Dry Eye - Dr. Jiwani & Associates

What is dry eye?

Dry eye syndrome — also called dry eye disease (DED) — is one of the most common eye conditions worldwide and a primary reason for visits to the optometrist. Dry eye syndrome is caused by a chronic lack of sufficient lubrication and moisture on the surface of the eye or poor-quality tears. According to the American Association of Optometrists, tears are made up of three layers: oil, water and mucus. Each component protects and nourishes the front surface of 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, dry eye symptoms can develop. In addition to being called dry eye syndrome, dry eye disease, or simply “dry eye,” alternative medical terms used to describe dry eyes include:

Keratitis sicca – used to describe dryness and inflammation of the cornea usually when the layer of tears is inadequate.
Keratoconjunctivitis sicca – used to describe dry eye that affects both the cornea and the conjunctiva.
Dysfunctional tear syndrome – used to emphasize that inadequate quality of tears can be just as important as inadequate quantity.

What causes dry eye?

According to the American Association of Optometrists dry eye can develop for many reasons, including:

Age

Dry eyes are a part of the natural aging process. The majority of people over age 65 experience some symptoms of dry eyes.

Hormonal Fluctuations

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 tear production.

Medical conditions

People 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.

Lifestyle

Extended use of computers, screens where you aren’t blinking, and wearing contact lenses can contribute to developing dry eyes.

Refractive Eye Surgeries

Refractive eye surgeries, such as LASIK, can decrease tear production and contribute to dry eyes.

What are the symptoms of dry eye?

Some common symptoms of dry eye include:

Burning sensation

Itchy eyes

Aching sensations

Heavy eyes

Fatigued eyes

Sore eyes

Dryness sensation

Red eyes

Photophobia

Blurred vision

Feeling of grit or foreign material in your eye

Did you know?

Watery eyes also can be a symptom of dry eye syndrome! If there is dryness on the surface of the eye, it may over-stimulate production of the watery component of tears as a protective mechanism. Unfortunately, this type of “reflex tearing” doesn’t correct the underlying dry eye condition.

Can dry eye harm my vision?

Consequences of dry eyes range from subtle but constant eye irritation to significant inflammation and even scarring of the front surface of the eye and infection. Prolonged, untreated dry eyes can lead to blurred vision as well. When our eyes are functioning optimally they continually produce tears to bathe the eye’s surface. This washes away dust, debris and microorganisms that may damage the cornea and lead to an eye infection.

As outlined on All About Vision, a normal tear film consists of three important components:

An oily (lipid) component
A watery (aqueous) component
A mucous-like (mucin) component

Each component of the tear film serves a critical purpose and if one or more of these components isn’t working properly it can cause dry eye.

How do I know if I have dry eye?

The only way to be sure if you’re experiencing any of the above symptoms and irritation is to make an appointment for a comprehensive eye exam.

What is the treatment for dry eye?

Usually after an eye exam determines your dry eye and we work together to determine your contributing factors to see if they can be reduced. Treatment may consist of the following:

If at first you don’t succeed cry, cry again…

Adding tears: Mild cases of dry eyes can often be managed by assisting natural tear production. Preservative-free artificial tear solutions are recommended because they contain fewer additives, which can further irritate the eyes. People with dry eyes that don’t respond to artificial tears alone will need to take additional steps to treat their dry eyes.

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, or a surgical procedure can permanently close the tear ducts. 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: This is usually accomplished through a prescribed eye drop and taking an omega 3 fatty acid supplement.

In addition to tears the following may be recommended to reduce eyelid or ocular surface inflammation:

Prescription eye drops or ointments
Warm compresses and lid massage
Eyelid cleaners- to help decrease inflammation around the surface of the eyes.

There are also lifestyle changes you can make to help alleviate, reduce or eliminate dry eye. They are:

Remember to blink! – Staring at screens for long periods of time especially when concentrating can often make us forget to blink. Look away from screens regularly and blink to restore moisture.
Humidity Helps- Increase the humidity in the air at work and at home.
Eyewear- Wear sunglasses outdoors, particularly those with wraparound frames, to reduce exposure to drying winds and the sun.
Nutritional supplements- Supplements containing essential fatty acids such as fish oil or astaxanthin, may help decrease dry eye symptoms in some people.
Drink- Water that is! Avoid becoming dehydrated by drinking plenty of water (8 to 10 glasses) each day.

How we can help

Dry eyes can cause inflammation and (sometimes permanent) damage to the surface of the eye which is why it’s important to have an eye exam or give us a call if you suspect you have it. It can also be annoying to feel as though you have something in your eye, and we can offer over the counter or prescription drops that can provide relief. Visit us so we can work with you to determine the causes of your dry eye and solutions.