Dry eye (keratoconjunctivitis sicca) is a common and often chronic condition, particularly in older adults and women, in which there is an insufficient quantity or unhealthy quality of tears to lubricate and nourish the eye. Despite being a very common and treatable disease, dry eye often goes undiagnosed and untreated.
With each blink of the eyelids, tears are spread across the front surface of the eye. Tears provide lubrication, reduce the risk of eye infection, wash away foreign matter on the eye, and keep the surface of the eyes smooth and clear. Tears are necessary to maintain the health of the eye and to provide clear vision. People with dry eyes either do not produce enough tears or have a poor quality of tears.
When you blink, a film of tears spreads over the eye, making the surface of the eye smooth and clear. The tears consist of three layers, each with its own purpose:
- An Oily (Lipid) Layer: produced by the Meibomian glands in the eyelids, forms the outermost surface of the tear film. Its main purpose is to smooth the tear surface and reduce evaporation of tears.
- A Watery (Aqueous) Layer: produced by the lacrimal glands in the eyelids, cleanses the eye and washes away foreign particles or irritants.
- A Mucus (Mucin) Layer: produced by the conjunctiva. Mucus allows the watery layer to spread evenly over the surface of the eye and helps the eye remain moist. Without mucus, tears would not stick to the eye.
Though dry eyes can be a chronic condition, your eye doctor can prescribe a series of treatments to keep your eyes healthy, more comfortable, and prevent your vision from being affected. Some of these treatments or actions include:
Adding Tear Solution – Mild cases of dry eyes can often be managed using over-the-counter artificial tear solutions. These can be used as often as needed to supplement natural tear production.
Adding Tear Ointment – Artificial tear ointments are also available over the counter for severe dry eyes. These ointments are great to use at night before bed. In fact you will still feel the effects of the ointment when you wake up in the morning, since ointments stay in the eyes longer than drops. They will make vision blurry. As a result, it is not advisable to use the artificial tear ointments during the day or while driving.
Conserving Tears – An additional approach to reducing the symptoms of dry eyes is to keep natural tears in the eyes longer. 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 punctal plugs that can be removed, if needed. A surgical procedure to permanently close tear ducts can also be used. 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 done through prescription eye drops that help increase your own tear production and by treating the eyelid and ocular surface inflammation.
Improving Tear Film Health – Omega-3s are a family of essential fatty acids (EFAs) that are anti-inflammatory in nature. These O3s aid in the reduction of inflammation of the lacrimal glands, leading to better tear production and improvement of Dry Eye Syndrome. The combination of these nutrients helps support healthy vision and optimal eye health.
Treatment of the Contributing Eyelid or Ocular Surface Inflammation – Warm compresses, masks and lid massage, or eyelid cleaners are the mainstay for conservative treatment of ocular surface inflammation. In addition, prescription eye drops or ointments, may be recommended to help decrease inflammation of the eyelid margins.
Other simple steps to minimize environmental factors that cause or exacerbate dry eye include:
- Avoid air blowing in your eyes. Don’t direct hair dryers, car heaters, air conditioners or fans toward your eyes.
- Wear glasses on windy days and goggles while swimming. The wraparound style of glasses may help reduce the effects of the wind.
- Add moisture to the air. In winter, a humidifier can add moisture to dry indoor air. Some people use specially designed glasses that form a moisture chamber around the eye, creating additional humidity. These glasses can be worn at night, and may be especially helpful for people that sleep with their eyes partially open. They can also be worn during the day to relieve dry eye symptoms.
- Avoid rubbing your eyes. You can irritate your eyes further by rubbing them.
- Take preventive steps. Use eye drops before, rather than after the symptoms begin; your eyes become irritated as a result of visually demanding activities. Try to avoid activities that might worsen the problem.
- Remember to blink. Consciously blinking repeatedly helps spread your own tears more evenly. When performing tasks that require intense visual concentration, take occasional breaks and rest your eyes by closing your lids for several seconds.
- Avoid smoke. Smoke, whether yours or someone else’s, can contribute to dry eyes.
- Avoid antihistamine or other allergy medications: Often these medications are designed to ‘dry up’ your nose; they tend to dry your eyes at the same time.
- Stay hydrated by drinking plenty of water regardless of the season: If your body becomes dehydrated, so do your eyes.