What is dry eye?
Dry eye happens when your eyes don’t make enough tears to stay wet, or when your tears don’t work correctly. This can make your eyes feel uncomfortable, and in some cases it can also cause vision problems.
Dry eyes are an recurring problem, especially in older people.
When you blink your eyes, the tears will spread out over your face called your cornea.
Tears provide a lubricant and a barrier against eye disease.
Excess tears flow into tiny drainage pipes inside of your eyelid that drain down to the back. Dry eyes occur as tears have not produced and are not balanced.
Tell me the difference between dry eye disease and dry eye syndrome?
Dry eyes is the absence of lubrication and moisture in the eye.
Dry eye disease (DED), also known as dry eye syndrome (DES), keratoconjunctivitis sicca (KCS), and keratitis sicca, is a multifactorial disease of the ocular surface due to a loss of homeostasis of the tear film. They are the same.
A healthy layer of tear is necessary in the eyes for good vision.
Tear bathing keeps the eyes hydrated and wipes away dirt, debris and microbes causing damage and causing eye infections.
What is tear?
Dry eye is the result of the tear film not working optimally . The tear film protects and lubricates the surface of the eye and is important for good vision
A typical tear film includes a watery (aqueous) component produced from meibomian glands under the eyelids and contains the following: water, oils and mucus.
Tears are a combination of:
- Water,-
- Oils, for lubrication and to prevent evaporation of tear liquid.
- Mucus, for even spreading of tears on the surface of the eye.
Each layer serves a purpose.
The inner layer is made up of mucus that coats the surface of the eye.
The mucin layer binds tears to the eye to prevent tears evaporate too quickly.
The cornea is naturally hydrophobic, so the mucous layer helps to connect watery layer above. The mucous layer is also responsible for spreading the water layer evenly over the surface of the eye. The middle layer which is also the thickest layer is mostly oils.
Tear contains Antibodies and special proteins, for resistance to infection,
These components are secreted by special glands located around the eye.
A smooth oil layer helps prevent evaporation of the water layer, while the mucin layer spreads 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, or when there is an imbalance or deficiency in this tear system, a person may experience dry eye.
Dry eye disease categories
Dry eye disease types can be grouped in many different ways according to the components of the disease. In some cases meibomian glands do not produce sufficient oil which causes tear film.
This underlying disorder is known as meibomian gland dysfunction, which often is the cause of dry eye syndrome.
Dry eye symptoms
Dry eye symptoms are associated with constant eye irritation, burning, dry, red, stinging, scratching, light sensitive, gritty, watery, blurry vision, and stringy mucus hear the corners of the eye.
Sometimes watery eye happens when the dry eye surface cause the over production of watery parts of the tear making eyes watery constantly ( reflex tear). However, reflex tears cannot remain in the eye for longer to correct an underlying dry eye condition.
Symptoms
Typ0ical Dry Eye Symptoms:
- Burning
- dry
- scratchy feeling,
- blurry vision,
- red eyes
- Watery
- stinging
- light sensitivity
- Stringy mucus near the eye
Symptoms of dry eye Trusted Source can include: a stinging or burning feeling in the eyes a feeling of pressure in the eyes, or a feeling that something is in them redness blurred vision or sensitivity to light difficulty or discomfort when opening the eyes.
Causes & risk factors
Dry eyes occur when tear production cannot flow smoothly.
Dry eyes can damage the retina and impair vision.
Common causes include but not limited to:
Diabetes :
Nearly half of people with diabetes have dry eyes. The development of dry eye is often linked to a loss of nerves in the cornea (neuropathy). Without functional nerves in the cornea, tear production from the tear-producing lacrimal glands is decreased.
Rosacea :
While rosacea is primarily known as a skin condition that causes facial redness and visible blood vessels, more than half of these patients also develop eye problems known as ocular rosacea.
Medications.
Certain medicines, including antihistamines, decongestants, blood pressure medications, and antidepressants, can reduce tear production
Many prescription and nonprescription medicines increase the risk of dry eye symptoms, including antihistamines, antidepressants, certain blood pressure medications such as beta-blockers or diuretics and birth control pills.
Eyelid problems
Eyelid problems – Incomplete closure of the eyelids when blinking or sleeping (called lagophthalmos ) can cause severe dry eyes. Severe dryness can lead to a corneal ulcer if left untreated.
Autoimmune diseases
Such as Sjogren’s, Rheumatoid arthritis, Lupus, Hypothyroid, Rosacea, Uveitis, Iritis. See more below.
What causes dry eyes?
There are various reasons for dry eyes.
Dry eyes result when your natural tears do not adequately lubricate the eye.
meibomian gland dysfunction,
An abnormality of the glands on the edge of the eyelid (meibomian glands) that are supposed to produce the oil to prevent evaporation of the tears.
Blepharitis
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.
Ocular Rosacea
Inflammed eyes due to facial rosacea which is genetic.
Contact lens –
The chances of developing dry eye problems can vary widely. Dry eyes are also mainly a cause for the lack of contact lenses.
Long-term use of contact lenses can be a factor in the development of dry eyes.
Certain types of contact lenses can help protect the surface of the eye and trap moisture. This helps to keep the cornea hydrated and promotes healing.
Aging
Dry eyes generally occur at any ages and become more prevalent at 50.
Menopause:
Postmenopausal women are most susceptible to dry eyes.
Blepharitis
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
Refractive eye surgeries , such as LASIK, can decrease tear production and contribute to dry eyes.
Autoimmune Diseases.
If you have an autoimmune or other health conditions, such as rheumatoid arthritis or systemic lupus erythematosus, your eye doctor will treat your dry eye disease so you can be pain free with clear vision and one less health concern to manage.
People with rheumatoid arthritis, diabetes, and thyroid problems are more likely to have symptoms of dry eyes. Cyclosporine is also used to treat patients with rheumatoid arthritis and psoriasis.
Prevalence of dry eye
Dry eyes syndrome is an important eye condition that causes the majority of recurring eye problems worldwide and the eye physician is often the most frequently seen complication.
A new study published in “The Journal of Global Health” shows that dry eyes can affect as many as 5 per cent of the population worldwide.
Researchers felt large variations could be caused by varying diagnostic criteria in a range of study types, unique characteristics of the questioned population.
Diagnosis
An eye exam that includes a complete history of your overall health and your eye health can help your doctor diagnose the cause of your dry eyes.
Testing procedures for dry eyes includes :
Schirmer’s Test – testing the amount of the tears in the eye. A thin layer of paper is put under the eyelid. Measure how many strips your tears have covered with water for five minutes.
Other techniques to measure tearing volume are phenol- red thread tests. During the tests threads are placed onto lower eyelashes dipped in acid to produce a color that changes in pH. The tears will be moist for 15 seconds and measured for tears volume.
Slit Lamp Examination – The exam is simple and painless — your doctor will give you some eye drops to dilate (widen) your pupil and then check your eyes for dry eye and other eye problems.
Tear Osmolarity – A tear osmolarity test measures the composition of particles and water in your tears. With dry eye disease, there will be less water in your eyes. Tear samples to look for markers of dry eye disease, including elevated matrix metalloproteinase-9 or decreased lactoferrin.
Treatments
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.
TheraLife Eye – Oral Dry Eye Treatment
All natural dry eye treatment that works. Learn more
Best dry eye relieve with TheraLIfe.
Artificial tears
Artificial tears are available over the counter.
One of the first steps is to recommend artificial tears twice daily. The most effective over-the-counter eye drops are preservative-free and are sold in single, one-use vials.
The use of artificial teardrops is a palliative (soothing) treatment that helps symptoms for a few minutes but does not treat the underlying cause of the dry eye disease.
No one drop works for everyone, so you might have to experiment to find the drop that works for you. If you have chronic (long-lasting) dry eye, it is important to use the drops even when your eyes feel fine, to keep them lubricated.
For people who have occasional dry eye symptoms, they may need regular eyedrops (artificial tears).
Artificial tears simply moisten your eyes. If you have moderate symptoms of dry eye, artificial tears may be all you need
When you are unable to get rid of symptoms, there is an alternative. It is dependent on the problem that causes the eyes to itch.
Some treatments are directed at preventing the symptoms of dry eyes.
Other treatment options
Other treatments may increase your tears’ quality or prevent the tears from draining from your eyes.
There are also over-the-counter moisturizing gels and ointments that may help your eyes feel better.
People with dry eyes that don’t respond to artificial tears alone will need to take additional steps to treat their dry eyes.
Nonsteroidal anti-inflammatory drugs (NSAIDS):
Oral NSAIDs purchased over the counter may be used to help ease discomfort associated with dry eye disease.
Prescription eye drops
For more severe dryness, there are highly effective prescription drops.
An eye doctor can prescribe eye drops that increase tear production.
If your dry eye is more serious, your eye doctor may give you a prescription for medicines called cyclosporine (Restasis).
Topical cyclosporine is an eye drops (Restasis®): These are given twice a day in each eye to treat the underlying inflammation in the tear glands so they produce more and better quality tears. It typically takes 1 to 4 months before the cyclosporine A drops reduce symptoms and signs of dry eye.
Tear-stimulating drugs. Drugs called cholinergics (pilocarpine, cevimeline) help increase tear production. These drugs are available as pills, gel or eyedrops.
Other prescription drugs include Cequa or lifitegrast ( Xiidra ) eye drops to help increase tear production.
If you have ocular rosacea associated with dry eye, then newer artificial tears contain lipid to help prevent tear evaporation. If you take artificial tears 4 or more times a day, you should use non-preserved artificial tears, since preservatives will likely worsen your condition.
Autologous blood serum drops.
Autologous serum drops: In severe cases of dry eye, artificial tears made from the patient’s own serum can be prepared and given 6 to 8 times a day in both eyes. This treatment, although often effective, is expensive ($300 to $400 every 3 months) and is not covered by Medicare or insurance.
Fish oil
You can take alpha omega fatty acids or fish oil or flaxseed oil orally (by mouth
Warm compresses
Warm compresses are especially helpful for people with meibomian gland dysfunction.
Oitment
Thick eye drops that make it less likely to evaporate. May cloud your vision for a while.
Eye lid cleanser
Your eye doctor might recommend prescription eye drops or ointments, warm compresses and lid massage, or eyelid cleaners to help relieve dry eye symptoms.
Punctal Plugs
Sometimes it is necessary to close the ducts that drain tears off the eye.
Conserving tears.
Keeping natural tears in the eyes longer can reduce the symptoms of dry eyes. 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.
Punctal plugs are tiny devices placed in the tear ducts of the eyelids which stop fluid from draining from the eye.
If tears are draining too quickly from your eyes, your doctor may suggest putting special plugs (called punctal plugs) in your tear ducts (small holes in the inner corners of your eyes). These plugs can help keep your tears in your eye.
Surgery
In some cases, dry eye can happen because your lower eyelids are too loose, causing tears to drain too quickly out of your eye.
IPL
Intense pulsed light (IPL) therapy is an alternative treatment that’s typically used to reduce rosacea and acne symptoms.
In one study Trusted Source for chronic dry eye, 93 percent of participants reported they were satisfied with their degree of symptoms after treatment with IPL therapy.
Intense pulsed light treatment for dry eye disease due to meibomian gland dysfunction; a 3-year retrospective study. DOI: 10.1089/pho.2014.3819 FEEDBACK: Medically reviewed by Ann Marie Griff, O.D. — Written by Sonia Pearson — Updated on August 11, 2020.
The hardened oil-like substance trapped in the glands. It also uses pulsed pressure to open and express the clogged glands. By removing the hardened oil-like substance from the glands, the glands can begin producing healthy oils to prevent evaporation of tears. This procedure takes about 12 minutes.
LipiFlow
Clearing blocked oil glands. Your doctor may recommend a procedure known as LipiFlow thermal pulsation Trusted Source to clear blocked oil glands.
The technique involves placing what looks like a large contact lens over your eye and behind your eyelids. Another shield is placed outside your eyelids and both devices apply heat
Dry eye treatment and prevention
Dry eyes syndrome is a persistent and progressive disorder. In some cases the disease cannot be completely prevented.
Dry eyes are usually treated well. The treatment often leads to better sleep quality while reducing dry eye symptoms. Dry eye diseases have several causes and varying treatment options are available.
Sometimes eye doctors ask patients for information before they begin a dry eye procedure.
Other dry eye treatment considerations
Besides the above described dry eye treatment, your eye doctor can suggest some of the following measures in your case.
Many drugs such as antibiotics and antidepressants are often used in the treatment of dry eye. Even nonprescription medications are known to have an adverse effect on eye sight.
If you’re suffering from dry eyes, you should consult your eye doctor. Do not stop using medications until you speak to the eye doctor.
Alternative medicine
The research suggests these alternative medicines may help in relief from dry eyes. Tell your doctor how it works for you.
Lifestyle and home remedies
You can control dry eyes with daily eye wash and eyedrops. Use Eyedrops when the skin feels dry or damaged.
Your eyes may also feel better if you: Try to avoid smoke, wind, and air conditioning
Humidity
On your own, you can take these steps to improve dry eye: Humidify the bedroom to at least 40 percent humidity when you are sleeping (when tear production is lowest). This can be measured with a humidity meter (hygrometer) on the nightstand. Humidity may be very low (less than 25 percent) during the winter when the heater is on, and this worsens the dry eye condition
Preparing for your appointment
You’ll need first contact an eye doctor. You can then ask your eye doctor for advice. Since appointments are usually short it’s advisable to prepare properly to make an appointment.
