Dry Eye Syndrome
Dry eye syndrome is a chronic lack of sufficient lubrication and moisture on the surface of the eye.
Its consequences range from subtle but constant irritation to ocular inflammation of the anterior (front) tissues of the eye.
Dry Eye Syndrome Symptoms
Persistent dryness, scratchiness and burning sensation in your eyes are symptoms of dry eyes. These symptoms alone may prompt your eye doctor to diagnose dry eye syndrome.
But sometimes your eye doctor may want to measure the amount of tears in your eyes. A thin strip of filter paper placed under the lower eyelid, called a Schirmer’s test, is one way to measure tear production.
Another symptom of dry eyes is a “foreign body sensation,” the feeling that something is in the eye.
And it may seem odd, but dry eye syndrome can cause watery eyes. This is because dryness on the eye’s surface sometimes will overstimulate production of the watery component of your tears as a protective mechanism.
What causes Dry Eyes?
Tears bathe the eye, washing out dust and debris and keeping the eye moist. They also contain enzymes that neutralize the microorganisms that colonize the eye. Tears are essential for good eye health.
In dry eye syndrome, the lacrimal gland or associated glands near the eye don’t produce enough tears, or the tears have a chemical composition that causes them to evaporate too quickly.
Dry eye syndrome has several causes. It occurs as a part of the natural aging process, especially during menopause; as a side effect of many medications, such as antihistamines, antidepressants, certain blood pressure medicines, Parkinson’s medications and birth control pills; or because you live in a dry, dusty or windy climate.
If your home or office has air conditioning or a dry heating system,that too can dry out your eyes. Another cause is insufficient blinking, such as when you’re staring at a computer screen all day.
Dry eyes also are a symptom of systemic diseases such as lupus, rheumatoid arthritis, ocular rosacea or Sjogren’s syndrome (a triad of dry eye’s, dry mouth and rheumatoid arthritis or lupus).
Long-term contact lens wear is another cause; in fact, dry eyes are the most common complaint among contact lens wearers.
Recent research indicates that contact lens wear and dry eyes can be a vicious cycle. Dry eye syndrome makes contact lenses feel uncomfortable, and evaporation of moisture from contact lenses worsens dry eye symptoms.
Incomplete closure of the eyelids, eyelid disease and a deficiency of the
Tears are composed of three layers:
- The outer, oily lipid layer;
- The middle, watery, lacrimal layer;
- And the inner, mucous or mucin layer.
Each layer is produced by different glands near the eye. The lacrimal gland located above the outer corner of the eye produces the lacrimal layer, for example. So, a problem with any of those sources can result in dry eyes.
Dry eye syndrome is more common in women, possibly due to hormone fluctuations. A recent study also indicates that the risk of dry eyes among men increases with age.
Recent research suggests that smoking, too, can increase your risk of dry eye syndrome.
With increased popularity of cosmetic eyelid surgery (blepharoplasty) for improved appearance, dry eye complaints now occasionally are associated with incomplete closure of eyelids following such a procedure.
Treatment for Dry Eyes
Dry eye syndrome is an ongoing condition that may not be completely curable (depending on the cause). But the accompanying dryness, scratchiness and burning sensation can be managed. Your eye care practitioner may prescribe artificial tears, which are lubricating eye drops that may alleviate the dry, scratchy feeling.
It is recommended that a patient suffering from dry eyes try to first use artificial/lubricating drops and a night time gel treatment. If a patient sleeps with a fan on, it is recommended that the patient try to turn off the fan at night or wear a sleeping shield to keep the eyes from air contact.
Punctal plugs are another option that may help patients. Plugs are small inserts that are usually inserted in the lower punctum of both eyes to help close off the drainage, to help keep moisture on the eye by keeping tears from draining too quickly.
Prescription eye drops called Restasis or Xiidra, would be going one step further: they help your body produce more tears by reducing inflammation associated with dry eye syndrome. It is very important if a patient wants to try Restasis or Xiidra, that they are very diligent about using them twice a day, every day for at least a month, before they will notice a difference. Restasis or Xiidra are a systemic eye drops that work internally through the body’s system. It is still important to continue artificial eye drop treatment along with Restasis or Xiidra treatment for full benefit.
Sometimes people use eye drops that are advertised to “get the red out” to treat their dry eyes. While these drops can reduce or eliminate eye redness temporarily, they may or may not be effective at lubricating the eye, depending on the formulation.
Not only that, but the vasoconstrictors in these formulas that reduce redness by contracting the eyes blood vessels are addictive, in the sense that over time, more and more is needed to achieve the same effect. With frequent use, the effect diminishes after a while – the blood vessels simply won’t constrict as much as they did when you first used the drops.
If you wear contact lenses, be aware that many eye drops, especially artificial tears cannot be used while your contacts are in your eyes. You’ll need to remove them before using drops and wait 15 minutes or even longer (check the label) before reinserting the lenses.
If your dryness is mild, then contact lens rewetting drops may be sufficient to make your eyes feel better, but the effect usually is only temporary.
Check the label, but better yet, check with your optometrist or ophthalmologist before buying any over-the-counter eye drops. It will probably save you a lot of money, because he or she will know which formulas are effective and long-lasting and which are not, as well as which drops will work with your contact lenses.