount of tears. Tears are produced by several glands in and around the eyelids. Tear production tends to diminish with age, with various medical conditions or as a side effect of certain medicines. Environmental conditions, such as wind and dry climates, can also decrease tear volume due to increased tear evaporation. Symptoms of dry eye can develop when the normal amount of tear production decreases, or tears evaporate too quickly from the eyes.
- Poor quality of tears. Tears are made up of three layers: oil, water, and mucus. Each component protects and nourishes the front surface of the eye. A smooth oil layer helps prevent evaporation of the water layer, while the mucin layer spreads the tears evenly over the surface of the eye. If the tears evaporate too quickly or do not spread evenly over the cornea due to deficiencies with any of the three tear layers, dry eye symptoms can develop.
Other risk factors include:
- Age. Dry eyes are a part of the natural aging process. Most people over age 65 experience some symptoms.
- Gender. Women are more likely to develop dry eyes due to hormonal changes caused by pregnancy, the use of oral contraceptives and menopause.
- Medications. Certain medicines, including antihistamines, decongestants, blood pressure medications, and antidepressants, can reduce tear production.
- Medical conditions. People with rheumatoid arthritis, diabetes, and thyroid problems are more likely to have symptoms of dry eyes. Also, problems with inflammation of the eyelids (blepharitis), inflammation of the surfaces of the eye, or the inward or outward turning of eyelids can cause dry eyes to develop.
- Environmental conditions. Exposure to smoke, wind and dry climates can increase tear evaporation resulting in dry eye symptoms. Failure to blink regularly, such as when staring at a computer screen for long periods of time, can also contribute to drying of the eyes.
- Other factors. Long-term use of contact lenses can be a factor in the development of dry eyes. Refractive eye surgeries, such as LASIK, can decrease tear production and contribute to dry eyes.
Advanced dry eyes may damage the front surface of the eye and impair vision.
What are the symptoms of dry eye?
Pain, burning or scratchy sensation- Thin, string-like mucus
- Sensitivity to light
- Redness
- A sensation of having a foreign object in your eye
- Difficulty wearing contact lenses
- Difficulty with night-time driving
- Watery eyes – the body’s response to irritation
- Blurred vision or eye fatigue
Treatment
- Adding tears. Mild cases of dry eyes can often be managed using over-the-counter artificial tear solutions. These can be used as often as needed to supplement natural tear production. Preservative-free artificial tear solutions are recommended because they contain fewer additives, which can further irritate the eyes. People with dry eyes that don’t respond to artificial tears alone will need to take additional steps to treat their dry eyes.
- Conserving tears. Keeping natural tears in the eyes longer can reduce the symptoms of dry eyes. This can be done by blocking the tear ducts through which the tears normally drain. The tear ducts can be blocked with tiny silicone or gel-like plugs that can be removed if needed. The goal is to keep the available tears in the eye longer to reduce problems related to dry eyes.
- Increasing tear production. Use eye drops that increase tear production.
- Treating eyelid or ocular surface inflammation. Eye drops or ointments, warm compresses and lid massage, or eyelid cleaners can help to decrease inflammation around the surface of the eyes. Taking an omega-3 fatty acid nutritional supplement may also help.
- Oral antibiotics are prescribed in some cases.
- IPL therapy – this procedure can open clogged glands, especially if the underlying cause is Rosacea.
- Maskin probing- a very thin probe is used to manually open clogged glands.
Prevention
You can take the following steps to reduce symptoms of dry eyes:
- Remember to blink regularly when reading or staring at a computer screen for long periods of time. Remember the 20/20/20 rule – every 20 minutes look up for 20 seconds at a distance of 20 feet or 6m.
- Increase the humidity in the air at work and at home by using humidifiers
- Wear sunglasses outdoors, particularly those with wraparound frames, to reduce exposure to drying winds and the sun.
- Nutritional supplements containing essential fatty acids may help decrease dry eye symptoms in some people. Ask your doctor if taking dietary supplements could help your dry eye problems.
- Avoiding becoming dehydrated by drinking plenty of water (8 to 10 glasses) each day.
- Avoid air getting blown in your eyes by directing car heaters away from your face.
- Avoid environments that are drier than normal, such as deserts, airplanes, and places at high altitudes.