Persistent dryness, scratchiness, red eyes and a burning sensation are common symptoms of dry eyes. Dry eyes can become red and irritated, causing a feeling of scratchiness. Another symptom of dry eyes is a “foreign body sensation,” which is a feeling that something is in your eye.
And it may seem odd, but dry eye syndrome also can cause watery eyes. This is because dryness on the eye’s surface sometimes will overstimulate production of the watery component of your tears as a protective mechanism.
What Causes Dry Eye Symptoms?
Tears bathe the eye, washing out dust and debris and keeping the eye moist. They also contain enzymes that neutralize microorganisms that colonize the eye. Tears are essential for good eye health.
Tears are complex, containing many different essential elements, including oils produced by special glands in the eyelids called meibomian glands. These oils prevent evaporation of the tears.
In dry eye syndrome, the lacrimal gland or associated glands don’t produce enough tears, or dysfunction of the meibomian glands reduces oil output, leading to excessive evaporation of the tears. This is called evaporative dry eye and is now considered to be the primary cause or a contributing factor of most cases of dry eye.
Dry eye syndrome has many causes. It occurs as a part of the natural aging process (especially during menopause in women); as a side effect of many medications, such as antihistamines, antidepressants, certain blood pressure medicines, Parkinson’s medications and birth control pills; or because you live in a dry, dusty or windy climate.
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 also are a symptom of systemic diseases such as lupus, rheumatoid arthritis, ocular rosacea and sjogren’s syndrome (a triad of dry eyes, dry mouth and rheumatoid arthritis or lupus).
Long-term contact lens use is another cause; in fact, dry eyes are the most common complaint among contact lens wearers
Incomplete closure of the eyelids, eyelid disease and a deficiency of the tear-producing glands are other causes.
Tears consist of three essential components:
- The outer, oily lipid component
- The middle, watery, lacrimal component
- The innermost component, consisting of mucous or mucin
- Each component of the tear film serves a critical purpose. For example, tear lipids prevent evaporation and increase lubrication, while mucins help anchor the tears to the ocular surface.
Each tear component is produced by a different gland:
- The outer oily component is produced by meibomian glands in the eyelids.
- The watery component is produced by lacrimal glands located above the outer corner of the eyes.
- The inner mucoid component is produced by goblet cells in the conjunctiva.
A problem with any of those sources can result in tear instability and dry eyes.
Dry eye syndrome is more common among women, possibly due to hormonal fluctuations. A recent study also indicates that the risk of dry eyes among men increases with age.
Smoking can increase your risk of dry eyes.
How are dry eyes diagnosed?
Dry eyes can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on the evaluation of the quantity and quality of tears produced by the eyes, may include:
- Patient history to determine any symptoms the patient is experiencing and the presence of any general health problems, medications taken, or environmental factors that may be contributing to the dry eye problem.
- External examination of the eye, including lid structure and blink dynamics.
- Evaluation of the eyelids and cornea using bright light and magnification.
- Measurement of the quantity and quality of tears for any abnormalities. Special dyes may be instilled in the eyes to better observe tear flow and to highlight any changes to the outer surface of the eye caused by insufficient tears.
Using the information obtained from testing, your optometrist can determine if you have dry eyes and advise you on.
Additional Lab work may be needed to rule out an Sjogren’s Syndrome (an autoimmune condition that causes dry eyes and dry mouth)
How are dry eyes treated?
One of the primary approaches used to manage and treat mild cases of dry eyes is adding tears using over-the-counter artificial tear solutions.
Dry eyes can be a chronic condition, but your doctor can prescribe treatment to keep your eyes healthy, more comfortable, and prevent your vision from being affected. The primary approaches used to manage and treat dry eyes include adding tears, conserving tears, increasing tear production, and treating the inflammation of the eyelids or eye surface that contributes to the dry eyes.
- Adding tears– Mild cases of dry eyes can often be managed using over-the-counter artificial tear solutions. Preservative-free artificial tear solutions are recommended because they contain fewer additives that could further irritate the eyes. However, some people may have persistent dry eyes that don’t respond to artificial tears alone. Additional steps need to be taken to treat their dry eyes.
- Conserving tears– An additional approach to reducing the symptoms of dry eyes is to keep natural tears in the eyes longer. This can be done by blocking the tear ducts through which the tears normally drain. The tear ducts can be blocked with tiny silicone or gel-like plugs that can be removed, if needed. A surgical procedure to permanently close tear ducts can also be used. In either case, the goal is to keep the available tears in the eye longer to reduce problems related to dry eyes.
- Increasing tear production– Prescription eye drops (Restasis) that help to increase production of tears can be recommended by your optometrist, as well as omega-3 fatty acid nutritional supplements.
- Treatment of the contributing eyelid or ocular surface inflammation– Prescription eye drops or ointments, warm compresses and lid massage, or eyelid cleaners may be recommended to help decrease inflammation around the surface of the eyes.
What are Autologous Serum Eye Drops? Autologous means that the donor and the recipient are the same person. The eye drops are made from your own blood. Red blood cells and clotting factors are removed, leaving behind blood serum. This is diluted with a sterile, preservative-free solution to produce a tear substitute that is unique to the patient, and contains many important growth factors and nutrients normally found in healthy tears. Since blood and tears have an almost identical salinity and pH, there is no issue of burning or stinging upon instillation. Because they are non-preserved, the drops are stored in the freezer until you need them.
TrueTear® is now available at Beyer Eye Associates
If you feel like your eyes aren’t making enough tears, our Eye Care Providers and you
can decide together if TrueTear® could be right for you. TrueTear® is a device that
uses state-of-the-art technology called neurostimulation to help your eyes temporarily
make more of your own tears.
- Your own natural tears
- Drop-free, drug-free option
- Prescription only
- Fits into your daily routine
We are excited to be among a select group of practices offering TrueTear®.
Contact our office today to schedule a TrueTear® demo during your next appointment.