DRY EYE

dryeye

A condition known as dry eye Keratoconjunctivitis Sicca occurs when tear film abnormalities prevent the eyes from being comfortable. Although dry eye can occur in both men and women at any age, women are most often affected.
Tear production normally decreases as we age.
Dry eye can also be associated with arthritis, and occasionally with a dry mouth. Medications sometimes cause dry eye by reducing tear secretion. Since these medications are often necessary, the dry eye condition may have to be tolerated or treated with “artificial tears.” A wide variety of common medications that can cause dry eye include diuretics; betablockers; antihistamines; sleeping pills; medications for “nerves”. (Antidepressants); pain relievers; or alcohol. Be sure to tell your ophthalmologist the names of all the medications you are taking. People with dry eye are often more prone to the toxic side-effects of eye medications, including artificial tears.

Stimulation at the surface of the eye (Dryness/irritation)results in reflex tearing from the lacrimal gland. Thus anything that disrupts this pathway can affect tear production. When a foreign body irritates the eye or when a person cries, more tears are produced. Excess tearing from dry eye may sound like a contradiction, but your tears must have the right balance of oil, water, and mucus to be able to protect your eyes. Without this balance, your eyes become dry and irritated and produce too many tears.

SYMPTOMS

These are caused by a hyperosmolar or too concentrated tear film, frictional forces due to lack of lubrication and lack of supporting elements like lactoferrin and inflammation as a consequence of all of this. Production of MMP enzymes causes adverse effects on the corneal surface with breakdown of the tissue in some cases.

  • Eye irritation or scratchiness.
  • Excess tearing, especially when reading, driving, or watching television.
  • Stringy mucus in or around the eyes.
  • Difficulty wearing contact lenses.
  • Symptoms are almost always worse at night.

Tears are complex and consist of three layers

  • Oily layer
  • Watery layer
  • Mucoid layer next to the eye

Keratoconjunctivitis sicca can be caused by:

  • a deficit in tear production
    Non Sjogren’s
    Sjogren’s (www.sjogrens.org/)
  • Evaporational Dryness
    Meibomian gland dysfunction and lipid deficiency.
DRY EYE ESSENTIALS

Keep Hydrated
Drink lots of water-especially indoors in winter when central heating is on.If necessary buy a humidifier

Avoid Irritants
Especially smoky atmospheres. Wear dark glasses in the car to protect from heater blowers and in bright sunshine

Medications
Discuss with your GP the possibility of modifying treatments such as diuretics .

Supplements
Flaxseed oil capsules.

Treat Lid Disease
Blepharitis, any other lid anomalies.

Punctum Plugs
If drops are not enough, these can be inserted painlessly.

Other Medications
Your ophthalmologist may decide on oral medication to stimulate tear secretion.

An excellent overview of the types of treatment available can be found HERE.