Dry Eye Treatment and Symptoms
Dry eye syndrome (DES) is a chronic condition in which your eyes do not produce enough tears to keep the surface lubricated, leading to a range of symptoms. This can result from reduced tear production or increased evaporation due to low oil levels in the tear film. Symptoms range from mild dryness and discomfort to pain, blurred vision, and infections.
Symptoms of Dry Eye Disease
Symptoms vary by severity and may include:
- Dry, itchy eyes
- Burning or stinging
- Irritation
- Watery eyes
- Blurred vision
- Pain
- Foreign body sensation
Tears protect the cornea by washing away debris and keeping the eye surface moist and clear. They also remove dust and contain enzymes that protect against infection. Dry eye is a condition in which tear production does not maintain a proper moisture balance. This can cause scratchiness, dryness, stinging, and a foreign body sensation. Dry eye can also trigger excessive tearing, leading to watery eyes.
Causes of Dry Eye
Dry eye can result from aging or hormonal changes, including pregnancy, contraceptive use, or menopause. In fact, women over 50 have a 50% greater risk of dry eye disease than men do of the same age. It can also result from medications that reduce tear production, such as antihistamines, blood pressure drugs, and antidepressants. Environmental factors can also dry the eyes, and DED is common in dry, dusty, and windy climates. Air conditioning, heating systems, and prolonged screen use can worsen symptoms by reducing blinking.
Individuals who have conditions such as diabetes, blepharitis, lupus, arthritis, and thyroid disease are at higher risk of DED. Other causes include eye surgery such as LASIK, incomplete eyelid closure, and extended contact lens use.
Diagnosing Dry Eye
Doctors diagnose dry eye disease through a comprehensive exam and symptom review. Your doctor may perform tests to measure how quickly your tears evaporate. Using a dye called fluorescein, the doctor measures how long your tears remain stable after a blink. This is called TBUT, or a Tear Break Up Time test. A low TBUT indicates a lack of oil in the tear film due to poor gland function. In a Schirmer test, the doctor places a strip under your eyelid to measure tear production. The doctor then measures the moisture on the strip. Eye doctors perform Schirmer tests less frequently than TBUT tests.
Dry Eye Treatment
Treatment depends on the cause and severity of dry eye. Mild cases can improve with artificial tears or lubricating eye drops. If over-the-counter drops do not help, your doctor may prescribe drops to increase tear production or reduce inflammation.
Severe cases may require a punctal insert in the lower eyelid to increase tear production. Blepharitis often causes DED, so your doctor may recommend warm compresses, eyelid scrubs, or antibiotics. Your doctor may use punctal plugs to reduce tear drainage and keep your eyes hydrated.
If possible, changing medications may reduce symptoms. Your doctor may recommend limiting contact lens wear or switching to a different lens to reduce dryness.
Preventing Dry Eye
If dry eye is caused by environmental factors, removing the cause may resolve symptoms. Avoid dry environments, heaters, fans, and smoke. Wear protective eyewear in dusty or windy conditions. Use a humidifier to add moisture to dry indoor air. When using a computer or watching TV, blink regularly to prevent dryness. Also, avoid rubbing your eyes as this can further irritate them. Staying hydrated by drinking at least 8 to 10 glasses of water per day can also help.
Dry eye usually does not cause permanent vision loss, but treatment can improve comfort and symptoms. Dry eye is a chronic condition that requires ongoing care. Your doctor will develop a long-term plan to manage your symptoms.