Understanding Dry Eye Syndrome

What is dry eye?

Dry eye occurs when your eyes either don’t produce enough tears to stay moist or when the tears they have don’t function properly. This can lead to discomfort and, in some cases, vision issues. Many people experience dry eye each year, but the good news is there are several ways to maintain eye health and stay comfortable if you have this condition.

What are the Symptoms of Dry Eye Syndrome?

If you have dry eye syndrome, you might notice symptoms like burning, itching, or stinging sensations in your eyes. Your vision may become blurry, and your eyes might appear red. You could also become sensitive to light, experience watery eyes, notice mucus, feel sand in your eyes, or feel discomfort when reading or using a computer for a long time.

Am I at risk for dry eye?

Dry eye can affect anyone, but your risk may be higher if you:

  • Are 50 years old or older.
  • Are a woman.
  • Wear contact lenses.
  • Lack sufficient vitamin A (found in foods like carrots, broccoli, and liver) or omega-3 fatty acids (found in fish, walnuts, and vegetable oils) in your diet.
  • Have specific autoimmune conditions such as lupus or Sjögren’s syndrome.

Causes of Dry Eye Syndrome

Causes of Dry Eye Syndrome:

  • Decreased Tear Production

    • Tears have three layers: outer oily, middle watery, and inner mucus.
    • Inflammation or insufficient water, oil, or mucus production by tear glands leads to dry eye.

  • Increased Tear Evaporation

    • Tears lacking proper layers (water, oil, or mucus) evaporate quickly, leaving eyes without consistent moisture.

Risk Factors

  • It is more common in individuals aged 50 and older, with females experiencing it more than males.
  • Pregnancy, hormone replacement therapy, and menopause increase the risk.
  • Underlying conditions like chronic allergies, exposure to wind or dry air, LASIK eye surgery, certain medications, and long-term contact lens wear can contribute.

Exams and Tests

To check for dry eye, the following tests may be done:

  • Checking how well you see
    • Use an eye chart to measure your vision.
  • Examining your eyes with a special light (slit lamp exam)
    • Look closely at your eyes to see if there are any issues.
  • Putting a special dye on your eyes to see tears and cornea more clearly (Diagnostic staining)
    • Use a dye to check the condition of your tears and the outer layer of your eyes.
  • Measuring how long it takes for your tears to break up (Tear film break-up time – TBUT)
    • Timing how quickly your tears start to break down.
  • Checking how much tear production you have (Schirmer test)
    • Use paper strips to measure how many tears your eyes make.
  • Measuring the concentration of tears (Osmolality)
    • Assessing the balance of substances in your tears.

Treatment

Treatment for dry eyes depends on the cause and severity of symptoms. Here are some common treatments:

  • Over-the-counter eye drops: Use artificial tears, available without a prescription, to relieve mild dry eye. There are also moisturizing gels and ointments you can try.
  • Prescription medicines: For more severe dry eye, your eye doctor may prescribe medications like cyclosporine (Restasis) or lifitegrast (Xiidra) as eye drops to stimulate tear production.
  • Lifestyle changes: 
    • Adjust your environment to protect your eyes, such as avoiding smoke, wind, and air conditioning.
    • Use a humidifier at home to prevent dry air.
    • Take breaks from screen time and wear sunglasses outdoors.
    • Stay hydrated, sleep enough, and avoid factors that worsen dry eye.
  • Tear duct plugs: If tears drain too quickly, your doctor may insert tiny plugs (punctal plugs) into your tear ducts to keep tears in your eyes.
  • Surgery: In rare cases where loose lower eyelids cause excessive tear drainage, surgery may be recommended to tighten the eyelids.

When to Contact a Medical Professional?

Get in touch with your doctor if:

  • Your eyes are red or painful.
  • You notice flaking, discharge, or a sore on your eye or eyelid.
  • You’ve had an eye injury or have a bulging eye or drooping eyelid.
  • You experience joint pain, swelling, stiffness, a dry mouth, and dry eye symptoms.
  • Your eyes don’t improve with self-care after a few days.

Conclusion

A dry eye is when your eyes lack moisture, causing discomfort. Symptoms include itching and redness. It can affect anyone, especially if you’re older, a woman, or wear contact lenses. Causes include not enough tears or quick tear evaporation. Treatments include eye drops and lifestyle changes. Keep your eyes healthy by following your doctor’s advice.