For many people, having the symptoms associated with dry eyes is a daily challenge. The sensations of burning, stinging, or excessive blinking can impact routines and activities and feel embarrassing. The main reasons for this condition are that the eyes produce fewer tears or the tears are not effective in lubricating the eye. Over time, tear instability leads to inflammation and lasting damage. Dry eyes occur in 4.88 million people in the US and can stem from a number of causes, including:
1) Age: The natural process of aging brings many changes to vision and eyes. One of these changes is that the eyes produce less natural tears. The Mayo Clinic has found that most people over the age of 65 experience dryness in their eyes, and that it affects their nighttime driving and their sensitivity to light.
2) Medical conditions like Sjögren’s syndrome: Sjögren’s syndrome is a long-term autoimmune disorder that impacts the body’s ability to produce moisture (particularly in the eyes and salivary glands). Other medical conditions like rheumatoid arthritis, lupus, scleroderma, sarcoidosis (where the body has abnormal lumps of inflammatory cells), and thyroid disorders also can cause dry eyes.
3) Gender: Interestingly, chronic dry eye and dry eye disease (also known as DED), occurs more frequently in women than men. Women experience this due to hormonal changes in pregnancy or menopause, and when they are using birth control or hormone medications.
4) Medications: In 2012, a study discovered that patients taking multiple medications experienced a higher rate of DED. They referred to this as “poly-pharmacy”, which is the term for taking more than one medication at a time, and found that prescription medications were not the only culprits. Natural remedies and supplements also posed a risk to patients who were taking more than one at a time. Lastly, the study found that medications which caused dry mouth were also likely to cause dry eyes.
5) History of refractive surgery: Patients who have had LASIK or other refractive surgeries (most involve using a laser to change the shape of the cornea) are more likely to have dry eyes. It’s been shown that in the postoperative period (up to one month after surgery), 60% of patients who have had LASIK report dry eyes. The symptoms usually peak within 3 months of surgery and show maximum improvement within 12 months after surgery.
6) Allergies: Oral antihistamines are one of the main reasons that people can experience dry eyes due to allergies. These types of medications reduce the number of tears that are naturally produced. Additionally, allergic conjunctivitis (which is swelling and irritation of the eye tissue) can cause the body to produce tears that are not effective.
7) Meibomian Gland Dysfunction (MGD): The Meibomian glands are tiny oil glands on the edges of the eyelids. They secrete oils that coat the surface of the eye and keep natural tears from evaporating. Together, water and the oils from these glands work together to create the layer called a tear film. If the glands become inflamed or blocked, it creates a disruption in the tear film and causes blurry vision and dry eyes. This blockage results in rapid evaporation of your tears and can lead to irritation, discomfort and if not treated, gland dropout. A series of evaluations will be performed to determine if you have MGD. This can include a LipiView® tear film and gland imaging and a meibomian gland evaluation.
How to prevent and protect yourself from dry eyes:
If you are experiencing dry eyes, you likely want to know how to prevent or improve the condition. There are many steps that patients can take to help keep their eyes lubricated and avoid symptoms like blurry vision and the sensation of stinging or burning. Here are some of the top recommended solutions:
- Avoid situations where the air is blowing in your eyes: Everyday items like conditioners and fans can increase dryness and can make eyes that are already vulnerable even drier. It’s best to reduce your use of fans and instead use a humidifier that can add moisture to the air.
- Use artificial tears: Artificial tears are available at most drugstores and are very inexpensive. Using them as directed can help keep your eyes moist and lubricated throughout the day. Just be sure to check if they’re safe for the type of contact lenses you use because some can degrade contact lens material.
- Warm compresses: This is a very easy intervention that you can do at home if you are experiencing dry eyes. Using a clean washcloth with warm water can help your eyes produce more oils in the tear glands, which improve the quality of the tears you are producing. Better quality tears help keep the eye lubricated and prevent irritation.
- Increase your intake of Omega-3 fats: Fatty acids can help improve the quality and consistency of oil produced by the Meibomian glands. Some foods that are high in Omega-3s include flaxseed oil and fish oil. Always consult your primary physician before beginning a new supplement.
When to see a doctor
If you are trying many interventions and strategies at home and are not seeing improvement, it may be time to see an eye care provider. They can help guide you to the root of your dryness, whether it is a lack of tears or inefficient tears. If you are needing to use artificial tears more than four times a day, a provider can recommend a series of evaluations to determine if you have MGD. This can include a LipiView® tear film and gland imaging and a meibomian gland evaluation. Knowing what is causing your Dry Eye will help your doctor determine the best treatment option. It’s important to be seen if your symptoms are not improving because long-term dry eyes can cause damage to the front of your eye. Here at Medical Eye Center, we are well versed in the signs and symptoms of dry eyes and can help you find solutions to improve your quality of life.