Dry Eye

The natural tears that your eyes produce are composed of three layers: the outer oily layer, the middle watery layer, and the inner mucous layer.

Dry eye is the term used to describe eyes that do not produce enough tears or that produce tears without the proper chemical composition in any of these layers. Dry eye is most often a result of the eyes’ natural aging process. Most people’s eyes tend to become drier as they age, but the degree of dryness varies, with some people having more problems than others. In addition to age, dry eye can result from the following:

• Problems with normal blinking
• Certain medications such as antihistamines, oral contraceptives, and antidepressants
• Environmental factors such as a dry climate and exposure to wind
• General health problems such as arthritis or Sjögren’s disease
• Chemical or thermal burns to the eye 

Dry eye symptoms are often different in different people, but the following are commonly experienced by those whose tear production is inadequate:

• Irritated, scratchy, dry, or uncomfortable eyes
• Redness of the eyes
• A burning sensation of the eyes
• A feeling of a foreign body in the eye
• Blurred vision
• Excessive watering as the eyes try to comfort an overly dry eye
• Eyes that seem to have lost the normal clear, glassy luster 

If untreated, dry eye can be more than just irritating or uncomfortable. Excessive dry eye can damage eye tissue and possibly scar the cornea, the transparent front covering of the eye, impairing vision. Contact lens wear may be more difficult because of the possibility of increased irritation and a greater chance of eye infection.

If you have the symptoms of dry eye, your optometrist can perform dry eye tests with diagnostic instruments to give a highly magnified view and special dyes to evaluate the quality, amount, and distribution of tears. Your optometrist will also need to know about your everyday activities, general health, medications you are taking, and environmental factors that may be causing your symptoms.

In most cases dry eye cannot be cured, but your eyes’ sensitivity can be lessened and treatment prescribed so that your eyes remain healthy and your vision is not affected. Possible treatments include the following:

• Frequent blinking to spread tears over the eye, especially when using a steady focus for an extended period
• Changing environmental factors, such as avoiding wind and dust and increasing the level of humidity
• Using artificial tear solutions
• Using moisturizing ointment, especially at bedtime
• Administering cyclosporine immunomodulator drops

Other forms of treatment include the following:

• Insertion of small plugs in the corners of the eyes to slow drainage and loss of tears
• In rare cases, surgery

Whatever treatment is prescribed, you must follow your doctor of optometry’s instructions carefully. Dry eye does not go away, but by working together, we can keep your eyes healthy and protect your vision.