Dry Eyes and Dry Eye Syndrome
What is dry eye syndrome?
Dry eye syndrome can be characterized by problems with the tear film that keeps the eyes lubricated and moist. Your eyes must be constantly covered by fluid. Your tear film keeps your eyes moist between blinks. If you have a stable tear film then you will not get dry eyes. Your eyes will remain clear and you will remain comfortable. The dry eye syndrome is also known as keratoconjunctivitis sicca.
The dry eye syndrome can come about because of several factors. If the production of fluids in your eyes decreases then the tear film can become destabilized. Breaks will appear on the tear film and you will experience some dry spots on the surface of your eyes. Any kind of imbalance in the substances that support the tear film can harm eye’s health. Dry eyes can cause a lot of discomfort so you should take care of the tear film and have it treated when there are problems. Lessen the dryness, discomfort, and blurry vision if you can.
What are some of the symptoms of dry eyes?
- sensitivity to light
- stinging sensations in your eyes
- stringy mucous in the eye area
- a burning feeling in your eyes
- difficulty wearing contact lenses
- the urge to scratch your eyes often
- blurry vision especially after a long day or after focusing for a long time
- increased eye irritation because of wind or smoke
- getting tired quickly after reading for a short while
What are the causes of dry eyes?
Your tears are made up of fatty oils, water, proteins, bacteria fighting substances, and electrolytes. These substances are used to maintain harmony and balance in your eyes. They regulate certain cell processes and keep your eyes healthy, smooth, and clear. You will not be able to see clearly if you do not have tears.
Dry eyes are sometimes caused by an imbalance of the chemical composition of tears. If people do not produce enough tears to keep their eyes lubricated then there will be problems. Some other factors that can lead to dry eyes are problems with your eyelid, environmental factors, and some medications.
The Quality of your Tears
There are three basic layers in a tear film – the oil, the water, and the mucous. If there are problems with any of these layers then there will be some dry eye symptoms.
- Oil – The meibomian glands are responsible for lubricating your eyes with oil. They are found on the edge of your eyelids. Oil is found in the outermost layer and it smoothes the tear surface. The evaporation of water in the middle layer is also slowed down with these oils. These fatty oils are also known as lipids. Without this layer or when this layer is not functioning properly, the water layer underneath it will evaporate faster than usual. This will cause your eyes to dry. If the meibomian glands are not functioning properly or if they are clogged then you will have dry eyes. This is common in people with inflamed eyelids or blepharitis, some skin disorders, and rosacea.
- Water – The layer in the middle is mainly composed of water and some salt. The glands that are responsible for the water in this layer are the lacrimal glands or the tear glands. These glands clean your eyes and make sure that foreign substances are washed away. Shallow water layers in this layer can affect your tear film. If your lacrimal glands do not produce enough water then the oil layer and the mucous layer may touch and cause stringy discharges. This is evident in people with dry eyes.
- Mucous – The innermost layer is the mucous layer. The mucous enables your tears to spread smoothly over your eyes. If there is inadequate production of mucous then you will notice dry spots forming in the cornea area or in the front of the eye.
A decrease in the production of your tears
For people who are more than forty years of age, dry eyes are widespread. When people get older, the production of tears starts to decline. You are unable to produce enough tears and as a result, your eyes dry easily and become irritated faster than usual. Doctors describe this condition as keratoconjunctivitis sicca.
Dry eyes is a condition that affects both men and women. Women who have gone through menopause are more likely to get dry eyes because of the hormonal changes, damage to the tear glands because of inflammation, or damage to the tear glands from radiation. If you have medical conditions like rheumatoid arthritis, scleroderma, diabetes, Sjogren’s syndrome, lupus, and Vitamin A then you may also get dry eyes.
Laser Eye Surgery
If you have gone through a laser eye surgery then you may also get dry eyes. Refractive eye surgery like LASIK or laser-assisted in-situ keratomileusis can cause dry eyes afterwards but will usually go away after a few weeks.
Poor lid function
Human beings blink every twelve seconds on average. This enables your eyes to renew a thin film of tears and keep it lubricated. If you have complications with your eyelids then your blinking will be affected. When your blinking is affected then this thin film of tears will not refresh itself properly. You will end up with dry eyes. Some eyelid problems are associated with old age. They are ectropion or the turning outwards of the eyelids or entropion or the turning in of the eyelids.
This is a disorder characterized as an inflammation of the eyelids, particularly on its edges. This can cause your eyes to feel dry and itchy.
Medications that can cause dry eyes
There are several medications in the market today that can cause dry eyes. They can be over-the-counter drugs or drugs that are prescribed by doctors. Some of these medications that can dry eyes include
- sleeping pills
- birth control pills
- isotretinoin-type drugs used to treat acne
- opiate based pain relievers like morphine
- diuretics or drugs that are used to treat high blood pressure
- angiotensin converting enzyme or ACE inhibitors for high blood pressure
Your dry eyes can become worse if they are exposed to certain environmental elements. Environmental factors that speed up drying include exposure to the sun, high altitudes, dry climates, wind, hot air, and the kind of air that you experience in high altitude cabin airliners.
There are also some activities that increase dry eyes. Activities that require you to focus your eyes and concentrate will make dry eyes worse. These activities include working on your computer, reading, driving a car, and writing. These activities tend to reduce your blink rate and thus, increase evaporation on your eyes.
When should you seek medical advice?
Dry eyes will not cause permanent damage to your eyes although if it is already affecting your vision then you may need medical attention already. If you are having difficulty performing your day-to-day tasks then you should seek medical attention. If you are hindered from enjoying life because of your dry eyes then you must seek medical attention right away.
You should see your doctor if your dry eyes do not seem to go away. If you have had dry eyes for a long time then you should seek medical attention. If your eyes are red, tired, painful, or irritated for a prolonged period then you must seek medical attention. Your doctor will check the cause of your dry eyes and recommend steps to remedy the problem.
How is the dry eye syndrome diagnosed?
For eyes that are dry and irritated, the doctor will test the amount of tears you produce and the quality of your tears. Using the Schirmer tear test, blotting strips of paper are used. They are put under your lower eyelids for five minutes. Afterwards, the doctor will measure the amount of tears that were soaked by the paper strip.
Sometimes special dyes in the form of eye drops are used to find out how the surface of your eyes is doing. Your doctor will check the pattern of evaporation and the rate of evaporation on your cornea.
What are some of the complications that can arise from dry eyes?
The production of your tears can happen in two ways. The first way is basic tearing and it constantly produces tears at a steady rate. This way, your eyes are kept lubricated. The second way of producing tears is through reflexes. This is when large amounts of tears flow out of your eyes. These reflex tears happen in response to pain, emotions, or irritations. These reflex tears contain a lot more water in proportion to the mucous and oils.
The lacrimal glands will fill your eyes with reflex tears whenever they are irritated. The tear ducts will be filled with fluid and they will overflow from your eyelids. These tears are poor quality tears so they do not help in dry eyes. In fact, they even prompt you to produce even more tears.
Most of the people who have dry eyes usually do not experience any complications in the long run. Take note that severe dry eyes can turn into infections, inflammations, and cornea surface scarring so have your dry eyes treated if you can.
How is dry eye treated?
Your doctor will give you a thorough examination first so that the factors which cause your dry eyes can be identified. Finding out the cause of your dry eyes is important in treating it. In order to fix dry eye problems, the doctor will find a way to keep your eyes moist. Here are some of the ways your doctor will treat dry eyes.
Managing Lid Problems
People with eyelid conditions like anatomic abnormalities or people with incomplete blinks can make the dry eye problems even worse. You may be referred to an oculoplastic surgeon, or a surgeon who specializes in the plastic surgery of the eyelids. Sometimes your eyelids may be inflamed. This condition is called blepharitis. Your doctor will advise you to clean the area with a dilute solution of baby shampoo on a regular basis. On top of that, you may also need antibiotic drops, antibiotic ointments, antibiotic treatments, oral antibiotics like tetracycline or doxycycline, and other short-term treatments that you may have to apply during the night.
Artificial tears can be a smart solution for a mild case of dry eyes. You can purchase these artificial tears over-the-counter. If you are hesitant to purchase these tears on your own then you can ask advice from a doctor. You may even get to purchase some prescription-based artificial tears. These lubricating drops are a great way to instantly address dry eyes. You can use them as often as you need. If you want to use them several times in an hour in order to provide relief for your eyes then you can do so. In some cases, the eye drops may have preservatives. These eye drops can be used for up to four times a day. Eye drops with redness removers may make your dry eye worse so make sure you don’t purchase these types of eye drops. You can prevent making your dry eyes worse if you use the lubricating eye drops before starting eye-straining activities like using the computer or reading. Some ointments can be used in order to make sure that your eyes are well lubricated although the may cause your vision to blur. In this case, you can use these ointments before you go to bed instead of using tem in the day time.
Some eye doctors will advise you to keep your natural tears around. They will do this by completely closing the tear ducts or merely closing part of it. These tear ducts are used to drain the tears and they can be held back by using silicone plugs. Your tears can be conserved with these plugs. If you are using artificial tears then they can be conserved as well. You can leave these silicon plugs in your eyes or you can remove them. If you want a permanent solution for these tear ducts then you can opt for thermal cautery. This procedure involves numbing the area with anaesthetic. A hot wire will be used to shrink the tissues of the drainage area. This will then scar and then eventually close the tear duct.
If your dry eyes aren’t too severe then artificial tears may provide you with a quick remedy. There are people who do not respond to artificial tears though. Their eyes may appear normal but will still be dry. The more severe dry eyes require more intense treatments. Silicone plugs are a more serious solution for dry eyes. There are also special customized contact lenses called Boston Scleral Lens that can address more severe dry eyes. This kind of lens will rest on the sclera. The sclera is the white part of the eye. This will create a fluid layer over the cornea and thus, prevent dry eyes.
Medications for Dry Eye
Cyclosporine or Restasis is one of the medications that can treat dry eye. It reduces the inflammation of the eye surface and it promotes the production of healthy tears. There are people who experience burning sensations when they use this medication so make sure you get advice from a doctor before using this. People who have had a history of herpes infection in their eyes or who have had an eye infection should not use Restasis.
There are times where doctors will prescribe steroid drops in order to help in reducing any inflammation in your eyes. These steroid drops are usually prescribed if there si continued irritation in the eye despite the application of lubricating drops.
People who have a diet that is rich in Omega-3 Fatty acids can lower their risk of dry eyes. There are some dietary supplements that are rich in these fatty acids and they may help in reducing the risk of dry eyes as well. There have been research studies that show that topical application of these fatty acids may alleviate dry eyes.
Recommendations for avoiding dry eyes
Any liquid that is exposed to air will evaporate. Your tears are no exception. Here are some tips that you can keep in mind so that you manage the evaporation of your tears.
- you should refrain from rubbing your eyes because they make dry eyes even worse
- you should stay away from smoke whether it is from you or from someone else
- you should avoid blowing air into your eyes. Avoid exposing your eyes to hair dryers, car heaters, air conditioners, and electric fans that are directed to your eyes
- always blink. If you blink consciously then you will help in spreading your tears evenly across your eyes. When you are doing activities that strain your eyes like typing on the computer, reading, or watching television, you should take frequent breaks. You should rest your eyes as much as you can. Close them for a couple of seconds and rest them. You can consciously increase your blink rate so that the fluids are spread constantly over your eyes. If you have gone through previous surgery then you should follow these tips for better post-operative results
- consider wearing eye protection equipment like sunglasses on windy days or goggles when you go for a dip in the pool. Some glasses have a wrap-around style that can minimize the effects of the wind
- consider taking preventive steps like using eye drops before activities that strain your eyes like using the computer, reading, or driving. You can even consider avoiding these eye straining activities altogether
- consider adding moisture in the air that surrounds you. For example, during the winter, you can install a humidifier in your place so that the dry indoor air becomes more moist
- put on eyewear that makes your eyes moist. There are specially designed glasses nowadays that create moisture chambers near your eye areas. You can wear these glasses at night. These glasses are useful for people who sleep with their eyes slightly open. These glasses can be worn at daytime in order to relieve any signs of dry eye