Dry eye syndrome (DES) is a common condition that affects millions each year. For these patients, their tears (tear film), for many different reasons, lack the proper balance and/or stability to maintain a healthy eye. Our eyes depends on a healthy tear film to protect it, as well as provide vital nutrients in order to feed it. To understand why we get dry eyes, we must first understand what are tears are made of.
Our tear film is composed of 3 parts. An oily layer, a mucous layer, and a water layer. All three parts must maintain perfect harmony to keep our eyes healthy. Because of this tear film composition, there are many different types of DES, as well as many different treatment options.
What Causes Dry Eyes
There are many factors that can cause or affect DES.
Age - the strength and stability of the tear film slowly diminishes as we get older
Gender - Women are more likely to experience DES, and the condition typically worsens for women going through hormonal changes such as pregnancy and menopause.
Environment - DES appears to be worse in arid and/or cold environments. For many, winter is a brutal time for DES. The cold, windy, dry air outside, coupled by the dry heat inside makes for a one-two punch.
Activities - Increased computer use and or reading can cause DES. When we read or stare at a computer we do not blink normally. This allows the tear film to evaporate more quickly leaving an exposed, sensitive cornea.
Medication- many medical conditions such as rheumatoid arthritis, sjogrens syndrome, and diabetes have been linked to DES. Also, there are numerous medications that treat many common conditions have been proven in trials to cause or worsen patients DES. Allergy medications such as antihistamines are a very common cause for dry eyes. If you suffer from DES, you should always tell your doctor before taking a new medication. Though, in most cases, the benefits of systemic medication outweigh the risks of dry eyes.
Contact Lenses/ LASIK - Contact lens patients typically have some form of dry eye irritation. This is not always the same as DES. Specifically because most of the symptoms resolve once the contact, or in most cases, the contact-lens solution is removed. For many, switching to a Daily Disposable contact reduces these symptoms. DES is a common complaint post-LASIK. The cutting of the corneal epithelium causes an inflammatory response that can lead to chronic dry eyes post-op. This is becoming less frequent with the use of pre-op treatment such as Restasis, and new LASIK procedures such as Intralase.
Vitamin Deficiency - A proper diet is crucial for the stability of your eyes tear film.
Poor Eye Lid Closure - many patients do not fully close their eyes with each blink or while sleeping. This can result in corneal exposure and can significantly damage the health of the eye.
Dry Eye Symptoms / Diagnosis
At Gahanna Vision Center, our eye doctors can easily diagnose DES by either simply looking at the health of your eyes, or using very simple test to examine your tear film more closely.
Knowing you have DES can be a bit more difficult to tell. Symptoms of DES can be mild to severe. Most patients are unaware that their tear film is not as healthy as it should be.
Common symptoms for DES are:
Burning / Itchy eyes - many patients blame this common symptom on their allergies. This results in mis-treatment by unnecessary use of OTC allergy eye drops.
Watery eyes / Excessive tearing - This is caused by the body's reaction to an unhealthy tear film. To put it simply, the eyes tell the brain to turn on the faucet and help it out. Because of the over-production of the "watery" component of tears this does not make for a balanced, and therefore stable tear film.
Something in your eyes / Under your eye lid - In many cases the tear film breaks down so much that it leaves an exposed, sandpaper-rough cornea. This exposes corneal nerves that are very sensitive. (note: there are more nerves per square millimeter in your cornea than anywhere else on your body) Upon blinking, the exposed nerves are stimulated giving the feeling that something is in the eye, or under the eye lid.
Blurred Vision - Your eye is a camera. If one part of the camera is not 100%, the picture doesn't turn out. Since your tear film is the first component of your eye that light must pass through it must be 100% healthy and stable to produce a 20/20 image.
Decreased reading duration/ computer use - Patients with DES may notice that they cannot comfortably read or use the computer as long as they would like. This can cause some eyestrain (asthenopia) under these conditions.
Light Sensitivity (photophobia) - Just like frost on a windshield, a non-stable tear film can distort the light creating glare and sensitivity to light.
Only your optometrist can decide which form of dry eye syndrome you have, and which treatment option(s) may be best for you.
Artificial Tears - typically the most important foundation in treating any form of DES. However, not all artificial tears are the same.
Warm Compresses - Applying heat to your eyes will open the oil glands along your eye lid margin to provide a stable tear film. Learn more about warm compresses here.
Lid Scrubs - In most all of us, we get a build up of dead skin cells at the base of our eye lashes. This can create flaky, dandruff like, debris that can get into our eyes and irritate it. By performing simple lid scrubs, we can remove this debris and eliminate the problematic source. Learn how to perform lid scrubs here.
Punctal Plugs - Your optometrist may feel that punctal plugs are a good option in treating your DES. Punctal plugs close the major tear duct, holding your eyes natural tears in your eyes for a longer period of time. Learn more about Punctal Plugs here.
Vitamin Supplements - Many vitamins such as vitamin E, fish oils, and omega-3 have been proven to help the tear film stability.
Medication - Our doctors may prescribe medication such as a mild anti-inflammatory drop or antibiotic ointment for short-term treatment, or a long-term treatment such as Restasis.
Nighttime masks - Masks are a great option for DES suffers who need protection while sleeping. Your optometrist may prescribe a mask such as Tranquileyes mask if you suffer from incomplete eye closure, wear a c-pap or bi-pap at night, or just like to sleep with a fan in the room.
What to Do
If you work in front of a computer or like to read a lot, make sure you take time to blink regularly. Also, be sure to relax your eyes by looking away for a minute or two after 20 minutes of near activities.
Eat a proper diet including the essential fatty acids.
Use an indoor humidifier if your home is very dry.
Stay hydrated. Be sure to drink the recommended 8-10 glasses of water a day.
Dr. Miller performs an extensive Dry Eye Evaluation as part of every Lifestyle Eye Exam.
Call or e-mail Gahanna Vision Center today to schedule your Lifestyle Eye Exam