Dry eye syndrome (DES or dry eye) is a chronic lack of sufficient lubrication and moisture on the surface of the eye. Its consequences range from minor irritation to the inability to wear contact lenses and an increased risk of corneal inflammation and eye infections.

Signs and Symptoms of Dry Eye

Persistent dryness, scratchiness and a burning sensation on your eyes are common symptoms of dry eye syndrome. These symptoms alone may be enough for your eye doctor to diagnose dry eye syndrome. Sometimes, he or she may want to measure the amount of tears in your eyes. A thin strip of filter paper placed at the edge of the eye, called a Schirmer test, is one way of measuring this.

Some people with dry eyes also experience a “foreign body sensation” – the feeling that something is in the eye. And it may seem odd, but sometimes dry eye syndrome can cause watery eyes, because the excessive dryness works to overstimulate production of the watery component of your eye’s tears.

What Causes Dry Eyes?

In dry eye syndrome, the tear glands that moisturize the eye don’t produce enough tears, or the tears have a chemical composition that causes them to evaporate too quickly.

Dry eye syndrome has several causes. It occurs:

• As a part of the natural aging process, especially among women over age 40.
• As a side effect of many medications, such as antihistamines, antidepressants, certain blood pressure medicines, Parkinson’s medications and birth control pills.
• Because you live in a dry, dusty or windy climate with low humidity.

If your home or office has air conditioning or a dry heating system, that too can dry out your eyes. Another cause is insufficient blinking, such as when you’re staring at a computer screen all day.

Dry eyes are also associated with certain systemic diseases such as lupus, rheumatoid arthritis, rosacea or Sjogren’s Syndrome (a triad of dry eyes, dry mouth, and rheumatoid arthritis or lupus).

Long-term contact lens wear, incomplete closure of the eyelids, eyelid disease and a deficiency of the tear-producing glands are other causes.

Dry eye syndrome is more common in women, possibly due to hormone fluctuations. Recent research suggests that smoking, too, can increase your risk of dry eye syndrome. Dry eye has also been associated with incomplete lid closure following blepharoplasty – a popular cosmetic surgery to eliminate droopy eyelids.

Treatment for Dry Eye

Dry eye syndrome is an ongoing condition that treatments may be unable to cure. But the symptoms of dry eye – including dryness, scratchiness and burning – can usually be successfully managed.

Your eyecare practitioner may recommend artificial tears, which are lubricating eye drops that may alleviate the dry, scratchy feeling and foreign body sensation of dry eye. Prescription eye drops for dry eye go one step further: they help increase your tear production. In some cases, your doctor may also prescribe a steroid for more immediate short-term relief.

Another option for dry eye treatment involves a tiny insert filled with a lubricating ingredient. The insert is placed just inside the lower eyelid, where it continuously releases lubrication throughout the day.

If you wear contact lenses, be aware that many artificial tears cannot be used during contact lens wear. You may need to remove your lenses before using the drops. Wait 15 minutes or longer (check the label) before reinserting them. For mild dry eye, contact lens rewetting drops may be sufficient to make your eyes feel better, but the effect is usually only temporary. Switching to another lens brand could also help.

Check the label, but better yet, check with your doctor before buying any over-the-counter eye drops. Your eye doctor will know which formulas are effective and long-lasting and which are not, as well as which eye drops will work with your contact lenses.

To reduce the effects of sun, wind and dust on dry eyes, wear sunglasses when outdoors. Wraparound styles offer the best protection.

Indoors, an air cleaner can filter out dust and other particles from the air, while a humidifier adds moisture to air that’s too dry because of air conditioning or heating.

For more significant cases of dry eye, your eye doctor may recommend punctal plugs. These tiny devices are inserted in ducts in your lids to slow the drainage of tears away from your eyes, thereby keeping your eyes more moist.

If your dry eye is caused by meibomian gland dysfunction (MGD), your doctor may recommend warm compresses and suggest an in-office procedure to clear the blocked glands and restore normal function.

Doctors sometimes also recommend special nutritional supplements containing certain essential fatty acids to decrease dry eye symptoms. Drinking more water may also offer some relief.

If medications are the cause of dry eyes, discontinuing the drug generally resolves the problem. But in this case, the benefits of the drug must be weighed against the side effect of dry eyes. Sometimes switching to a different type of medication alleviates the dry eye symptoms while keeping the needed treatment. In any case, never switch or discontinue your medications without consulting with your doctor first.

Treating any underlying eyelid disease, such as blepharitis, helps as well. This may call for antibiotic or steroid drops, plus frequent eyelid scrubs with an antibacterial shampoo.

If you are considering LASIK, be aware that dry eyes may disqualify you for the surgery, at least until your dry eye condition is successfully treated. Dry eyes increase your risk for poor healing after LASIK, so most surgeons will want to treat the dry eyes first, to ensure a good LASIK outcome. This goes for other types of vision correction surgery, as well.

Red eye and dry eye syndrome are quite easily confused. Both conditions include itchy, red and dry-feeling eyes. A person who has dry eye syndrome will often think that their red, dry, itchy eyes are nothing more than something minor, like allergies, and live a long time with the severe comfort that comes with dry eye syndrome. He/she will find that, regardless of what measures are taken, the condition does not change significantly and an eye doctor must be consulted to bring relief. Fortunately, Dr. Thomas Holden is very familiar with the the symptoms of dry eye syndrome and how to treat it. Dr. Holden has compiled some points of essential knowledge below, to help his patients recognize the indications of this uncomfortable and painful eye condition in a more timely fashion, so that they can prevent prolonging the pain and discomfort of this extremely uncomfortable.

Dry Eye Syndrome

Dry eye syndrome is characterized by itchy, red, dry feeling eyes that do not get better unless professional medical help is obtained. Doctors generally discuss two broad causes for dry eye syndrome. Either:

The eyes don’t make enough tears, and the eye cannot be comfortably hydrated

OR

The eye produces tears which are flawed. They often lack one or more essential parts normally included in tears to allow them to properly coat and hydrate the eye.

The leading defense against either of these forms of dry eye syndrome is a type of specialty eye drops called “artificial tears.” These special eye drops combat the uncomfortable symptoms of dry eye syndrome by imitating real tears as closely as possible. In order to do this in the best way possible, there are many different formulations of artificial tears. Each formulation addresses a different underlying cause of your dry eye. Some help to to address the issues of dry eye syndrome in which tears are lacking in quantity, and others will add one or more building blocks to your tears to help them better perform their intended function.

Red Eyes

Red eyes are generally not as worrisome as dry eye syndrome and you shouldn’t worry too much about them. In most cases, red eyes are caused by allergens or foreign substances, which can cause your eyes to become irritated. Small blood vessels throughout your eyes then become inflamed and enlarged, becoming much more visible and turning your eyes a reddish hue. This is where the term “red eyes” comes from.

Many times, red eyes will heal up and return to normal without any medical attention at all. A not of caution, however: The great number of conditions that can cause dry eyes makes it very hard to know exactly what the cause may be sometimes. If your red eyes are accompanied by a high fever, headache and/or a great deal of eye pain, go to the doctor immediately. This note aside, red eyes are almost always minor and should not cause anxiety unless accompanied by these additional symptoms.

Even with a brief but comprehensive explanation such as this, it can sometimes be hard to tell the difference between these two similar looking conditions. If you feel your red eyes may be something more, come see Dr. Holden today.

Sometimes a person is unable to produce enough tears or their tears do not possess the right qualities to keep eyes healthy and comfortable. This can cause a consistent lack of sufficient lubrication and moisture on the surface of the eye, known as dry eyes.

Normally, the eye constantly lubricates itself with tears by producing them at a slow and steady rate, keeping itself moist and comfortable. Usually these tears consist of three layers, an oily, a watery, and a mucus layer. Each layer has a specific role in lubricating your eyes. The oily layer is outermost. It’s main purpose is to slow evaporation of the tear. The watery layer is in the middle. This makes up the majority of what a person normally thinks of as tears. This layer cleans the eye and helps to wash away small foreign objects and particles. The inner layer consists of mucus. This mucus allows the watery layer to stick to the eye and spread evenly over the eye in order to keep it lubricated. In a person with dry eyes, either hormonal changes, side effects from medication or some other factor causes the eye to either not produce enough tears, or leave out parts of the tear that make proper lubrication possible.

Dr. Thomas Holden, of Family Optometric in Oxnard, California explains, “Symptoms of dry eyes include stinging or burning in the eyes, scratchiness, and excessive irritation from smoke or wind. Although it may sound counter-intuitive, the eyes’ response to the consistent irritation caused by dry eyes may also cause a person to experience excessive tearing. In this case, the eye is attempting to flush and lubricate itself by producing more tears, but is unable to do so successfully due to the rate of evaporation or inability to spread the tears properly.”

Although dry eyes are not always curable, your optometrist may prescribe artificial tears to help with some of the symptoms. Artificial tears are lubricating eye drops that may help with dry, scratchy feeling eyes. Different artificial tears work in different ways. Some help replenish parts of the tear that your eyes are not producing on its own, others help to produce more tears overall. Your eye doctor will assist you to choose which will help you most. Dr. Holden cautions, however, “These artificial tears should not be confused with eye drops that are advertised to ‘get the red out.’ These eye drops may indeed reduce the appearance of redness in your eyes, but this is accomplished by making the blood vessels in your eyes smaller rather than actually lubricating your eyes. As such, these drops can sometimes actually make your symptoms worse. One should also be aware that if you wear contacts, some eye drops require you to take them out before using the drops and wait 15 minutes or more before reinserting your contact lenses.”

Some cases of dry eyes are seasonal, such as those which occur as a result of cold, dry winter air. In this case, your eye doctor may recommend wearing sunglasses or goggles when outdoors to reduce your eyes’ exposure to the sun, wind and dust. For indoors, your optometrist may recommend an air cleaner and humidifier to take dust out of the air and add moisture to air which is too dry.

Studies have also shown that nutrition may have a part in helping to relieve some symptoms of dry eyes. Your eye doctor may recommend nutritional supplements such as omega-3. Good sources of omega-3 fatty acids are cold-water fish, cod, herring and salmon, as well as flaxseed oil. Mild dehydration can make symptoms worse too, so be sure to drink plenty of water, 100 percent fruit and vegetable juices and milk.

For more information, and to have Dr. Holden and Dr. Knapp help you with your dry eyes, be sure to make an appointment with your eye doctor today.