Dry eye is one of the most common eye conditions eye doctors diagnose and treat. In fact, it is estimated over 25 million Americans experience dry eye. Dry eye occurs when there are either not enough tears to adequately lubricate the eye or the tears are of poor quality.
To better understand dry eye, it is helpful to understand the components of a tear. The main layers of tears are:
- Mucus layer: This layer helps spread the water layer and adhere it to the surface of the eye.
- Water layer: This layer keeps the surface of the eye healthy and hydrated.
- Oil layer: This layer prevents tears from evaporating.
When one or more of these layers of tears becomes inadequate, dry eye can occur.
What Causes Dry Eye?
There are many different causes of dry eye including:
- Age: Dry eye particularly affects those over the age of 50. As we age, we naturally produce less tears.
- Environment: Dry, dusty, windy, or smoky environments can increase dry eye.
- Digital screen use: Staring at a computer, smartphone, or TV for prolonged periods can result in decreased blinking.
- Eyelid health: Certain eyelid conditions increase the risk of dry eye including blepharitis (inflammation of the eyelid) and entropion/ectropion (eyelids turn inward or outward).
- Certain medications, such as antidepressants, antihistamines, and decongestants, diuretics.
- Certain diseases, such as diabetes, Sjogren's, and rheumatoid arthritis.
- Hormonal changes: Women are more likely to develop dry eye during menopause and pregnancy.
- Meibomian gland dysfunction: A condition in which the meibomian glands become clogged and do not produce enough oil for the tears. This causes tears to evaporate too quickly.
- History of laser refractive surgery, such as LASIK.
What are the Symptoms of Dry Eye?
Dry eye typically affects both eyes. Symptoms that appear may include:
- Red eyes
- Itchy eyes
- Burning sensation
- Eyes feel scratchy or gritty
- Watery eyes
- Blurry vision
- Difficulty wearing contact lenses
- Eyes feeling tired or fatigued
How is Dry Eye Diagnosed?
Diagnosing dry eye requires your optometrist or ophthalmologist to perform a comprehensive eye exam. Your eye doctor will evaluate the health of your eyelids, examine the surface of your eye and assess your blink reflex. Sometimes, additional tests can be done to further evaluate for dry eye.
How is Dry Eye Treated?
There are numerous effective dry eye treatments available as technology has seen many advancements. Your eye doctor will discuss what treatments may work for you. One or more treatment options may be necessary including:
- Artificial Tears: This is the most common treatment for mild dry eye and is effective at lubricating the eye for temporary relief. There are a variety of over-the-counter eye drops available ranging from liquid drops to gel drops to preservative-free drops.
- Prescription Eye Drops: If artificial tears aren’t adequate, your doctor may recommend prescription eye drops such as Restasis® or Xiidra®. These eye drops may help with lubricating the eye as well as reducing inflammation.
- Warm Compresses: Placing warm compresses on the eyelids can help warm up clogged meibomian glands, which is a common cause of dry eye.
- Lid Scrubs: Cleaning your eyelids with lid scrubs can help reduce inflammation of the meibomian glands.
- Punctal Plugs: If eye drops are determined to be insufficient, punctal plugs may be used. A punctal plug is placed into the tear duct to prevent tears from draining out of the ducts. This allows the tears to remain in the eye and keep it lubricated.