A condition known as dry eye occurs when tear film abnormalities prevent the eyes from being comfortable. Although dry eye can occur in both men and women at any age, women are most often affected.
Tear production normally decreases as we age. Dry eye can also be associated with arthritis, and occasionally with a dry mouth. Medications sometimes cause dry eye by reducing tear secretion. Since these medications are often necessary, the dry eye condition may have to be tolerated or treated with "artificial tears." A wide variety of common medications that can cause dry eye include diuretics; betablockers; antihistamines; sleeping pills; medications for "nerves"; pain relievers; or alcohol. Be sure to tell your ophthalmologist the names of all the medications you are taking. People with dry eye are often more prone to the toxic side-effects of eye medications, including artificial tears.
There are two kinds of tears: those that constantly lubricate the eye and those that are produced as a response to irritation or emotion. The healthy eye constantly produces tears that lubricate. When a foreign body irritates the eye or when a person cries, more tears are produced. Excess tearing from dry eye may sound like a contradiction, but your tears must have the right balance of oil, water, and mucus to be able to protect your eyes. Without this balance, your eyes become dry and irritated and produce too many tears.
- Stinging or burning
- Eye irritation or scratchiness
- Excess tearing, especially when reading, driving, or watching television
- Stringy mucus in or around the eyes
- Difficulty wearing contact lenses
The symptoms described above may not necessarily mean that you have dry eye. However, if you experience one or more of these symptoms, contact your eye doctor for a complete exam.
The commonest cause of dry eye is blepharitis. This is treated with lid care products, warm compresses and lubricating eye drops.
A new treatment is available, Lipiflow that effectively clears the eyelids of trapped debris that cause the symptoms of blepharitis and dry eye.
Lipiflow is available as an outpatient procedure and is performed together with an assessment of the glands in the eyelid margins (Meibomian glands).
Your ophthalmologist is often able to diagnose dry eye by simply examining the eyes. Sometimes tests that measure tear production may be necessary. Such tests may involve placing filter-paper strips under the lower eyelids to measure the rate of tear production under various conditions
Dry eye is sometimes treated using eye drops called "artificial tears." Artificial tears are available without a prescription. You may want to try several brands to find the one that you like best. Preservative-free eye drops are available if you are sensitive to the preservatives in artificial tears. If you need to use artificial tears more than every two hours, preservative-free brands may be better for you. Solid lid inserts that gradually release lubricants during the day may also be beneficial for some people.
Some patients with mild dryness may benefit from blinking more frequently, especially when reading, driving, or watching television.
Conserving the tears in your own eyes is another approach to keeping the eyes moist. Tears drain out of the eye through a small canal into the nose (that is why your nose runs when you cry). Your ophthalmologist may close these canals either temporarily or permanently. This closure conserves your own tears and makes artificial tears last longer.
Other methods may include steps to prevent the evaporation of tears. In winter, when indoor heat is on, a humidifier or a pan of water on the radiator will add moisture to dry air. Wrap-around glasses (illegal to wear while driving in some states) may reduce the drying effect of the wind. Anything that adds to dryness such as an overly warm room, hair dryers, or wind should be avoided by a person with dry eye. Smoking is especially bothersome. Some people with dry eye complain of "scratchy eyes" upon awakening. This symptom can be treated by using an ointment at bedtime. Use the smallest amount of ointment necessary for comfort, since the ointment can cause your vision to blur temporarily.
Dry eye caused by a lack of vitamin A in the diet is rare in the United KIngdom, but is more common in poorer countries. Ointments containing vitamin A can help dry eye caused by this unusual condition. Vitamin A does not seem to help people with ordinary dry eye.