Dry Eyes & Dry Eye Syndrome
Dry eyes occur when the eyes either don’t make enough tears, or the quality of the tears produced is reduced, meaning they evaporate rapidly from the surface of the eye, allowing the eye to dry. Often, the reduced tear quality is a result of blockage or inflammation of the oil glands within the lid margin.
When the surface of the eyes dry out they can appear red or pink and swollen, and the eyes can become very irritated, feel gritty or burning. They may also water a lot.
Dry eyes can be divided into two broad categories
If the main problem is a lack of tear production, then the term 'keratoconjunctivitis sicca' or ‘aqueous deficiency’ is used. However, if the main problem is poor quality of tears (but plenty of them) as a result of inflammation or blockage of the oil secreting glands in the lid margin, then the condition is called ‘obstructive meibomian gland disease’, more commonly referred to as blepharitis (see info on next page).
What are the symptoms of Dry Eye Syndrome?
The symptoms can be extremely variable, causing anything from mild irritation to severe discomfort.
Foreign body sensation/feels like something is in the eyes
Eyes feel ‘gritty’ – often worse in the mornings
Intermittent blurred vision
Burning sensation in eyes
Redness of the whites of the eyes
What causes Dry Eye Syndrome?
It is more common in women than men
It tends to affect the over 50s age group more but can occur at any age
Prolonged use of VDUs, or reading for a long period of time - we blink less often when concentrating on such things which dries the eyes out
Hot, dry or windy environments
Inflammatory diseases – e.g. Rheumatoid arthritis affecting joints, is associated with higher risk of dry eyes.
Side effects from medications e.g. The oral contraceptive pill
How is Dry Eye Syndrome treated?
There is no absolute cure for dry eye syndrome. However, most people can get significant relief from symptoms using a variety of treatments and measures.
Lid Margin Hygiene
If the underlying cause is blepharitis/lid margin disease, then treating this can often improve symptoms.
A hot compress is very helpful for this and we'd recommend a product called an EyeBag. It heats up quickly in a microwave, stays warm, and isn't messy like hot water and flannels. Its a nice relaxing way to spend ten minutes lying back with this on your eyes!
Follow this with cleansing of the eyelids using a specialist solution such as Blephasol.
Some people recommend using baby shampoo or sodium bicarbonate but these can cause irritation, and so are best avoided.
Regular lubrication in the form of gels or drops help keep the surface of the eyes moist, and therefore reduce symptoms. Often, this is combined with lid margin hygiene.
There are a wide range of eye drops available – your optometrist will advise you on the best one to suit your needs
Tear duct surgery
When there is severe dry eye with reduction in tear production, blocking the drainage of tears down the tear ducts can help keep the tears that are produced on the surface of the eye.
Temporary plugs are normally inserted first. In some cases, permanent closure with surgical cautery may be used.
Dietary omega-3 oils can help to improve tear quality. These can be found in nuts and seeds and oily fish, or for more convenience in supplement form.
When concentrating (e.g. using a computer or driving), we can blink up to 5x less often, leading to increased tear evaporation. Remembering to blink more often can help keep the eye surface wet.
Moist air leads to less evaporation of tears. Avoiding air conditioned environments and direct heat (e.g. an open fire or heat from a cooker) can help for the same reason.