Dry eye syndrome is a dysfunction of the tear film. It usually presents as sore, red, and tired eyes. Environmental factors play a role, however, treatment depends on which type of dry eyes you have. Artificial tear drops can help to relieve symptoms, but further treatment may be required.
What is Dry Eye Syndrome
Dry eye syndrome is a complex problem and is also known by a number of other names:
- Keratoconjunctivitis sicca (KCS)
- Dysfunctional tear syndrome
- Lacrimal keratoconjunctivitis
- Evaporative tear deficiency
- Aqueous tear deficiency
- LASIK-induced neurotrophic epitheliopathy (LNE)
The tear film is a fluid that protects the surface eye from damage. Three layers make up the tear film, each serving an important function. Firstly a mucous layer holds the tears to the eye’s surface skin cells.
The second component is aqueous (water) which is the bulk of the tears and provides nutrients to the eye. The water layer also lubricates the eyelids, and washes away foreign bodies from the eye surface.
Lastly, the top layer is a lipid (oil) and it stops the aqueous from evaporating. All components are produced by different glands and need to work together to provide a healthy functioning tear film. If there is a deficiency in the production of any layer, this leads to dry eye syndrome.
Causes of Dry Eye Syndrome
A common cause of dry eyes is blepharitis, which is a chronic inflammation of the eyelids, similar to dandruff. Post-menopausal women are often severely affected by dry eyes. Especially so if they have an underlying inflammatory condition such as rheumatoid arthritis.
Increased dry eye discomfort is also often associated with excessive screenwork. This is due to the decrease in blinking whilst using digital devices and is part of digital eye strain.
Environmental factors such as air-conditioning, dry, hot, windy, smokey and dusty environments also contribute to evaporative tear deficiency. Contact lens wear and refractive LASIK surgery often exacerbate symptoms. Some medications can also negatively affect tear production.
Sufferers of KCS often experience a wide range of symptoms including irritated, itchy, sore, and red eyes. They can also have tired, heavy eyes, blurred vision, and sensitivity to bright lights. These can range in severity from mild to so severe that it can be debilitating.
Furthermore, it’s important to realise that KCS and related conditions may in fact present as watery eyes. This is counter-intuitive but relates back to the tear film quality and the eye’s natural response to produce more tears.
The optometrist will examine the ocular surface and tear film to determine the cause and severity of the dry eye syndrome. Biomicroscopy and a special stain that colours the tear film will demonstrate tear quality and quantity. The optometrist may also use enhanced Meibography imaging using our advanced corneal topographer instrument.
Tailored therapy is matched to the type of dry eye syndrome present. So, the optometrist will recommend a management plan for your type of dry eyes.
Treatments may include frequent lubrication with an artificial tear replacement, daily warm compresses with a purpose-made heat pack, and eyelid scrubs with a mild detergent solution.
More severe dry eyes may need treatment with topical steroid eye drops, oral antibiotic tablets or punctal occlusion plugs to keep the tears on the eye’s surface for longer.
Dry eye therapies are common. However, a large number of purported “miracle cures”, have no clear evidence to support their claims.
Reducing your risk
To lessen the severity of dry eye symptoms you can use lubricating artificial tear drops regularly and take frequent breaks during computer use. Control your environment by avoiding fans and air-conditioning blowing directly into your eyes. Using humidifiers can help. Shielding your eyes with sunglasses or safety glasses also helps to lessen the impact of the outside environment. A diet high in omega-3 fatty acids is also beneficial.