Dry Eyes

Dry eye syndrome (DES) is a chronic condition that develops when your eyes do not produce or maintain enough tears to keep the surface of the eye lubricated. This occurs due to reduced tear production or increased evaporation caused by a lack of oil from the eyelid glands. The effects range from minor dryness and discomfort to pain, blurred vision, and frequent infections.

• Dry, itchy eyes
• Burning or stinging
• Irritation
• Watery eyes
• Blurred vision
• Pain
• Foreign body sensation

Tears protect the cornea by washing away debris and keeping the eye’s surface moist, smooth, and clear. Tears also rinse away dust particles from your eyes and contain enzymes that protect your eyes from bacteria that can cause infections. Dry eye is a condition that develops when tear production is insufficient to maintain a balanced moisture level. This can cause a scratchy feeling, dryness, stinging, or a foreign body sensation. Ironically, dry eyes can cause you to produce excessive tears, which is why some people experience watery eyes.

Dry eyes can occur naturally as a result of aging or hormonal changes, typically in women who are pregnant, taking oral contraceptives, or going through menopause. In fact, women over 50 have a 50% greater risk of dry eye disease than men do of the same age. It can also result from taking certain medications that reduce tear production, such as antihistamines, blood pressure medications, and antidepressants. Environmental factors can also dry out the eyes, and DED is more common in dry, dusty, and windy climates. Air conditioning, heating systems, and prolonged screen time can worsen symptoms by reducing blinking.

People with conditions such as diabetes, blepharitis, lupus, arthritis, and thyroid disorders are more likely to develop DED. Other causes include eye surgery, such as LASIK, incomplete eyelid closure, and extended contact lens use.

Eye doctors typically diagnose dry eye disease through a comprehensive exam and symptom review. On some occasions the eye doctor might decide to do a test that measures how quickly your tears evaporate from the surface of your eye. The doctor may use a dye called fluorescein to observe how quickly your tear film breaks up after a blink. This is called TBUT, or a Tear Break Up Time test. A low TBUT indicates a tear film with insufficient oil due to poor gland function. In a Schirmer test, your doctor places a strip of paper under your eyelid and asks you to close your eye for five minutes. After the test, your doctor measures the moisture on the strip. Doctors use Schirmer tests less often than TBUT tests.

Treatment options depend on the cause and severity of the condition. Many mild forms of DED can be alleviated using artificial tears or lubricant eye drops to make up for the lack of natural tears usually produced by your eyes. If over-the-counter drops don’t alleviate your symptoms, your doctor might prescribe prescription drops that actually stimulate tear production or steroids for short-term relief.

Your eye doctor may treat more severe cases with a punctal insert, a small device that releases lubrication inside the lower eyelid. Because DED often links to eyelid inflammation (blepharitis), your doctor may recommend warm compresses, eyelid scrubs, or antibiotic ointment. For severe cases, doctors may insert punctal plugs to reduce tear drainage and keep your eyes moist.

If you can stop or switch medications, this may eliminate symptoms. Your doctor may recommend limiting contact lens use or switching to a different type to reduce dryness.

If an environmental factor causes your dry eyes, removing it may relieve your symptoms. Avoid dry environments, hair dryers, heaters, fans directed at your eyes, and smoke. Wear protective eyewear in dusty or windy conditions. Use a humidifier to add moisture to dry indoor air. When using a computer or watching TV, blink regularly to prevent dryness. Also, avoid rubbing your eyes as this can further irritate them. Staying hydrated by drinking at least 8 to 10 glasses of water per day can also help.

Dry eye disease may not permanently affect vision, but treatment can improve comfort and reduce symptoms. Dry eye is a chronic condition that requires consistent treatment. Your doctor will create a long-term treatment plan to manage your symptoms.