When the eye does not produce adequate tears, or if the quality of the tears produced is poor, or in case the tears get evaporated at a speed greater than normal, the eyes may feel gritty and tired. This is called dry eye.
The surface of the eye may get inflamed along with dryness. If left untreated, this may lead to discomfort, pain, ulceration and scarring of the cornea.
Dry eye can make working on the computer or reading uncomfortable, and can also decrease the tolerance to dry, arid environments (including airplanes, and air-conditioned spaces).
Any disease process that alters the components of tears can make them unhealthy and result in dry eye.
The symptoms of dry eye include:
• Stinging or burning of the eye
• Gritty feeling, feeling a foreign body in the eye
• Excessive tearing
• Stringy discharge from the eye
• Pain and redness
• Episodes of blurred vision which may improve on blinking
• Decreased contact lens tolerance
• Discomfort while reading, working on the computer
• General eye fatigue
Causes of dryness of the eye include:
• Diseases of the eyelids such as meibomian gland dysfunction, lagophthalmos, increased size of palpebral fissure due to thyroid disease, trauma
• Pregnancy
• Menopause, and hormone replacement therapy
• Post- LASIK.
• Following chemical and thermal burns
• Infrequent blinking
• Long-term contact lens wear
• Dry eye can be associated with disorders such as Sjögren’s syndrome, lupus, and rheumatoid arthritis.
• Exposure to pollutants and irritants
• Thyroid disease and diabetes
• Facial nerve palsy
• Side effect of some medications, including anti allergics, tranquilizers, certain blood pressure medicines, Parkinson’s medications, contraceptive pills and anti-depressants.
Treatment of dry eye is an ongoing process. In case the underlying cause can be identified, it is treated while providing supportive therapy to ensure symptomatic relief.
Usually, your eye doctor will prescribe tear supplements (eye drops and gels) to keep you comfortable, the nature and frequency of which will be determined by disease severity. Preservative free tear supplements work best for dry eye.
Cyclosporine, an anti-inflammatory medication, is the only prescription drug available to treat dry eye. It is known to increase basic tear production, and reduce symptoms.
Your doctor may offer to insert punctal plugs into your eyes. These are small plugs that are inserted into the punctum of the eye, the drainage holes in your eyelid, that connect the eyes to your nose and throat. These plugs are made of silicone or collagen, are reversible, and do not cause any discomfort following insertion.
In some patients supplements or dietary sources (such as tuna fish) of omega-3 fatty acids may decrease symptoms of irritation.
Other supportive measures which may help you be more comfortable include:
• Wearing glasses or sunglasses (wrap around)
• Using a humidifier indoors
• Decreasing screen time
• Avoiding contact lens use
• Remembering to blink