Understanding Dry Eye: Symptoms, Causes and Treatment

Introduction:

TExperiencing redness, excessive tears, or irritation in your eyes? If so, then you might be suffering from dry eyes. This generally occurs when you spend long hours on any digital device, while sitting in an airconditioned room, traveling in aircrafts, or even riding a bike.

Tears help our eyes to stay healthy and comfortable. Dry eye syndrome is also known as Keratoconjunctivitis Sicca (KCS), is an eye condition that occurs due to inadequate lubrication of the eyes or poor-quality tear production in the eyes.

Symptoms of Dry eye

Dry eye syndrome is caused by lack of lubrication by the tear glands. The first symptoms of this eye condition are sting or burning sensation in your eyes which leads to reflex tearing. Symptoms associated with this eye problem are redness, irritation of the eyes, discharge, blurred vision which may vary from occasional to continuous and mild to severe.

Dry eye condition when left untreated leads to tear instability, This is not only uncomfortable but also leads to inflammation of the eye and damages the cornea and affects vision.

Symptoms of this eye condition also include:

• Dry, scratchy, and painful sensation in the eye
• Irritation of the eye, a feeling of something in the eye
• Redness
• Presence of mucus in the eye or around
• Sensitivity to light
• Tired eyes
• Watery eyes, which is the body’s response to the irritation of dry eyes
• Blurred vision

A consultation with your Ophthalmologist is necessary if you have any of the symptoms. Prolonged signs and symptoms may affect your vision and your daily routine. Treatments offered by the eye specialist will help you control the dry eye syndrome and make you comfortable.

What Causes Dry eyes

The tear film of the eye is made up of three layers: fatty oils, aqueous fluid and mucus. This combination usually keeps the surface of your eyes lubricated. Problems with any of these layers can cause dry eyes. Usually the cause of dry eyes is decreased tear production or increased tear evaporation.

Decreased tear production

Common causes of decreased tear production are:

• Aging
• Medical conditions such as Sjogren’s syndrome, allergic eye disease, rheumatoid arthritis, lupus, scleroderma, sarcoidosis, thyroid disorders, or vitamin A deficiency
• Medicines such as antihistamines, decongestants, hormone replacement therapy, diuretics, antidepressants, and medicines for high blood pressure, acne, birth control and Parkinson’s disease

Increased tear evaporation

This is caused due to blocked tear glands. The oil film is produced by small glands on the edge of your eyelids (meibomian glands). When these become clogged it leads to increased tear evaporation. Blocked meibomian glands are more common in people with rosacea or other skin disorders.

Treatment Options for Dry Eyes

Ideally, any treatment for your eyes should be after a consultation with an Ophthalmologist. However, over-the-counter eye drops and gels are also readily available.

Non-prescription products

There is a plethora of over-the-counter medicines for treating dry eyes. These include lubricating artificial tear eye drops, gels and ointments.

• Artificial tearscan be used to control mild dry eye symptoms. However, depending on the severity of your problem, an Eye specialist can guide you with the type of artificial tears and its dosage.
• Lubricating eye ointmentis supposed to be used at night time and gives longer lasting relief

Eye drops can be used at any time and usually do not interfere with your vision. However, a few factors need to be considered while choosing over-the-counter medications:

• Choose a preservative free artificial tear drops. If you use eye drops more than four times a day, preservative free drops are safe.
• Lubricating eye ointment is preferred for night-time application. The high viscosity of the lubricating eye ointment can cause blurry vision.

Prescription medications for dry eyes

Medicines help to reduce eyelid inflammation. Eyelid inflammation may block the oil secreting glands over the edge of the eyelids. Your eye doctor may prescribe antibiotics either oral or topical to reduce this inflammation.

• Eye drops to control surface inflammation. Inflammation on the surface of your eyes (cornea) may be controlled with prescription eye drops that contain the immune-suppressing medicine cyclosporine (Restasis) or corticosteroids. Corticosteroids are not ideal for long-term use due to possible side effects.
• Autologous blood serum drops– these are eye drops made from your own blood. A sample of one’s blood is processed and used as eye drops. This is an option if one has severe dry eye symptoms that do not respond to any other treatment.
• Lacrisert: These are eye inserts which are the size of a rice grain and need to be inserted between lower eyelid and eyeball. This dissolves slowly, releasing a substance that is used in eye drops to lubricate your eye
• Nasal spray – a recently approved treatment option for dry eyes is the new addition to the armamentarium.

Advanced treatments for severe dry eyes-

Depending on the severity of the eye condition, an Eye specialist may consider advanced treatment techniques such as-

• Punctal plugs: This is to block your tear ducts. This makes tears stay longer on the surface. Tear ducts can be plugged with tiny silicone plugs which are removable.
• Contact lenses: New age contact lenses are designed to help people with dry eyes. This helps to protect the surface of the eyes and trap moisture.
• Unblock Oil glands: Warm compresses of eye masks can be used daily to clear up blocked oil glands. A thermal pulsation device is another way to unclog the oil glands.
• Light therapy and eyelid massage: A technique called intense-pulsed light therapy followed by massage of the eyelids may help people with severe dry eyes

Lifestyle modification:

Modifications in Lifestyle and natural methods can also help in providing relief to Dry Eye syndrome. Some of the methods include:

• Avoid directing hair dryers, car heaters, air conditioners or fans toward your eyes. A humidifier can add moisture to dry indoor air.
• Eyelid hygiene should be maintained by application of lid scrubs in case of eyelid inflammation.
• Take periodic breaks while reading. Close your eyes for a few minutes. Or blink repeatedly for a few seconds to help spread your tears evenly over your eyes.
• Position the computer screen below eye level so that you will not open your eyes as wide. This may help slow the evaporation of your tears between eye blinks.
• Avoid smoke as it tends to worsen dry eyes symptoms.

Conclusion

Dry eye is a chronic condition. Besides causing discomfort in the eyes, it can adversely affect one’s vision and quality of life as well. Nonetheless, there are treatment options available, and one must seek the help of an eye specialist in case of persistent dryness symptoms. An Eye specialist will recommend the best treatment option depending on the cause and severity of the eye problem and help restore the quality of life.