Dry eye
Tears lubricate the eye and stop the surface from drying out. A thin film of tears is swept over the eye surface every time you blink. This saline solution is topped with an even thinner coat of lipids (fatty compounds) that help to preserve the integrity of the film. To maintain eye comfort and health, the tear film needs to remain intact between blinks.
A person suffering from dry eye syndrome does not have a thick enough layer of tears on the front surface of their eyes. This can happen if they do not produce enough tears to keep the eye surface moist, or if, for some reason, the tears do not stay on the eyes long enough.
Over time, the resulting ‘dryness’ can damage the surface of the eyeballs. Dry eye can afflict anyone of any age, but is more common as we get older, and the volume of tears we produce reduces. Dry eye is particularly common in postmenopausal women and people with arthritis.
Some medications can also trigger dry eye syndrome. People with dry eyes typically find it difficult to wear contact lenses, and may also have problems with ‘drying’ environments (such as heavily airconditioned offices).
There is no cure for dry eye, but its symptoms can be alleviated.
Symptoms
The symptoms of dry eye syndrome include:
- Stinging or burning
- Itchiness (particularly in the corners of the eyes)
- Blurred vision.
- Redness
- Mucus around the eyelids, particularly upon waking
- A feeling of grittiness, or the sensation there is something foreign in the eye (like a lash or grain of sand).
Some of the factors that cause or contribute to dry eye include:
- Ageing, since tear production slows with advancing age.
- Menopause.
- Some conditions, such as arthritis.
- Medications including oral contraceptives, antidepressants, antihistamines, diuretics and beta blockers.
- Climatic conditions, such as dry air and wind.
- Irritants, such as cigarette smoke, dust or chemical exposure.
- Any trauma to the eye (including burns).
- Infrequent or incomplete blinking.
- Prolonged periods of time in front of the computer screen
Adequate tear production is vital to the health of the eye. Complications of untreated dry eye can include:
- Ocular discomfort (as described above)
- Transient fluctuations in vision
- Damage to the front surface of the eye (the cornea), which in extreme cases could lead to permanent scarring
Dry eye is diagnosed using a number of tests, including:
- Examination of the eye surface under a specially designed microscope (a ‘slit lamp biomicroscope').
- Special drops of dye administered to the eyes, which reveal distinctive patterns on the eye surface.
- Strips of filter paper held under the eyes to measure tear production.
There is no cure for dry eye, but the condition can be successfully managed. Treatment may aim to increase tear production, maintain tear film volume or prevent excess loss of tears. To achieve these ends, a range of options may be used:
- Make a conscious effort to blink more often.
- Boost the humidity of the air at home and work, by placing bowls of water around the room to evaporate.
- If particular medications are to blame, consult with your doctor to investigate other possible options.
- Use eyedrops that lubricate the surface (these are sometimes called ‘artificial tears’).
- Special plugs inserted into the eye’s drainage canals to prevent excessive loss of tears.
- Surgery to alter the canals that drain tears through the nose.
Some people with dry eyes suffer from inflammation of the eyelids, or blepharitis. For unknown reasons, bacteria that normally live harmlessly on the skin can cause infection of the eyelid margins of susceptible people. The end result is crusting of the lashes/lid margins (particularly upon waking).
In extreme cases, untreated blepharitis can stimulate inflammation, causing the eyelids to become red, swollen and irritated.
Although low-grade blepharitis is often a chronic condition, most cases respond well to appropriate management. Treatments include:
- Cleaning around lid margins with a cotton bud and very mild soapy water
- Antibiotic ointments and tablets.
- Your doctor
- Your optometrist
- Your ophthalmologist.
- Dry eye syndrome is characterised by insufficient tear production.
- Symptoms include itching, irritation and the sensation of having a foreign object in the eye.
- Treatment options include eyedrops of artificial tears.
Related articles:
Eyes explained.
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Article publication date: 01/02/2001
Last reviewed: 27/02/2004
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