An Overview of Dry Eye Syndrome
Dry eye syndrome, also called keratitis sicca, keratoconjunctivitis sicca, or xerophthalmia is a recurrent or persistent sensation of dryness of the eyes. The condition is uncomfortable and it can interfere with your quality of life. You may have trouble keeping your eyes open or you may not be able to work or drive due to severe dryness of your eyes. Dry eye disease can vary from mild to extremely severe. Getting treatment for your dry eyes can make a big difference in easing your discomfort.
Just as the name suggests, this condition makes the eyes feel dry, scratchy, and You may experience these symptoms all the time or intermittently, They tend to worsen after a long day, and they are generally less noticeable right when you wake up.
Common symptoms of dry eye syndrome may include:1
- Burning eyes
- A stinging sensation of the eyes
- Itchy eyes
- Painful eyes
- Sensitivity to light
- Redness of the eyes
- Blurry vision
- A feeling that there is a speck of dirt in the eyes
Dry eyes can actually cause your eyes to water. The tears are similar to the tear production that is triggered when something gets in your eye. They are called reflex tears.
Reflex tears don’t have the same lubricating qualities as the tears that normally protect your eyes, so they do not prevent dry eyes.
Most people who have dry eyes experience mild irritation with no long-term effects. But if the condition is left untreated or becomes severe, eye damage and even vision loss can occur. Severe problems with dry eyes can cause:
- Eye inflammation
- thinning of the surface of the eye
- Corneal infection
- Scarring of the eyes
- Vision loss
Tears serve as a protective coating, keeping the eyes moist, providing essential nutrients, and washing away dust and other particles. The tear film is made of water, oil, and mucus, all of which are important for maintaining good eye health.
The cornea, which covers the front of the eye, needs to be continuously bathed in tears, which protect it against infection. Dry eyes develop when the eyes don’t produce enough tears or don’t produce the right quality of tears.
There are several common factors that lead to dry eye syndrome.
Environmental conditions can lead to dry eyes. This can be especially bothersome if you are frequently exposed to these conditions.
- Air conditioning
- Cigarette smoke
Some people are more susceptible to developing dry eyes in response to environmental conditions, and this could be related to having other risk factors for dry eyes, such as contact lenses or autoimmune disease.
Aging is one of the most common causes of dry eyes because tear production decreases as we get older.
Not Blinking Enough
Another common culprit is not blinking enough, which happens during activities such as watching TV and computer use. Each time you blink, it coats the eye with tears. You normally blink about every 12 seconds. People who play computer games may only blink once or twice during a three-minute time span.2
Additionally, anything that causes an issue with the blink reflex can interfere with blinking. Possiblities include:
- Lid disease
- Foppy lid
- Parkinson’s disease
- Progressive supra nuclear palsy (PCP)
- Certain types of can interfere with blinking.
About half of all people who wear complain of dry eyes.3 Soft contact lenses, which float on the tear film that covers the cornea, absorb the tears in the eyes.
Laser Vision Correction and Other Procedures
Dry eye syndrome may begin or worsen after LASIK and other refractive surgeries, in which the corneal nerves are cut during the creation of a corneal flap. The corneal nerves stimulate tear secretion. If you’ve had dry eyes and are thinking about refractive surgery, this potential side effect is something to consider.
Dry eyes also can be caused by certain medications, including:
- Birth control pills
that affect the eyes can also cause dry eyes. Blepharitis, an inflammation of the eyelids, can interfere with the oil glands in the eyes. is a condition in which the glands in the eyes become inflamed and do not produce tears as they should. is a condition in which the tears are produced, but do not last due to evaporation.
Diagnosis of dry eyes often involves ruling out other eye conditions and medical conditions.
The effects of dry eyes can be similar to the effects of allergies, viral conjunctivitis (pink eye), corneal abrasion, migraines, and Bell’s palsy (when facial weakness prevents you from closing your eyelid).
If you have other issues, such as eye discharge, eye crusting, sneezing, congestion, headaches, vision changes, or tingling of your face, this can point to another cause of your symptoms besides dry eyes.
Your doctor may examine your eye or refer you to an eye doctor, who can perform specialized tests to determine the cause of your symptoms. You may need to have a vision test, as people who have undiagnosed vision problems may squint or feel a type of eye discomfort that can be confused with dry eyes.4
Specialized tests may include:
- The Schirmer test: A strip of special paper is placed on the edge of the lower eyelid. This measures how much moisture or tears are produced in the eye over time and is a useful test to determine the severity of the problem.
- Fluorescein or rose bengal: When you have this test, a dye is placed on your eye to stain the surface. This can show how much the surface of your eye has been affected by dryness.
- Tear break-up time (TBUT): This test measures the time it takes for tears to break up in the eye. Dye, such as fluorescein, is placed into your eye, and your tears are observed under a special light to assess how long it takes them to break up.
In addition to determining whether you have dry eyes, your doctors will also work with you to determine the cause. If there is a concern that you could have a medical condition causing your dry eyes, you may need blood tests to assess for signs of systemic diseases that may be responsible.
Prevention is a key factor in managing dry eyes, If environmental factors are the cause, protective eyewear or using a humidifier can be helpful. If you wear contact lenses, paying close attention to changing them when necessary is important.
There are several treatment approaches that can help with dry eyes, including over-the-counter (OTC) artificial tears, prescription medications, and interventional procedures.
The first line of treatment for dry eyes is usually OTC demulcent drops, also known as artificial tears.5 Artificial tears temporarily lubricate the eye and ease symptoms. Always read the directions, but these products can generally be used as often as needed throughout the day.
Commonly found ingredients in these products include hydroxypropyl methylcellulose, the ingredient in Bion Tears and GenTeal, and carboxymethylcellulose, contained in Refresh Plus and Thera Tears.
Your healthcare provider can guide you in choosing the right one for you. Some people use drops for red eyes, but that can make the eyes even drier. Red eyes could be caused by numerous factors, from allergies to an eye infection, which is why a proper diagnosis is important.
If you wear contact lenses, use rewetting drops specifically for contact lenses. Other types of drops may contain ingredients that damage the lens.
A number of prescription medications can be used for the treatment of dry eyes. Gels, ointments, and oral (by mouth) or topical (placed on the eye) steroids may reduce dryness.
Restasis (cyclosporine ophthalmic emulsion) and are approved for the treatment of dry eyes. Restasis helps the eye produce tears, while Xidra reduces the inflammation that may cause decreased tear production.
Keep in mind that prescription medications can cause side effects and they are not necessarily right for everyone.
In each eye, there are four puncta, which are small openings that drain tears into the tear ducts. can be inserted into the puncta to block tear drainage, preserving your tears in your eyes.6
The risks of punctal plugs are fairly minimal, but there is a risk of eye irritation, excessive tearing, and, in rare cases, infection.
You may still need to use artificial tears after having a punctal plug insertion.