Symptoms and Treatment of Dry Eye – By: Dr. Rosmary Sanchez, O.D.
This condition is present when there is a lack of tears on the surface of the eye. Tears are necessary to lubricate, nourish, and to reduce the risk of eye infections. They are essential for maintaining good eye health, keep eyes comfortable, and partly responsible for providing clear vision.
Tears are spread throughout the front surface of the eye with each blink. Tears are constantly produced by different glands around the eyes. Each eye has a drainage mechanism responsible to get rid of the excess tears. It starts with the flow of tears through a small drainage duct called puncta. They are normally located at the inner corner of each eyelid. Tears follow their course until their final drainage destination located in the back of the nose.
The tear film consists of three layers; each of them has its own purpose:
An oil layer: It is the outermost layer and it helps to reduce evaporation of tears. It is produced by meibomian glands, which are located at each eyelid margin.
A watery layer: It is the middle layer and its purpose is to reduce the risk of infections by washing away any irritants. It is produced by the lacrimal gland.
A mucous layer: It is the inner layer of the tear film. It is responsible for keeping the watery layer evenly adhered to the surface of the eye, which helps the eyes remain moist.
Causes of Dry Eye
Dry eye can result from having poor quality or quantity of tears.
Insufficient amount of tears: It happens when there is a decrease in the production of tears or tears evaporates faster than the normal rate. Production of tears may decrease with age, the use of certain drugs, hormonal changes, and the presence of certain medical conditions.
Other factors that may contribute to a decrease in tears are undergoing radiation therapy, having laser surgery, and environmental conditions. Similarly, eyelid problems may prevent even distribution of tears on the ocular surface and can contribute to a faster evaporative time of the tear film. The lack of vitamin A, omega 3, and water in a daily diet may also cause dryness.
Poor quality of tears: It occurs when there is a deficiency on any of the layers of the tears, especially the outer and inner layers. Evaporation of the tears can develop when there is not a good oily layer. An unhealthy mucous layer is not able to properly spread out the tears to provide with a smooth surface; therefore, instability of the tears happens quickly.
The most common cause is due to the insufficient amount of the water layer of tears.
Dry Eye Symptoms
The usual symptoms experienced are:
- Stinging and burning sensation
- Symptoms of foreign body sensation
- Red and irritated eyes
- Periods of excessive lacrimation
- Increase eye irritation due to wind or smoke
- Eye fatigue
- Blurred vision, often worse at the end of the day
- Discomfort when wearing contact lenses
Dry eye can be managed depending on the severity of the condition; it can be treated in different ways: adding tears, conserving tears, increasing tear production, treating the underlying condition that is contributing to dryness, as well as treating the inflammation.
They are usually recommended to treat mild dry eyes. They work as a substitute for the tear film not present in the ocular surface. Preservative free drops are the most recommended since they do not have any additives to the eyes that can potentially irritate the ocular surface. This treatment can be very successful for the patient. However, there are some patients who need to add another treatment to successfully get rid of the dry eye.
Conserving the Tears:
This method is trying to keep the natural tears on the ocular surface for a longer time. It is usually achieved by blocking the tear duct that is responsible for draining the tears out of the eye. The tear ducts can be blocked temporally or permanently with either collagen or silicon plugs, respectively. Also, the cauterization of the tear ducts can also be done to permanently conserve the tears on the surface.
Increasing Tear Production:
It is achieved with the prescription of eye drops that help with the production of tears as well as some supplements such as omega 3 fatty acids.
Treatment of the eyelid diseae or ocular surface inflammation:
It is usually recommended for patients with moderate to severe dry eyes. Prescription of warm compresses, lid massage and lid hygiene, as well as eye drops or ointment, are used to help decrease the inflammation present around the ocular surface.
If the dry eye condition is not treated, it can lead to more severe problems such as inflammation and scarring of the surface of the eye, causing a decrease in vision. Moderate to severe dryness can decrease the quality of life of the patient. The patient suffering from chronic dryness tends to suffer from ocular infection at a higher average than those with normal ocular surface since one of the tears’ functions is to protect the eyes from pathogens.
Lifestyle and Home Remedies
- Consider to buy a humidifier to add moisture and a purifier to get rid of dust particles both at home and at your work place.
- Remember to blink when in front of the computer or reading for long periods of time.
- Using sunglasses outdoors can reduce the effects of wind, sun, and dust on the surface of the eye, especially those with a wraparound style.
- Drink plenty of water throughout the day
If you are considering LASIK/PRK and have a condition of dry eyes, be aware that your eye doctor will want to treat your condition successfully before performing any surgical procedure. Dry eye may increase the risk of poor healing after LASIK/PRK and may prevent the patient from having a good LASIK/PRK outcome if left untreated. LASIK/PRK is associated with dryness, but the condition is temporary and improves within a few weeks. Because there may be several factors contributing to the dryness experienced by the patient, it is essential to discuss with your eye care practitioner potential factors that lead to dryness.