The eye’s health relies on the constant making and draining of tears. These tears do a great deal in looking after the eyes, from keeping them moist, protecting against infections and helping to heal injuries. People that suffer with dry eye disease make less or lower quality tears that are not able to maintain the surface of the eye comfortable and lubricated.
Tear film is made up of three layers. The outer oily layer called the lipid layer; this stops tears from evaporating too fast and helps keep the tears on the eye as long as possible. The middle layer is called the aqueous layer; this helps sustain and nourish the cornea and conjunctiva. The bottom layer is call the mucin layer; this layer aids the aqueous layer to spread across the eye to make sure the eye stays wet. The eyes make less tears as we age. Also in some people the lipid and mucin layers are of such low quality that tears just cannot stay on the eye long enough to keep the eye adequately lubricated.
A scratchy and gritty feeling in the eye are the main symptoms of dry eyes. Burning, stinging, pain and redness can also be symptoms, along with incidents of over tearing after a stage of a dry sensation, and stringy discharge coming from the eye. Some people that have bad dry eye disease can sometime feel like they have heavy eyelids, blurred or lowered vision, but complete vision loss is rare.
Some people that suffer with the disease may experience excess tearing, this can be due to the eye not producing enough lipid and mucin layers of tear film. With this there isn’t much help to keep the tears in the eyes and therefore the eyes to not stay lubricated throughout the day. Dry eye disease affects more women than men and especially after the menopause. Also people that live or spend time in climates with a dry air can cause or make the disease worse.
Some medications can exacerbate or even cause dry eyes, such as nasal decongestants, antihistamines and anti-depressants, that is why it is very important to tell your eye doctor, optician or optometrist all the medication you are on as it may be making your dry eye disease worse. People that have rheumatoid arthritis or other connective tissue diseases can also develop dry eye disease. Dry eyes can also be a symptom of a condition called Sjogren’s Syndrome. This disease attacks the lubricating glands, for example tear glands, in the body. It is always advised to have a thorough examination by an eye doctor or ophthalmologist if you suspect your dry eyes are being caused by an underlying condition, they will probably refer you to a GP or specialist for further tests to determine this.
Initially, artificial tear drops are used in the treatment of eye dry disease, these help lubricate the eye and can be brought over the counter. Sometimes ointments or gels are used at night time to help stop the eyes from drying out. People that suffer with severe dry eyes may be put on prescription medications and possibly have temporary or permanent closure of the puncta; these are the small openings in the corners of the eyes that tears drain from. Some simple but effect things such as using humidifiers, avoiding windy or dry conditions outside, using eye bags and eye lid massaging can give some relief of symptoms.
Author: Samer Hamada is a distinguished consultant ophthalmologist and cornea surgeon performing eye surgeries at his practice, Eye Clinic London. With nearly two decades’ experience, Mr. Hamada is recognised as a leading expert in the field of cataract, refractive lens exchange (RLE) and corneal surgeries.
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