Dry Eye

Dry eye is a common condition in which the eyes are insufficiently lubricated, leading to itching, redness and pain. The eyes can become dry and irritated because the tear ducts are not producing a sufficient number of tears, or because there is a chemical imbalance in the tears themselves. Natural tears require a particular chemical balance to lubricate the eyes efficiently.

Alleviating the symptoms of dry eye is important. Left untreated, they have the potential to damage vision. Dry eye can be diagnosed after a thorough examination of the eyes, and a Schirmer tear test to evaluate tear production.

People usually begin experiencing dry-eye symptoms as they age (they are more common in people older than 50), but they can also result from certain medications, medical conditions or injuries. Dry eye tends to affect women more than men because of the hormonal changes that take place during pregnancy and menopause. Oral contraceptives can also affect the consistency of tears. Other causes of dry eye include the following:

• Antihistamines, decongestants and blood-pressure medications
• Rheumatoid arthritis, diabetes, Sjögren’s syndrome and thyroid disease
• Environmental conditions such as smoke, wind or excessive sun
• Long-term contact lens use
• Eye injury
• Eye or eyelid surgery
• Inflammation of the eye (conjunctivitis or keratitis)

Any of these factors, alone or in combination, can affect the frequency or consistency of tears, either of which can lead to dry eye.

Treatment for dry eye depends on its cause and severity, as well as the patient’s overall health and personal preference.

Nonsurgical treatments, which include the following, are often effective:

• Deliberately blinking
• Increasing humidity levels at home or work
• Using artificial tears or a lubricating ointment
• Avoiding environmental irritants
• Eliminating medications that may be responsible
• Adding Omega-3 fatty acids to the diet or taking them as supplements

In many cases, simple lifestyle changes can alleviate dry-eye symptoms.

If less invasive methods are unsuccessful, surgical treatments, which include the following, may be an option:

• Insertion of punctal plugs to limit tear drainage
• Punctal cautery to permanently close the drainage holes
• Treatment of an underlying disease

If an eyelid condition is causing dry eye, eyelid surgery may be recommended.

There are steps that can be taken to prevent dry-eye symptoms. Simple lifestyle modifications such as wearing protective glasses on windy days, and giving the eyes a break during reading or other tasks that require intense focus, can effectively reduce the frequency and severity of symptoms.