Dry Eyes

Dry eye is a condition in which there are insufficient tears to lubricate and
nourish the eye. Tears are necessary for maintaining the health of the front
surface of the eye and for providing clear vision. People with dry eyes either
do not produce enough tears or have a poor quality of tears. Dry eye is a common
and often chronic problem, particularly in older adults.

With each blink of the eyelids, tears are spread across the front surface of
the eye, known as the cornea. Tears provide lubrication, reduce the risk of eye
infection, wash away foreign matter in the eye, and keep the surface of the eyes
smooth and clear. Excess tears in the eyes flow into small drainage ducts, in
the inner corners of the eyelids, which drain in the back of the nose.

Dry eyes can result from an improper balance of tear production and drainage.

• 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 affect tear volume by increasing tear evaporation. When the normal
  amount of tear production decreases or tears evaporate too quickly from the
  eyes, symptoms of dry eye can develop.
• Poor quality of tears – Tears are made up of three layers: oil, water,
  and mucus. Each component serves a function in protecting and nourishing the
  front surface of the eye. A smooth oil layer helps to prevent evaporation of
  the water layer, while the mucin layer functions in spreading 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.

The most common form of dry eyes is due to an inadequate amount of the water
layer of tears. This condition, called keratoconjunctivitis sicca (KCS), is also
referred to as dry eye syndrome.

People with dry eyes may experience symptoms of irritated, gritty, scratchy,
or burning eyes, a feeling of something in their eyes, excess watering, and
blurred vision. Advanced dry eyes may damage the front surface of the eye and
impair vision.

Treatments for dry eyes aim to restore or maintain the normal amount of tears
in the eye to minimize dryness and related discomfort and to maintain eye
health.

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.
• 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 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 (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 cause decreased tear production and dry eyes.

How are dry eyes diagnosed?

Dry eyes can be diagnosed through a comprehensive eye examination. Testing,
with special emphasis on the evaluation of the quantity and quality of tears
produced by the eyes, may include:

• Patient history to determine any symptoms the patient
  is experiencing and the presence of any general health problems, medications
  taken, or environmental factors that may be contributing to the dry eye
  problem.
• External examination of the eye, including lid
  structure and blink dynamics.
• Evaluation of the eyelids and cornea using bright light
  and magnification.
• Measurement of the quantity and quality of tears for
  any abnormalities. Special dyes may be instilled in the eyes to better
  observe tear flow and to highlight any changes to the outer surface of the
  eye caused by insufficient tears.

Using the information obtained from testing, your optometrist can determine
if you have dry eyes and advise you on treatment options.

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How are dry eyes treated?

Dry eyes can be a chronic condition, but your optometrist can prescribe
treatment to keep your eyes healthy, more comfortable, and prevent your vision
from being affected. The primary approaches used to manage and treat dry eyes
include adding tears, conserving tears, increasing tear production, and treating
the inflammation of the eyelids or eye surface that contributes to the dry eyes.

• 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 that could further irritate the eyes. However, some people may
  have persistent dry eyes that don’t respond to artificial tears alone.
  Additional steps need to be taken to treat their dry eyes.
• Conserving tears – An additional approach to reducing
  the symptoms of dry eyes is to keep natural tears in the eyes longer. 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. A surgical procedure to permanently close
  tear ducts can also be used. In either case, the goal is to keep the
  available tears in the eye longer to reduce problems related to dry eyes.
• Increasing tear production – Prescription eye drops
  that help to increase production of tears can be recommended by your
  optometrist, as well as omega-3 fatty acid nutritional supplements.
• Treatment of the contributing eyelid or ocular surface
  inflammation – Prescription eye drops or ointments, warm compresses
  and lid massage, or eyelid cleaners may be recommended to help decrease
  inflammation around the surface of the eyes.

Self Care

Steps you can take to reduce symptoms of dry eyes include:

• Remembering to blink regularly when reading or staring at a computer
  screen for long periods of time.
• Increasing the level of humidity in the air at work and at home.
• Wearing sunglasses outdoors, particularly those with wrap around frame
  design, to reduce exposure to drying winds and sun.
• Using nutritional supplements containing essential fatty acids may help
  decrease dry eye symptoms in some people. Ask your optometrist if the use of
  dietary supplements could be of help for your dry eye problems.

Avoiding becoming dehydrated by drinking plenty of water (8 to 10 glasses)
each day.

If you continue to experiencing these symptoms you may have chronic dry eye.
Call our office today to speak to an eyecare professional about what treatments may be available to you.