DRY EYE

WHAT IS DRY EYE?

Dry Eye is a condition which affects about 10% of people between the ages of 30 and 60 and more than 15% of adults over age 65.

Dry eye sensations occur when the eye does not produce tears properly, or when the tears are not of the correct consistency and evaporate too quickly. This can lead to inflammation of the surface of the eye & the eyelids. Whilst permanent loss of vision is uncommon, if dry eye is left untreated, it can lead to pain, ulcers, or scars on the cornea, and some loss of vision.

Dry eye can make it more difficult to perform some activities, such as using a computer or reading for an extended period of time, and it can decrease tolerance for dry environments, such as the air inside an airplane.

With each blink of the eyelids, tears spread across the front surface of the eye, known as the cornea. Tears provide lubrication, reduce the risk of eye infection, wash away foreign matter in the eye, and keep the surface of the eyes smooth and clear. Excess tears in the eyes flow into small drainage ducts in the inner corners of the eyelids, which drain into the back of the nose. Dry eyes can occur when tear production and drainage is not in balance.

WHAT ARE THE TYPES OF DRY EYE?

1)  Aqueous tear-deficient dry eye is a disorder in which the lacrimal glands fail to produce enough of the watery component of tears to maintain a healthy eye surface.

2)  Evaporative dry eye may result from inflammation of the meibomian glands, also located in the eyelids. These glands make the lipid or oily part of tears that slows evaporation and keeps the tears stable. This is the most common form of dry eye.

WHAT ARE THE SYMPTOMS OF DRY EYE?

Dry eye symptoms may include any of the following:

Stinging or burning of the eye
A sandy or gritty feeling as if something is in the eye
Excessive tears
Light sensitivity
A stringy discharge from the eye
Pain and redness of the eye
Episodes of blurred vision
Heavy eyelids
Inability to cry when emotionally stressed
Uncomfortable contact lenses
Decreased tolerance of reading, working on the computer, or any activity that requires sustained visual attention
Eye fatigue

Any combination of these symptoms may be present. Often, the symptoms fluctuate from day to day, or even hour to hour. In mild cases, symptoms may be intermittent and tolerable, while in severe cases, the symptoms may be constant, severe, and very disruptive to daily activities.

NOTE: If symptoms of dry eye persist, consult our optometrists to get an accurate diagnosis of the condition and begin treatment to avoid permanent damage.

If you are concerned that you may have dry eye please complete the following dry eye test take it with you when you see the optometrist.

WHAT ARE THE CAUSES OF DRY EYE?

Dry eyes can develop for many reasons, including:

Age: Dry eyes are a part of the natural aging process. The majority of people over age 65 experience some symptoms of dry eyes.

Gender: Women are more likely to develop dry eyes due to hormonal changes caused by pregnancy, the use of oral contraceptives and menopause.

Medications: Certain medicines, including antihistamines, decongestants, blood pressure medications and antidepressants, can reduce tear production.

Medical conditions: People with rheumatoid arthritis, diabetes and thyroid problems are more likely to have symptoms of dry eyes. Also, problems with inflammation of the eyelids (blepharitis), inflammation of the surfaces of the eye, or the inward or outward turning of eyelids can cause dry eyes to develop. Inability to fully close the eyelids can also lead to chronic dry eye.

Environmental conditions: Exposure to smoke, wind and dry climates can increase tear evaporation resulting in dry eye symptoms. Failure to blink regularly, such as when staring at a computer screen for long periods of time, can also contribute to drying of the eyes.

Other factors: Long-term use of contact lenses can be a factor in the development of dry eyes. Refractive eye surgeries, such as LASIK, can decrease tear production and contribute to dry eyes.

HOW DO YOU TELL IF YOU HAVE DRY EYE?

Looking at the symptoms and potential causes of dry eye syndrome will help determine if you may be suffering from a treatable condition. However, it is important to make an appointment to see our optometrist who will run a number of tests to accurately diagnose your condition using an Oculus Keratograph.

The Oculus Keratograph is able to analyse 4 key Dry eye factors:

Redness / Irritation
Lipid Layer
Tear Break-up Time
Meibomian Gland Infra-red Imaging

This very advanced equipment can produce a report on the cause and severity of your Dry eye symptoms.

HOW ARE DRY EYES TREATED?

Depending on the causes of dry eye, your optometrist may use various approaches to relieve the symptoms.

Dry eyes can be a chronic condition, but your optometrist can prescribe treatment to keep your eyes healthy and comfortable and to prevent your vision from being affected. The primary approaches used to manage and treat dry eyes include adding tears using over-the-counter artificial tear solutions, conserving tears, increasing tear production, and treating the inflammation of the eyelids or eye surface that contributes to the dry eyes.

Adding tears: 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. Preservative-free artificial tear solutions are recommended because they contain fewer additives, which can further irritate the eyes. People with dry eyes that don’t respond to artificial tears alone will need to take additional steps to treat their dry eyes.

Conserving tears: Keeping natural tears in the eyes longer can reduce the symptoms of dry eyes. 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 plugs that can be removed if needed. Or a surgical procedure can permanently close the tear ducts. 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: Your optometrist can prescribe eye drops that increase tear production. Taking an omega-3 fatty acid nutritional supplement may also help.

Treating the contributing eyelid or ocular surface inflammation: Your optometrist might recommend prescription eye drops or ointments, warm compresses and lid massage, or eyelid cleaners to help decrease inflammation around the surface of the eyes.

Medications: Consult your doctor about the medications you take as side effects may include drying the eyes.

Belphasteam: Some types of dry eyes requires special treatment that uses heat and moisture to help unblock the glands in your eyelids.

Intense Pulse Light therapy has been shown to be very effective in reducing the symptoms of dry eye especially due to Meibomian Gland Dysfunction.

Cyclosporine, an anti-inflammatory medication, is a prescription drug available to treat dry eye. It decreases corneal damage, increases basic tear production, and reduces symptoms of dry eye. It may take three to six months of twice-a-day dosages for the medication to work. In some cases of severe dry eye, short-term use of corticosteroid eye drops that decrease inflammation is required.

Plug the drainage holes, using punctual plugs. These plugs are made of silicone or collagen, are reversible, and are a temporary measure. In severe cases, permanent plugs may be considered.

Surgery, called punctal cautery, is recommended, in extreme cases, to permanently close the drainage holes. The procedure helps to keep the limited volume of tears on the eye for a longer period of time.

WHAT CAN I DO TO HELP MYSELF?

You can take the following steps to reduce symptoms of dry eyes:

  • Remember to blink regularly when reading or staring at a computer screen for long periods of time.
  • Increase the humidity in the air at work and at home. A humidifier also may help by adding moisture to the air.
  • Wear sunglasses outdoors, particularly those with wraparound frames, to reduce exposure to drying winds and the sun.
  • Nutritional supplements containing essential fatty acids may help decrease dry eye symptoms in some people. Ask your optometrist if taking dietary supplements could help your dry eye problems.
  • Avoiding becoming dehydrated by drinking plenty of water (8 to 10 glasses) each day.
  • Use artificial tears, gels, gel inserts, and ointments – available over the counter – as the first line of therapy. They offer temporary relief and provide an important replacement of naturally produced tears in patients with aqueous tear deficiency. Avoid artificial tears with preservatives if you need to apply them more than four times a day or preparations with chemicals that cause blood vessels to constrict.