Dry Eye Treatment
What are the symptoms of dry eye?
- Dry eye symptoms may include any of the following:
- stinging or burning of the eye;
- a sandy or gritty feeling as if something is in the eye;
- episodes of excess tears following very dry eye periods;
- a stringy discharge from the eye;
- pain and redness of the eye;
- episodes of blurred vision;
- heavy eyelids;
- inability to cry when emotionally stressed;
- uncomfortable contact lenses;
- decreased tolerance of reading, working on the computer, or any activity that requires sustained visual attention;
- eye fatigue
And it may seem odd, but dry eye syndrome also can cause watery eyes. This is because dryness on the eye's surface sometimes will overstimulate production of the watery component of your tears as a protective mechanism.
What are tears, and how do they relate to dry eye?
Tears, made by the lacrimal gland, are necessary for overall eye health and clear vision. Tears bathe the surface of the eye, keeping it moist, and wash away dust and debris. They also help protect the eye from bacterial and other types of infections.
Tears are composed of three major components: a) outer, oily, lipid layer produced by the meibomian glands; b) middle, watery, lacrimal layer produced by the lacrimal glands; and c) inner, mucous or mucin layer produced by goblet cells located within a thin transparent layer over the white part of the eye and covering the inner surface of the eyelids. Tears are made of proteins (including growth factors), electrolytes, and vitamins that are critical to maintain the health of the eye surface and to prevent infection.
Tears are constantly produced to bathe, nourish, and protect the eye surface. They are also produced in response to emergencies, such as a particle of dust in the eye, an infection or irritation of the eye, or an onset of strong emotions. When the lacrimal glands fail to produce sufficient tears, dry eye can result.
Any disease process that alters the components of tears can make them unhealthy and result in dry eye.
What causes dry eyes?
The development of dry eyes can have many causes. They include:
- Age—dry eye is a part of the natural aging process. The majority of people over age 65 experience some symptoms of dry eyes.
- Medications—certain medicines, including antihistamines, decongestants, blood pressure medications and antidepressants, can reduce the amount of tears produced in the eyes.
- Medical conditions—persons with rheumatoid arthritis, diabetes and thyroid problems are more likely to have symptoms of dry eyes. Also, problems with inflammation of the eyelids, 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 or reading 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 can cause decreased tear production and dry eyes.
Treatment for Dry Eyes
Dry eyes can vary in severity and should be treated accordingly. Initially, you may want to:
- Take breaks often when you read, watch TV, or use a computer. Do not rub your eyes, Over-the-counter artificial tears may help when you are doing these activities.
- Avoid smoke and other things that irritate the eyes.
- Use wraparound sunglasses to protect your eyes from the sun, wind, and grit.
- Use a vaporizer or humidifier to add moisture to your bedroom.
- Do not use fans while you sleep.
- If you usually wear contact lenses, use rewetting drops or wear your glasses until your eyes feel better.
- Try using artificial tears (lubricating eye drops) at least 4 times a day.
- If you need artificial tears more than 4 times a day, use preservative-free artificial tears. The are less likely to irritate your eyes.
- Use a lubricating ointment or gel at bedtime. Lubricants are thicker and last longer, so there is less burning, and dryness when you wake up in the morning. The will make your vision blurry for a short time after installation.
- Use warm, moist compresses on your eyelids for about 5 minutes, daily
- Prescription eye drops may be necessary if symptoms are severe.
Dry eye can be managed as an ongoing, chronic condition. The first priority is to determine if a disease is the underlying cause of the dry eye (such as Sjogren’s syndrome or lacrimal and meibomian gland dysfunction). If it is, then the underlying disease needs to be treated.
It is important to work with your doctor to find ways to help your eyes feel better. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems.
Testing the quality of your tears (Osmolarity Testing) using the TearLab can be done in our office to determine the severity of your dry eyes and treatment can be designed accordingly.