The National Eye Institute defines Dry Eye as:
". . . a disorder of the tear film due to tear deficiency or excessive tear evaporation which causes damage to the interpalpebral [the exposed area between the upper and lower lids] ocular surface and is associated with symptoms of ocular discomfort."
Symptoms of dry eyes include: discomfort or pain, stinging, burning, itching, chronic irritation, foreign body sensation or gritty, sandy feeling in eyes, redness, blurred vision, contact lens intolerance, and symptoms usually worse at the end of the day. In severe cases, there can be damage to the cornea with loss of vision.
What causes dry eyes?
Tears normally consist of three layers: lipid (oily layer produced by the meibomian glands in the eyelid), aqueous (watery layer produced by the lacrimal glands), and mucous (produced by goblet cells of the conjunctiva.) Dry eyes occur when one or more of these layers are deficient or of poor quality.
There are many causes of dry eyes including:
- Rapid evaporation of tears: Meibomian gland dysfunction, overheated and air-conditioned buildings, infrequent blinking, Bells Palsy or other eyelid malpositions.
- Decreased production of tears: from lacrimal gland dysfunction; from Sjogren's syndrome which is a connective tissue disorder associated with rheumatoid arthritis or lupus; certain medications (antidepressants, allergy medicines, hormonal replacement therapy) can aggravate dry eyes.
- Increased inflammation of the ocular surface: Studies have shown that patients with dry eye have a higher osmolarity in their tear film, as well as higher levels of inflammatory cytokines and lower levels of beneficial growth factors.
Dry eyes are 2-3 times more common in women than men, probably related to hormonal effects.
How are dry eyes treated?
This condition is not curable, although it is manageable. The mainstay of therapy is artificial tears. Your eye care specialist will recommend moisturizing drops and ointments to ease any symptoms. Sometimes changing your environment by turning down the heat or using a humidifier can help as well.
Treating the eyelid margin is very important, and therapies include eyelid scrubs, warm compresses, topical antibiotic drops or ointments or oral antibiotics.
Ingesting Omega 3 oils found in fish and flaxseed have been shown to benefit patients with dry eye due to their anti-inflammatory effects. Please check with your doctor on the recommended dosages.
Often, patients with decreased production of tears may be candidates for punctal occlusion which is closure (either temporary or permanent) of the channel that drains the tears from the eye.
Prescription medications that are commonly prescribed for patients with dry eye include: Restasis (cyclosporine 0.05%) and topical steroids. Both of which treat the inflammatory component of dry eye.
Dry eyes are a chronic problem that require continued monitoring. If you are suffering from dry eye, please see your eye care specialist.