Dry Eyes

Our eyes need tears to stay healthy and comfortable. If your eyes do not produce adequate tears, you may develop dry eyes. Dry eye is a chronic, progressive condition that can cause tired, uncomfortable eyes, and blurred or fluctuating vision. In moderate to severe cases, it affects the quality of life by making it too difficult to keep the eyes open long enough to read, drive, watch a movie, or look at a computer. In some patients, their occupation requires 8-10 hours per day on a computer. Dry eye can impact the ability to do their job.

So How do tears work?

When you blink, a film of tears spreads over the eye. This keeps the eye’s surface smooth and clear. The tear film is important for good vision.

The tear film is made of three layers:

  • An oily layer
  • A watery layer
  • A mucus layer

Each layer of the tear film serves a purpose.

The oily layer is the outside of the tear film. It makes the tear surface smooth and keeps tears from drying up too quickly. This layer is made in the lids’ meibomian glands.

The watery layer is the middle of the tear film. It makes up most of what we see as tears. This layer cleans the eye, washing away particles that do not belong in the eye. This layer comes from the lacrimal glands underneath the orbital rim.

The mucus layer is the inner layer of the tear film. This helps spread the watery layer over the eye’s surface, keeping it moist. Without mucus, tears would not stick to the eye. Mucus is made in the conjunctiva.

Our eyes constantly make tears to stay moist. If our eyes are irritated, or we cry, our eyes make a lot of tears. But, sometimes the eyes don’t make enough tears or something affects one or more layers of the tear film. In those cases, we end up with dry eyes.

Symptoms can be mild to severe and may include:

  • Eye redness and swelling
  • Sandy or gritty feeling in the eyes
  • Stinging or burning sensation
  • Sensitivity to light
  • Difficulty wearing contact lenses or driving at night
  • Blurred vision
  • Aching sensation
  • Heavy and fatigued eyes
  • Eyelid twitching

Causes of Dry Eyes

Health Conditions like

  • Diabetes
  • Thyroid dysfunction
  • Rheumatoid arthritis
  • Parkinson’s disease
  • Rosacea
  • Previous eye surgery (LASIK)

Drugs that often cause dry eye include:

  • Sedatives like Benadryl, sleep aids, cold remedies or anxiety pills, anti-depressants
  • Allergy pills
  • Blood pressure medications
  • Medicated eye drops such as glaucoma drops, or other drops that contain preservatives.

Treatments

Your ophthalmologist can recommend treating dry eyes through a combination of treatment options. They may recommend:

  • Over the counter and/or prescription eye drops or ointments
  • Warm compresses on the eyes
  • Massaging your eyelids
  • Certain eyelid cleaners

Adding tears

You can use artificial tears as often as you need to. There are many brands. Try a few until you find a brand that works best for you.

If you use artificial tears more than six times a day or are allergic to preservatives, you should use preservative-free tears. This is because if the tears with preservatives are used a lot, these chemicals may start to irritate your eyes.

Conserving tears - Punctal plugs

When eye drops are not effective in treating your dry eye condition, your ophthalmologist may suggest blocking your tear ducts through punctal plugs. These tiny silicone or gel plugs (called punctal plugs) are inserted inside the tear ducts to block them. These plugs prevent the drainage of fluid from the eye surface, helping to restore moisture to dry, scratchy eyes.