What is dry eye? Why does it happen? What are the symptoms? How is it treated? Are there any drops? What problems does it cause? What is good for dry eyes? You can find the answers to all these questions and much more below.
What is dry eye?
Dry eye is a common condition that occurs when your tears cannot provide enough lubrication for your eyes. Tears can be insufficient for many reasons. For example, dry eyes can occur if you don’t produce enough tears or if you produce low-quality tears.
People with dry eyes feel discomfort in their eyes. If you have dry eyes, you may experience a stinging or burning sensation in your eyes. On an airplane, in an air-conditioned room, while riding a bike, or after staring at a computer screen for a few hours, you may experience dry eyes in some cases.
Treatments for dry eyes can make you more comfortable. These treatments may include lifestyle changes and eye drops. You will probably need to take these measures indefinitely to control the symptoms of dry eyes.
Causes of dry eyes
Dry eyes are caused by a lack of tears. Your tears are a complex mixture of water, oils and mucus. This mixture helps to keep the surface of your eyes smooth and clear and to protect your eyes from infection.
For some people, the cause of dry eye is decreased tear production. For others, there is an increase in tear evaporation or an imbalance in tear content.
Decreased tear production
Dry eyes can occur when you cannot produce enough tears. The medical term for this condition is keratoconjunctivitis sicca. Common causes of decreased tear production include:
- Certain medical conditions, such as diabetes , rheumatoid arthritis , lupus disease , scleroderma , Sjogren’s syndrome , thyroid disorders , and vitamin A deficiency
- Certain medications, including antihistamines, decongestants, hormone replacement therapy, antidepressants, and medications for high blood pressure, acne, birth control, and Parkinson’s disease
- Laser eye surgery (dry eye symptoms associated with this procedure are usually temporary)
- Tear gland damage from inflammation or radiation
increased tear evaporation
Common causes of increased tear evaporation include:
- Wind, smoke or dry air
- Less frequent blinking (for example, when concentrating on something, reading at the computer, driving or working)
- Eyelid problems such as outward turning of the lids ( ectropion ) and inward turning of the lids ( entropion )
Imbalance in tear composition
The tear film has three basic layers: oil, water, and mucus. Problems with any of these layers can cause dry eyes. For example, the oil film produced by the small glands ( meibomian glands ) at the edge of your eyelids can become clogged.
Who is at risk?
Factors that increase the likelihood of experiencing dry eyes include:
- Being older than 50: Tear production decreases as we age. Dry eyes are more common in people over the age of 50.
- Being a woman: Lack of tears is more common in women, especially if they’re using birth control pills due to pregnancy or experiencing hormonal changes during menopause.
- Vitamin deficiency: Low intake of vitamin A found in liver, carrots and broccoli or eating a diet low in omega-3 fatty acids found in fish, walnuts and vegetable oils are also risk factors.
- Contact lens wear: Wearing contact lenses can cause dry eyes in some cases.
dry eye symptoms
Symptoms that usually affect both eyes can include:
- A stinging, burning, or itchy feeling in the eyes
- Fibrous mucus in or around your eyes
- light sensitivity
- eye redness
- The feeling that there is something in the eyes
- Difficulty using contact lenses
- Difficulties with car driving
- Eye watering, which is the body’s response to the irritation of dry eye
- blurred vision or eye strain
When should you see a doctor?
You should consult your doctor if you have signs of prolonged dry eye, including red, irritated, tired or sore eyes. Your doctor can take some steps to determine what’s bothering your eyes or refer you to a specialist.
Diagnosis of dry eye
Tests and procedures that may be used to determine the cause of dry eye include:
- A comprehensive eye exam: An eye exam that includes a complete history of your general health and eye health can help your doctor diagnose the cause.
- Measuring the volume of your tears: Your doctor can measure your tear production using the Schirmer test . In this test, blotter strips are placed under your lower eyelids. After five minutes, your doctor measures the amount of strip soaked with your tears.
- Determining the quality of your tears: Other tests use special dyes in eye drops to determine the surface condition of your eyes.
dry eye treatment
For most people with occasional or mild symptoms of dry eye, regular use of over-the-counter eye drops (artificial tears) is sufficient. If your symptoms are persistent and more serious, you have other options. Treatment depends on what is causing the dry eye.
Some treatments focus on reversing or managing a condition or factor that causes dry eye. Other treatments can improve your tear quality or prevent your tears from draining quickly from your eyes.
Treating the underlying cause of dry eyes
In some cases, treating an underlying health condition can help relieve the symptoms of dry eye. For example, if a medication causes dry eyes, your doctor may recommend a different medication that does not cause this side effect.
If you have eyelid conditions such as protruding lids (ectropion), your doctor may refer you to an eye surgeon who specializes in plastic surgery of the eyelids (oculoplastic surgeon). If you have rheumatoid arthritis, your doctor may refer you to a rheumatologist.
Prescription medications for dry eyes include:
- Medications to reduce eyelid inflammation: Inflammation along the edge of your eyelids can prevent the sebaceous glands from releasing oil into your tears. Your doctor may recommend antibiotics to reduce inflammation. Antibiotics are usually taken orally, but some are used as eye drops or ointments.
- Eye drops to control corneal inflammation: Inflammation on the surface of your eyes can be controlled with cyclosporine, the immune-suppressing drug, or prescription eye drops containing corticosteroids. Corticosteroids are not ideal for long-term use due to possible side effects.
- Eye attachments that work like artificial tears: If you have moderate to severe dry eye symptoms and artificial tears aren’t helping, another option might be a small eye attachment that looks like a clear grain of rice. Once a day, you place the hydroxypropyl cellulose insert between your lower eyelid and your eyeball. The insert slowly dissolves and releases a substance used in eye drops to lubricate your eyes.
- Tear-stimulating drugs: Drugs called cholinergics help increase tear production. These medications are available as pills, gels, or eye drops. Possible side effects include sweating.
- Eye drops made from your own blood: These are called autologous blood serum drops . This may be an option if you have severe dry eye symptoms that do not respond to another treatment. To make these eye drops, a blood sample is processed to remove red blood cells and then mixed with a saline solution.
Remember, your doctor will decide which medicine to take and how.
Other procedures that can be used to treat dry eye include:
- Closing your tear ducts to reduce tear loss: Your doctor may recommend this treatment to prevent your tears from leaving your eye too quickly. This can be done by partially or completely closing your tear ducts, which normally drain tears. Tear ducts can be inserted with small silicone plugs ( punctal plugs ) and these can also be removed. Also, tear ducts can be plugged with a procedure that uses heat. This is a more permanent solution called thermal cautery .
- Using special contact lenses: You can ask your doctor about new contact lenses designed to help people with dry eyes. Some people with severe dry eye may prefer special contact lenses that protect the surface of the eyes and trap moisture. These are called scleral lenses or bandage lenses .
- Unblocking sebaceous glands: Daily use of warm compresses or eye masks can help clear clogged sebaceous glands. The thermal vibration device is another way to prevent the sebaceous glands from getting clogged, but it is not clear whether this method offers any advantages over hot compresses.
- Using light therapy and eyelid massage: Intense pulsed light therapy and a technique called eyelid massage have been proven to help people with severe dry eyes.
What is good for dry eyes?
While more studies are needed, some alternative medicine approaches may help relieve your dry eye symptoms. It’s still a good idea to consult your doctor about the benefits and risks of the following things.
Here are the things that are good for dry eyes:
- Fatty acids: Adding omega-3 fatty acids to your diet can help relieve symptoms of dry eyes. These can be taken as supplements and are found in foods such as flaxseed, salmon, and sardines.
- Castor oil eye drops: These eye drops can improve symptoms by reducing tear evaporation.
- Acupuncture: Some people have found relief from dry eye symptoms after acupuncture treatment.
- Apply a warm washcloth to your eyes: Wet a clean cloth with warm water. Hold the cloth over your eyelids for five minutes. When it has cooled, wet the cloth with warm water. Gently rub the cloth over your eyelids, including at the base of your lashes, to dissolve any dirt.
- Use a mild soap on your eyelids: Use baby shampoo or another mild soap. Put the cleanser on your clean fingertips and gently massage your closed eyes near the base of the lashes. Then rinse completely.
Can dry eyes be prevented?
If you experience dry eyes, you should pay attention to the situations that are most likely to cause your symptoms. Then find ways to avoid these situations to prevent your symptoms. E.g:
- Avoid blowing air into your eyes: Do not point hair dryers, car heaters, air conditioners or fans towards your eyes.
- Add moisture to the air: In winter, a humidifier machine can add moisture to the indoor air.
- Wear protective sunglasses or other protective glasses: Safety shields can be added to the top and sides of the glasses to block out wind and dry air.
- Take eye breaks during long tasks: If you’re reading or doing something that requires visual concentration, take periodic eye breaks. Close your eyes for a few minutes. Or blink repeatedly for a few seconds to spread your tears evenly across your eyes.
- Be aware of your surroundings: At high altitudes, desert areas, and on airplanes, the air can be extremely dry. When spending time in such an environment, it may be helpful to close your eyes frequently for a few minutes at a time to minimize the evaporation of your tears.
- Bring your computer screen below eye level: If your computer screen is above eye level, you will open your eyes wider to view the screen. Set your computer screen below eye level so you don’t open your eyes wide. This can help slow the evaporation of your tears between blinks.
- Quit smoking and avoiding smoke: If you smoke, ask your doctor for help developing a smoking cessation strategy that is likely to work for you. If you don’t smoke, stay away from people who do. Smoke can worsen dry eye symptoms.
- Use artificial tears regularly: If you have chronic dry eye, use prescription eye drops to keep your eyes wet, even when your eyes are well.
Dry eye complications
People with dry eyes may experience the following complications:
- Eye infections: Your tears protect the surface of your eyes from infection. Without enough tears, there may be an increased risk of eye infections.
- Damage to the surface of your eyes: If dryness in the eye is left untreated, it can lead to eye inflammation, erosion of the corneal surface, corneal ulceration and vision problems.
- Decreased quality of life: Dry eyes can make it difficult to perform daily activities such as reading.