Chronic dry eye is a painful condition marked by the sensation that your eyes are literally dried out and not producing enough moisture. While anyone can have the condition, it mostly affects older adults particularly women who are either pregnant, taking birth control pills, or going through menopause.
Having dry eye can make it more difficult to focus on certain tasks, especially tasks that involve a certain level of concentration such as reading, driving, and working on the computer.
The cause of dry eye can be another medical condition or an environmental factor. Working with a doctor or optometrist to pinpoint the root cause is key to finding an effective treatment method. Depending on what’s causing the dryness, the primary goal of treatment is to either increase, maintain, or trigger tear production or heal inflammation.
If you have dry eye syndrome, your eyes don’t produce enough tears or you aren’t able to maintain a normal layer of tears to coat your eyes. As a result, your eyes cannot eliminate dust and other irritants. This can lead to the following symptoms in your eyes:
See your doctor right away if you have dry eyes and a sudden increase in discomfort or a sudden decrease in your ability to see.
Reading extensively, working on the computer, or spending long hours in a dry environment may further aggravate your eyes if you have this condition. If you have dry eye syndrome, your eyes may also be prone to bacterial infections or the surface of your eyes may become inflamed, causing scarring on your cornea. Although it’s uncomfortable, dry eye syndrome almost never causes permanent vision loss.
The most common symptoms of dry eye syndrome are burning, pain, and redness in the eyes. Other common symptoms include watery tearing or stringy mucus in the eyes. You may find that your eyes get tired faster than they used to or that you have difficulty reading or sitting at the computer for long periods. The feeling of having sand in your eyes and blurry vision are common.
Tears have three layers. There’s the oily outer layer, the watery middle layer, and the inner mucus layer. If the glands that produce the various elements of your tears are inflamed or don’t produce enough water, oil, or mucus, it can lead to dry eye syndrome. When oil is missing from your tears, they quickly evaporate and your eyes cannot maintain a steady supply of moisture.
The causes of dry eye syndrome include:
- hormone replacement therapy
- exposure to the wind or dry air, such as constant exposure to a heater during the winter
- LASIK eye surgery
- some medications, including antihistamines, nasal decongestants, birth control pills, and antidepressants
- long-term contact lens wear
- staring at a computer for long hours
- not blinking enough
Dry eye syndrome is more common in people age 50 and older. It’s estimated that there are 5 million Americans in this age group with the condition. The majority of them are women, but the condition does occur in men. Women who are pregnant, on hormone replacement therapy, or going through menopause are more at risk. The following underlying conditions can also increase your risk:
- chronic allergies
- thyroid disease or other conditions that push the eyes forward
- lupus, rheumatoid arthritis, and other immune system disorders
- exposure keratitis, which occurs from sleeping with your eyes partially open
- vitamin A deficiency, which is unlikely if you get sufficient nutrition
If your eyes feel dry and you suddenly find yourself unable to see as well as you used to, visit an ophthalmologist right away. After describing your symptoms, you’ll likely undergo tests that examine the amount of tears in your eyes, such as a slit lamp, or biomicroscope, exam of your tears. For this test, your doctor will use a dye such as fluorescein to make the tear film on your eyes more visible.
A Schirmer’s test may also be used to measure how quickly your eyes produce tears. This tests your rate of tear production using a paper wick placed on the edge of your eyelid. Your eye doctor also might refer you to a specialist. Which doctor they’ll refer you to depends on the underlying cause of your condition. For example, they can refer you to an allergist if you have chronic allergies.
Eye drops that increase your eye moisture are among the most common treatments for dry eye syndrome. Artificial tears also work well for some people.
Your eye doctor might use plugs to block the drainage holes in the corners of your eyes. This is a relatively painless, reversible procedure that slows tear loss. If your condition is severe, the plugs may be recommended as a permanent solution.
The medication most commonly prescribed for dry eye syndrome is an anti-inflammatory called cyclosporine (Restasis). The drug increases the amount of tears in your eyes and lowers the risk of damage to your cornea. If your case of dry eye is severe, you may need to use corticosteroid eye drops for a short time while the medication takes effect. Alternative medications include cholinergics such as pilocarpine. These medications help stimulate tear production.
If another medication is causing your eyes to become dry, your doctor may switch your prescription to try to find one that doesn’t dry out your eyes.
You need a well-balanced diet with enough protein and vitamins to keep your eyes healthy. Omega-3 essential fatty acid supplements are sometimes recommended to enhance the oil content of the eye. Usually, people need to take these supplements regularly for at least three months to see an improvement.
If you have severe dry eye syndrome and it doesn’t go away with other treatments, your doctor may recommend surgery. The drainage holes at the inner corners of your eyes may be permanently plugged to allow your eyes to maintain an adequate amount of tears.
If you tend to have dry eyes, use a humidifier to increase moisture in the room and avoid dry climates. Limit your contact lens wear and the time you spend in front of the computer or television.