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What is Dry Eye? Do I Have It? – Causes, Prevention, Treatment

Dry eye or keratoconjunctivitis sicca (KCS), is a painful condition that can be overlooked or misdiagnosed. A person might be experiencing a feeling of heaviness in the eyelids, or fatigue, itching, stinging, or other symptoms that  might be misinterpreted as a common cold or allergy. Even a watery eye flooded with tears, can be caused from “dry eye.” So what is this condition and how can it be prevented and treated?

WHAT IS DRY EYE?

Dry eye is a condition which occurs when the eye does not produce enough tears, or when the tears evaporate before optimal lubrication of  the eye occurs. Without lubrication, permanent injury, such as scarring of the cornea, can occur. Our tears have three different layers:

  1. Outer oily layer – (lipid) layer
  2. Middle watery layer (aqueous) 
  3. Inner layer (mucus)

These three layers work together to help keep our eyes healthy and fight infection. When someone is suffering from dry eye, there is insufficient tear production or poor tear quality. There are different types of deficiencies. Some might experience aqueous tear-deficient dry eye (not enough watery later), or evaporative dry eye (not enough oil).

 

Eye Anatomy

Image Credit: Biographix Media http://www.biographixmedia.com/

Dry eye can result in inflammation of the lacrimal gland. People who have dry eye are not able to wash the eye every time they blink. The eye becomes dry and irritated. Approximately 5 million people age 50 and over in the United States have dry-eye syndrome. This about twice as many women have dry eye than men. The irritation and discomfort caused by dry eye can interfere with vision and become serious without proper care and treatment.

Eye Exam

WHAT ARE THE SYMPTOMS OF DRY EYE?

Symptoms of dry eye include:

  1. inflammation or red appearance
  2. itching in the eye
  3. stinging in the eye
  4. gritty or scratchy sensation
  5. dryness
  6. eye fatigue
  7. burning of the eye
  8. uncontrolled tearing
  9. chronic infections
  10. eye pain and discomfort
  11. stringy mucus in or around the eye
  12. sensitivity to light
  13. feeling as if something is in the eye
  14. difficulty wearing contact lenses
  15. difficulty with nighttime driving
  16. blurred vision

COMMON CAUSES OF DRY EYE

There are multiple causes and underlying conditions or circumstances which may aggravate symptoms of dry eye. Certain medications, medical conditions, diseases, lifestyle factors, and environmental conditions can dry out the eye. 

  1. aging (30% of people over 50 have dry eye)
  2. autoimmune diseases (rheumatoid arthritis, scleroderma, MS, and others)
  3. pregnancy
  4. menopause
  5. diabetes
  6. rosacea
  7. allergies
  8. dehydration
  9. excessive blinking 
  10. dry climate
  11. thyroid disorder
  12. blocked meibomian (MBG) glands or meibomianitis
  13. eyelid inflammation (blepharitis)
  14. air conditioning or heaters (fans)
  15. air pollution
  16. contact lenses
  17. vitamin A deficiency
  18. LASIK eye surgery (laser eye surgery or laser vision correction)
  19. prescriptions and over the counter medications

hands on drugsWHICH MEDICATIONS CAUSE DRY EYE?

Many prescription drugs and over the counter medications can cause or aggravate dry eye. These include:

  1. antihistamines
  2. blood pressure medications
  3. Parkinson’s disease medications
  4. nasal decongestants
  5. anti-redness eye drops (tetrahydrozoline ophthalmic)
  6. hormone replacement therapy
  7. contraceptive drugs
  8. acne medication
  9. antidepressants
  10. antipsychotic

TREATMENT OR PREVENTATIVE CARE

If you believe you may have dry eye, talk to your doctor or trusted healthcare practitioner about at treatment plan that is best for you. There are lifestyle changes you can make, natural cures, over-the-counter medications and prescription drugs. Here are a few options you might consider:

  1. Use over-the-counter artificial tears (not anti-redness drops, which can make dry-eye syndrome worse)
  2. Use prescription medication eye drops, prescribed by your trusted physician
  3. Change your diet by adding more Omega-3 fatty acids (salmon, sardines, tuna, walnuts, flax seed, etc.), or take Omega-3 supplements
    Swim Glass of Water
  4. Keep hydrated
  5. Consider tear-duct plugs (punctal plug, lacrimal plug)
  6. Try frequent eyelid cleansing to unclog glands
  7. Try therapeutic contact lenses (scleral lenses, bandage lenses)
  8. Use a humidifier
  9. Stop smoking or avoid smoky, polluted air
  10. Blink regularly

    Sunglasses

  11. Wear sunglasses if out in the sun
  12. Avoid staring for long hours at the computer or television; do eye exercises
  13. Apply warm wet compress and place over the eyes for several minutes
  14. Discuss with your doctor the possibility of discontinuing or changing certain medications which might trigger or aggravate dry eye symptoms.

Dry eye syndrome can be very debilitating and is not something to ignore. If not treated properly it could lead to more serious eye conditions, which might damage the eye. With loving care and attention, you can successfully treat and prevent dry eye.

Doctor and patient

Talk to your trusted healthcare professional to receive an accurate diagnosis and to discover out which treatment  most effectively addresses your needs.

 

References and Suggested Reading 

Boyd, Kierstan (Sept 2017) “What is Dry Eye?” American Academy of Opthamology.

Ding, J; Sullivan, DA (July 2012). “Aging and dry eye disease”. Experimental Gerontology. 47 (7): 483–90.

Meadows, Michelle (May – June 2005). “Dealing with Dry Eye”. FDA Consumer Magazine

Messmer, EM (30 January 2015). “The pathophysiology, diagnosis, and treatment of dry eye disease”. Deutsches Arzteblatt international. 112 (5): 71–81.

Miljanović B, Trivedi KA, Dana MR, Gilbard JP, Buring JE, Schaumberg DA (2005). “Relation between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye syndrome in women”. Am J Clin Nutr. 82 (4): 887–93.

Pucker AD, Ng SM, Nichols JJ (2016). “Over the counter (OTC) artificial tear drops for dry eye syndrome”. Cochrane Database Syst Rev. 2: CD009729.

Tavares Fde, P; Fernandes, RS; Bernardes, TF; Bonfioli, AA; Soares, EJ (May 2010). “Dry eye disease”. Seminars in ophthalmology. 25 (3): 84–93.

 

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Jean E. DartJean Dart, M.S. Special Education from Illinois State University, is a published author and has written hundreds of health articles as well as hosting a local television program, “Making Miracles Happen.” She is a Registered Music Therapist, Sound Therapist, and Master Level Energetic Teacher, and is the Executive Director, founder, and Health and Wellness Educator of the Monterey Bay Holistic Alliance, a 501(c)3 health education nonprofit organization. All photos used in this article are by www.pixabay.com unless otherwise noted. To find out more about our Health Educators, or to apply as a Monterey Bay Holistic Alliance writer or volunteer, visit our website at www.montereybayholistic.com

Disclaimer:  The Monterey Bay Holistic Alliance is a charitable, independent registered nonprofit 501(c)3 organization and does not endorse any particular products or practices. We exist as an educational organization dedicated to providing free access to health education resources, products and services. Claims and statements herein are for informational purposes only and have not been evaluated by the Food and Drug Administration. The statements about organizations, practitioners, methods of treatment, and products listed on this website are not meant to diagnose, treat, cure, or prevent any disease. This information is intended for educational purposes only. The MBHA strongly recommends that you seek out your trusted medical doctor or practitioner for diagnosis and treatment of any existing health condition.