Dry Eye

Dry Eye occurs when the quantity or quality of tears produced deteriorates. It is due to reduced tear production by the lacrimal gland and/or excessive evaporation from the eye surface. It can affect make some environments uncomfortable such as travel in a plane or prolonged time in air conditioning, and can make some activities more difficult such as prolonged reading or computer use. Dry Eye is common and is affected by environment, some medications (antihistamines, nasal decongestants, tranquilizers, certain blood pressure medicines, Parkinson’s medications, birth control pills, anti-depressants, hormone replacement therapy), hormonal state (pregnancy or menopause) and immune system disorders (eg Sjögren syndrome, lupus, and rheumatoid arthritis).

Dry Eye is particularly common in older people and in menopausal women. There are two main types of Dry Eye, aqueous deficient (in which there is insufficient watery tear component), and evaporative Dry Eye (where there is inflammation of the glands that produce the oily layer of tears resulting in increased tear evaporation.

Dry Eye can cause inflammation of the eye surface. Without treatment, this can lead to pain, ulcers, or scars on the cornea and potentially reduced vision. However permanent vision loss from dry eye is uncommon.

Dry Eye can cause irritation and grittiness, often followed by watery eyes. Sometimes redness, stinging and burning, intermittent blurred vision , and increased glare sensitivity are noted. Symptoms are generally worse in dry or windy conditions, or with prolonged computer work, air-conditioning and fluorescent lights indoors. Contact lens wearers generally report reduced tolerance to their lenses. Eye tiredness is usually reported in the afternoon or at the end of the day.

Initially over the counter lubricants in the form of drops, gels or ointments can be used. Different lubricants can replace the aqueous or lipid component of the tear film as is required. They can be taken as required or on a regular basis throughout the day. Products that cause blood vessels to constrict should be avoided on a regular basis, and if lubricants are used more than four times a day, then preservative free forms are recommended. It should be noted that many treatments involve treating the underlying source of the Dry Eye.

Wearing close fitting (wrap around) glasses or sunglasses may help slow tear evaporation and keep the eye moist. Where possible avoid dry conditions (fans and air conditioners) and allow your eyes to rest when performing activities that require you to focus your vision for long periods of time. You can also use lubricating eye drops while performing these tasks.

Other treatment options for very severe dry eye can include medication (corticosteroid drops, autologous tear serum drops, cyclosporine drops), lacrimal plugs, punctal cautery, and dietary supplements (omega 3 fatty acids).