Dry Eye Syndrome: Are Dry Eyes A Cause For Concern?

Some patients experience frequent drying of eyes due to medical conditions. Dry eye is a medical situation which occurs when the lachrymal glands are not able to produce tears in the required amount and consistency. This case may lead to inflammation of the eyes, and if this is not treated with care, will lead to pain, ulcers, severe scars on the cornea and finally loss of vision. Permanent vision loss is uncommon.

Lafayette Optometrist, Dr. Durocher explains, “Dry eyes make it difficult to perform daily activities like working on the computer, reading for an extended period, decreases the tolerance to changing environmental conditions like while traveling, the change in the air pressure inside the plane.”

Other terms of the disease are keratoconjunctivitis sicca(KCS), dysfunctional tear syndrome, lacrimal keratoconjunctivitis, evaporative tear deficiency, aqueous ear deficiency, LASIK-induced neurotrophic epitheliopathy (LNE).

Dry Eye Syndrome: Are Dry Eyes A Cause For Concern?

The cornea is an organized structure of cells and proteins, arranged in layers, it has no supply of blood cells and is nourished by tears and aqueous humor present in the chamber behind it.

The tears are made of various proteins, electrolytes, and vitamins which maintain the health of the eye surface, by continually nourishing it and preventing the eye from dryness and infection.

Failure of the lachrymal glands to produce tears causes dry eye syndrome.

Types of Dry Eyes

  • Aqueous tear-deficient dry eye: connected with the lacrimal glands to fall short to produce adequate of the watery constituent of tears to maintain the healthy eye surface.
  • Evaporative dry eye: results from the inflammation of the meibomian glands, located in the eyelids. The glands make the lipid or oily parts of the tear component, prevents evaporation, keeping the tears stable.

Dry Eyes also have an association with:

  • Severe inflammation of the surface of the eye, lacrimal gland, or the conjunctiva
  • Other disease process altering the components of the tears
  • Increase in surface of the eye, like thyroid diseases, glaucoma, and other related disorders
  • Any cosmetic surgery, if the eyelids are opened too widely.

=> Symptoms of Dry Eye

  • Severe stinging or inflammation of the affected eye
  • Sandy or rough, gritty feeling in the eye
  • Excess tears followed by severe drying
  • Stringy discharge from the eye
  • Redness and a pain in the eye
  • Blurred vision at times
  • Unexpected heavy eyelids
  • Not comfortable while wearing eye lens
  • Decreased tolerance of reading, working for extended hours on computer, any related activity requiring sustained visual attention
  • Severe eye fatigue

Reasons for Dry Eye

  • Dry eyes can be a side effect of medicines like antihistaminics, nasal decongestants, Parkinson’s medications, contraceptives.
  • Skin diseases around the eye or eyelids.
  • Disease conditions affect the glands in the eyelids like meibomian gland dysfunction causing dry eye.
  • Pregnant women are susceptible to dry eye disease.
  • Chemical or thermal burns which scar the membrane lining of the eyelids covering the eye.
  • Lack or inapt dosage of vitamins.
  • Loss of sensation in the cornea due to the long-term wearing of contact lenses.
  • Dry eyes also have an association with autoimmune disorders like lupus, rheumatoid arthritis. Sjogren’s disease affects all the mucous membranes of the body like eyes, mouth, leading to them drying and further inflammation.
  • Chronic conjunctivitis, inflammation of the conjunctiva, caused cure of eye diseases, infection, exposure to harmful irritants, like drafts from air conditioning and heating. This chronic symptom causes dry eyes.
  • Dry eyes may also occur from keratitis, a disease condition in which eyelids do not close properly during sleep.

Related Article: What are the causes of dry eye syndrome?

Dry Eye Syndrome: Are Dry Eyes A Cause For Concern?

Examinations for Dry Eye

  • The physical examination test for dry eye are:
  • Visual acuity measurement with correction.
  • External eye examination.
  • Slit lamp biomicroscopy.

The reason for these inspections is to:

  • Observe changes in the eye for dry eyes.
  • Assess the presence and severity of deficient aqueous tear production or increase vapor loss.
  • Detect other causes of ocular irritation.

Diagnostic Tests for Dry Eye

  • With mild irritation symptoms: reduced tear breakup time (TBUT), helps determine the unstable tear film with regular aqueous tear production
  • With  moderate to severe symptoms: (TBUT), helps identify the unstable tear film with regular aqueous tear production and ocular surface dye staining for ocular surface disease evaluation
  • Schirmer test: in the assessment of aqueous tear production

Treatment Options

Dry eyes can be a persistent condition, but your optometrist can prescribe an appropriate treatment to keep your eyes from dryness and to prevent your vision from being distorted.

The primary approaches used to manage and treat dry eyes include adding tears using over-the-counter artificial tear solutions, preserving tears, accelerating tear production, and addressing the inflammation of the eyelids or eye surface that adds to the dryness.

  • Adding tears: Mild to moderate cases of dry eyes can often be treated using artificial tear solutions. These solutions are available over-the-counter.  Fake tears can be used as many times as needed to supplement natural tear production. Preservative-free artificial tear solutions are recommended because they contain fewer additives, which can further irritate the eyes. People with dry eyes that don’t respond to false tears alone will need to take additional steps to treat their dry eyes.
  • Conserving tears: Holding natural tears in the eyes for more extended periods can lessen the symptoms of dry eyes. It is often done by blocking the tear ducts through which the tears drain with a minute silicone plug that can be detached if needed. A surgical method is also available that can permanently shut the tear ducts. The aim is to keep the preserved tears in the eye longer to reduce dryness.
  • Increasing tear production: Eye drops can be prescribed by your optometrist that increase tear production. You can also try taking an omega-3 fatty acid nutritional supplement.
  • Treating the contributing eyelid or ocular surface inflammation: Your optometrist might recommend prescribed drops or ointments for eyes, warm compresses and lid massage, or eyelid cleaners to help reduce swelling around the surface of the eyes.
  • Surgical: permanent punctal occlusion, repair of the eyelid.
  • Others: Eyelid therapy, and moisture chamber spectacles.

Dry eyes can cause a lot of pain and discomfort as well as loss of vision. It is advisable to visit an Optometrist immediately if you’re suffering from Dry Eye Syndrome.

References:

  1. http://www.aios.org/cme/pppseries1.pdf
  2. https://nei.nih.gov/sites/default/files/health-pdfs/factsaboutdryeye.pdf
  3. http://opmt.com/eye-disease-treatment/

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