A dry eye is an uncomfortable and painful condition. It can be understood as an
inadequate production of tears leading to dryness of eyes. Dry eyes make you more susceptible to
bacterial infections and trauma due to reduced lubrication over the cornea. As tear film is very thin,
reading, writing and watching becomes very uncomfortable.
Role of tears
Blinking makes your eyes moist every time and keeps the corneal surface smooth and clean. Tear film
contains a combination of oil, water and mucous. Outermost layer is made up of oil as it prevents tear
from drying. Second layer (water) comes from lacrimal gland and made up of mostly water as main content.
Water washes away any dirt and unwanted particles from the eye to keep it clean. Inner most layer is
made up of mucus and formed in conjunctiva, due to this layer tears don't stick to eyes. In general we
see with any irritant, our eyes protective response is to produce tears but in few local and system
medical conditions, tear formation is reduced and that hampers with the vision.
Why do I get dry eye condition?
We produce tears all the time, not only when we are emotional but with every blink. Dry
eye can be because of various reasons:
- Altered composition of tears or tears dry up too fast – imbalance is oil, water and
mucous content may result in dry eyes.
- Inflammation or trauma to the eye (lacrimal gland, conjunctiva) – dry eyes may result as a
consequence to damaged tear producing apparatus.
- Medical conditions for less production of tears – autoimmune diseases like lupus, scleroderma,
rheumatoid arthritis, Parkinsons disease.
- Vitamin A deficiency may result in poor eye health
- Disease like diabetes or radiation exposure also affects eye status.
- Hormonal imbalance like pregnancy or menopause also reduces tear production.
- Drugs like Antihistamins, antidepressants may result in dry eyes.
- Corneal nerve desensitivity caused by contact lens or nerve damage by laser eye surgery.
- As an aging process.
- Other medical conditions can lead to dry eyes, such as the following:
- Keratoconjuctivitis - It refers to the inflammation of the surface of your eye,
called the cornea or the conjunctiva
- Keratitis is another condition that's caused by irritation or swelling of your cornea when
your
eyes are dry for too long
- Keratoconjuctivitis Sicca – This term is used to describe an autoimmune
condition when you aren't able to produce enough tears and develop an infection or inflammation.
How do I know that I have dry eyes condition?
Symptoms experienced by patients suffering from dry eyes are:
- Fatigued and heavy eyes
- Sore and itchy eyes
- Burning and dryness sensation
- Red eyes with blurred vision
- Difficulty in wearing contact lenses
- Difficulty in night driving
- Sensitivity to light and stringy mucous around the eyes
- Eyelids sticking together when waking up after sleep
- Double vision
How diagnosis is made?
Ophthalmologist conducts a thorough eye examination and certain tests to reach to a
final conclusion and design the treatment plan.
- Detailed Medical and drug history of systemic diseases may help in diagnosis.
- History of trauma and family occurrence can be related to present condition.
- Schirmer test – this test is performed to see the volume of your tears, blotting
strips of paper are placed under your lower eyelids. After five minutes your doctor measures the
amount of strip soaked by your tears.
- Phenol red thread test - In this test, a thread filled with pH-sensitive dye (tears
change the dye color) is placed over the lower eyelid, wetted with tears for 15 seconds and then
measured for tear volume.
- Special dyes are used for your eye doctor to check the evaporation of your tears.
As tear composition has oil content in it, so if it is reduced, it may lead to quick drying of your
tears.
- Tear osmolarity test can be done to measure the composition of particles and water
in your tears.
- Special Tear markers for dry eye disease like matrix metalloproteinase-9 or
lactoferrin.
What are my treatment options?
Treatment is purely based on the cause as it may range from behavior modifications to medical
procedures.
- Behavior modifications like adjustment of your computer screens below eye level,
taking short breaks between long tasks. Avoid harsh environments like dry winds, driving without
protective eyeglasses; Sunglasses are must on sunny days.
- Artificial tears – ophthalmologists prescribe you artificial tears, their
composition is just like natural tears. If you are using more than six times a day, preservative free
tears are also available in the market.
- Treating local factors - warm compresses to the eyes, eyelid cleaners and massaging
your eyelids.
- Medication to reduce inflammation and infection to the eyes
- Tear-stimulating drugs. Drugs called cholinergics (pilocarpine, cevimeline) help
increase tear production. These drugs are available as pills, gel or eyedrops
- Eye inserts that work like artificial tears. If you have moderate to severe dry eye
symptoms and artificial tears don't help, another option may be a tiny eye insert that looks like a
clear grain of rice.
- Unblocking oil glands - improves the composition of the tears.
- Punctal plugs – removal punctal plugs are tiny silicon plugs used to block the
tear
ducts to prevent tear loss. Punctal occlusion can be done by cautery.
- Surgery – sometimes problems like incomplete blinking is treated with surgical
procedure by oculoplastic surgeon (specialist in eyelid problems).
- Lipiflow - This medical device uses heat and pressure to unclog blocked glands on
your eyelids.
- Salivary gland transplantation – It is a surgical procedure that is occasionally
considered in persistent and severe cases that have not responded to other treatments.
- Light therapy - Using intense pulsed light therapy followed by massage.
- Using scleral or bandage lenses – Special lenses are designed to protect eyes and
smooth functioning by trapping the moisture.
- Autologous blood serum drops – They are actually made from your own blood and
work
in cases where other treatments have failed.
Complications
Often people with dry eyes experience poor quality of life as it's very difficult
for
them to read, write or watch anything for long period of time. Tears serve as protective coating,
without them you are prone to eye infections. If left untreated, dye eye may lead to damage to corneal
surface and permanent vision impairment may happen in severe cases.
Prevention
As an aging process, tears production will eventually go down, but still precautions may help to avoid
dry eyes discomfort.
- Add humidifier to your room in winters
- At high altitudes or extreme winters, take care of your eyes as dry winds may be traumatic to your
eyes and tear producing apparatus.
- If you are a person spending more time on computer or phone, take short brakes during your tasks as
your eyes get tired by long focus and radiation exposure.
- Use sunglasses while going outdoors
- Use of ointments instead of drops
- Frequent washing of your eyes also serves a natural way for eye moisture and cleaning.
- Mild soap use to reduce the irritation.
Important Reminder: This information is only intended to provide guidance, not a
definitive medical advice. Please consult eye doctor about your specific condition.
Only a trained, experienced board certified eye doctor can determine an accurate diagnosis and proper
treatment.
To schedule an appointment with our experts for Dry Eye Treatment in Ghatkopar, please call us
at +91 8451045935, +91-8451045934 or visit our
clinic at Address.
