Inability of the eye to produce tears adequately or facing the problem in which the tears produced are not of the correct consistency and quickly evaporates, results in dry eyes.

Inflammation of the eye surface along with dry eye may also occur. Without treatment, it can lead to ulcers, pain, or scars on the cornea, and even loss of some vision. However, a permanent loss of vision due to dry eye is not commonly observed.

It may be difficult to do certain activities such as reading for an extended period of time or using a computer due to this condition. Dry eyes can reduce the tolerance for dry environments, such as the air inside an airplane.

Dry eye condition is known by many names such as dry eye syndrome, keratoconjunctivitis sicca (KCS), lacrimal keratoconjunctivitis, dysfunctional tear syndrome, aqueous tear deficiency, evaporative tear deficiency and LASIK-induced neurotrophic epitheliopathy (LNE).

What are the types of dry eye?

1) Failure of the lacrimal glands to produce adequate amount of the watery component of tears required to maintain a healthy eye surface results in aqueous tear-deficient dry eye.

2) Inflammation of the meibomian glands, located in the eyelids leads to evaporative dry eye. Meibomian glands make up the lipid or oily part of tears and helps slow down the evaporation rate and maintains stability of tears.

Dry eye can be associated with the following conditions:

  • inflammation of eye surface, the conjunctiva, or the lacrimal gland;
  • any disease process that results in alteration of the components of the tears;
  • an increase in the surface of the eye, as in thyroid disease when the eye protrudes forward;
  • cosmetic surgery to correct the wide eyelids.

Causes

Dry eyes can occur due to the following causes:

  • Aging largely contributes to the development of dry eyes. Majority of people above the age of 65 develop dry eye symptoms.
  • Hormonal changes due to pregnancy, menopause and the use of oral contraceptives lead to a greater number of women developing dry eyes as compared to men.
  • Medications such as antihistamines, blood pressure medications, decongestants, and antidepressants, can lead to a reduction in tear production. 
  • Having rheumatoid arthritis, thyroid problems diabetes, problems with eyelid inflammation (blepharitis), inflammation of eye surface or the inward or outward turning of eyelids can lead to development of dry eyes.
  •       Wind and dry climates or exposure to smoke can result in an increased evaporation of tear causing dry eye symptoms

  •             Not blinking regularly while working on computer screen for a long time can also result in drying of the eyes.

  •             Long-term use of contact lenses and refractive eye surgeries, such as LASIK, can reduce tear production and contribute to dry eyes. 

Symptoms

Symptoms of dry eyes may include any of the following:

  • burning of the eye;
  • a feeling as if something is in the eye;
  • Experiencing excess tears formation followed by dry eye periods;
  • experiencing eye discharge;
  • pain and redness of the eye;
  • experiencing blurred vision;
  • heavy eyelids;
  • inability to cry accompanied with emotional stress;
  • experience discomfort with contact lenses;
  • reduced tolerance to activities that require sustained visual attention;
  • eye fatigue 

How are dry eyes diagnosed?

A comprehensive eye examination can help diagnose dry eyes. Tests and evaluation of the dry eye disorder, may include:

  • Taking down patient history to determine the symptoms and note any other factors such as general health problems, environmental factors or medications that could possibly contribute to the dry eye problem.
  • External examination of the eye.
  • Use of bright light and magnification to evaluate the eyelids and cornea.
  • Measurement of the quantity and quality of tears for any abnormalities using special dyes that help in a better observation of tear flow and indicate any changes in the outer surface of the eye as a result of insufficient tears.

How are dry eyes treated?

Addition of tears with over-the-counter artificial tear solutions, heightened tear production, conserving tears and treating the inflammation of the eyelids or eye surface that contributes to the dry eyes are the primary approaches in the management and treatment of dry eyes.

  • Addition of tears- Mild cases of dry eyes can often be managed using over-the-counter artificial tear solutions. These can be used as often as needed to supplement natural tear production. Artificial tear solutions that are free of preservatives are recommended as they do not result in eye irritation as they contain fewer additives. 
  • Conserving tears by keeping natural tears in the eyes for a longer duration by blocking the tear ducts through which the tears normally drain can reduce the dry eye symptoms. The tear ducts can be blocked with tiny removable silicone or gel-like plugs.
  • For increasing tear production, use of eye drops can result in an increased tear production. Also, nutritional intake of omega-3 fatty acid could be helpful in reducing the dry eye symptom.
  • For the treatment of ocular surface inflammation that might contribute to dry eyes, clinician might prescribe eye drops or ointments, lid massage and warm compresses, or eyelid cleaners.

Self-Care

You can take the following steps to reduce symptoms of dry eyes:

  • Remember to blink regularly while reading or doing computer work for long duration.
  • Increase the humidity in the air at work and at home.
  • Wear sunglasses outdoors to decrease exposure to drying winds and the sun.
  • Nutritional supplements with essential fatty acids may help in reduction of dry eye symptoms.
  • Avoid dehydration by drinking plenty of water (8 to 10 glasses) each day.

Dry eye treatment in India

Dry eye treatment at Sanjeevan helps improve the health of the lachrymal apparatus, focusing on the stimulation of the lacrymal and the meibomian gland. This ultimately helps in tear production which is rich in lubricating qualities. The patient begins to feel comfortable as we treat the symptoms associated with dry eyes which are mainly pain, itching and light sensitivity.

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