What is Dry Eye?
Dry eye is a common condition that occurs when the eyes are insufficiently moisturized, leading to itching, redness and pain from dry spots on the surface of the eye. The eyes may become dry and irritated because the lacrimal glands don’t produce enough tears, or because of an imbalance in the tear chemistry.
Patients with this condition often experience irritating symptoms and which may result in more serious damage to the vision if the condition is left untreated. It is important for patients with this condition to take special care of their eyes in order to alleviate symptoms and prevent complications. Dr. Van Norman can diagnose dry eye after a thorough evaluation of your eyes and tear production with a Schirmer tear test.
Primary Causes of Dry Eye
People typically begin experiencing dry eye symptoms as they age, but the condition can also result from certain medications, conditions, or eye injuries. Dry eye tends to affect women more often than men, due to the hormonal changes that take place during pregnancy or menopause. Oral contraceptives may also affect the consistency of tears, leading to dry eye. Dry eye is more common in people over the age of 50. Other causes of dry eye may include:
- An eye injury
- Long-term contact lens use
- Medications such as antihistamines, decongestants, blood pressure medications, or antidepressants
- Medical conditions such as rheumatoid arthritis, diabetes, or Sjogren’s syndrome
- Environmental conditions such as smoke, wind, air conditioning and dry climates
- Eye surgery or eyelid surgery
- Sun exposure or keratitis exposure
- Smoking exposure or second-hand exposure to smoke
- Thyroid eye disease
- Inflammation of the conjunctiva
These factors can affect the frequency or consistency of tears, both of which can lead to dry eyes. Our natural tears require a certain chemical balance in order to efficiently moisturize the eyes.
Symptoms of Dry Eye:
Dry eye causes a scratchy sensation or the feeling that something is in the eye. Other symptoms include stinging or burning, episodes of excess tearing that follow periods of dryness, discharge, pain, and redness in the eye. People with dry eye may also feel as if their eyelids are heavy and may experience blurred vision. Patients with dry eye may experience certain symptoms from this condition, usually affecting both eyes, which may also include:
- Eye fatigue
- Sensitivity to light
- Difficulty wearing contact lenses
- Excessive tearing
- Blurry vision
- Irritation from smoke or wind
Dry eye can damage the eye’s tissues leaving tiny abrasions on the surface of your eyes, impairing vision. Fortunately, many treatment options are available to help relieve the symptoms of dry eyes, restoring health back to the eyes ensuring clear vision and long-term health. If left untreated, dry eye could lead to the following complications:
- Ulcers or scars on the cornea
- Loss of vision
How Do Tears Relate To Dry Eye?
In a healthy eye, lubricating tears called basal tears continuously bathe the cornea, the clear, dome-shaped outer surface of the eye. With every blink of the eye, basal tears flow across the cornea, nourishing its cells and providing a layer of liquid protection from the environment. When the glands near each eye fail to produce enough tears, or when the composition of the tears changes, then the health of the eye and vision could be compromised. Vision may be affected because tears on the surface of the eye play an important role in focusing light.
Tears are a complex mixture of fatty oils, water, mucus, and more than 1500 different proteins that keep the surface of the eye smooth and protected from the environment, irritants, and infectious pathogens. Tears form in three layers:
- An outer, oily (lipid) layer, which is produced by the Meibomian glands, keeps tears from evaporating too quickly and helps tears remain on the eye.
- A middle (aqueous) layer contains the watery portion of tears, as well as some water-soluble proteins. This layer is produced by the main lacrimal gland and accessory lacrimal glands. It nourishes the cornea and the conjunctiva, which is the mucous membrane that covers the entire front of the eye and the inside of the eyelids.
- An inner (mucin) layer, produced by goblet cells, binds water from the aqueous layer to ensure that the eye remains wet.
Treatment Of Dry Eye
Treatment for dry eye depends on the cause and severity of the condition, as well as the patient’s overall health and personal preference. Non-surgical treatments are often effective, and may include the following:
- Blinking on purpose
- Increasing humidity levels at home or work
- Use artificial tears or a moisturizing ointment
- Stop smoking or exposure to secondhand smoke
- Avoiding air conditioning or windy conditions outdoors
- Stop the use of allergy and cold medicines
- Adding omega-3 fatty acids to the diet as food or supplements
If non-surgical methods are unsuccessful, surgical treatments may be an option. Dr. Van Norma can discuss with you which specific surgical treatment may be most successful in eliminating your dry eye.
How To Prevent Dry Eye
There are certain steps patients can take to prevent the symptoms of dry eye from occurring, which is especially useful for those at an increased risk of developing symptoms. Simple lifestyle modifications such as wearing protective glasses on windy days, giving your eyes a break during reading or other strenuous tasks can effectively reduce the frequency and severity of symptoms.
Change medications: Consult your physician about switching medications to alternative ones that are not associated with dry eye as a symptom.
Over-The-Counter (OTC) Topical Medications: Mild dry eye symptoms can be treated with over-the-counter medications such as artificial tears, gels, and/or ointments.
Prescription Dry Eye Medications: Cyclosporine and Lifitegrast are the only prescription medications approved by the U.S. Food and Drug Administration for treating dry eye. Corticosteroid eye drops also may be prescribed short-term to reduce eye inflammation.
Environmental and Lifestyle Changes: Cutting back on computer and/or television screen time, and taking periodic eye breaks, may help relieve dry eye. Closing the eyes for a few minutes, or blinking repeatedly for a few seconds, may replenish basal tears and spread them more evenly across the eye. Sunglasses that wrap around the face and have side shields that block wind and dry air can reduce symptoms in windy or dry conditions. Smoking cessation and limiting exposure to secondhand smoke also may help.
Surgical Options: Punctal plugs made of silicone or collagen may be inserted by Dr. Van Norman to partially or completely plug the tear ducts at the inner corners of the eye to keep tears from draining from the eye. In severe cases, surgical closure of the drainage ducts by thermal punctal cautery may be recommended to close the tear ducts permanently.
Our office can provide you with instructions as to how you can avoid the symptoms of dry eye based on your individual unique condition.