Dry eye syndrome, also known as dry eyes, is a chronic condition affecting 4.91 million Americans 50 years and older. Reports estimate that millions of younger people are also affected but have less severe symptoms that are mostly episodic.
While exact numbers on the prevalence of chronic dry eye in the younger population are difficult to pinpoint, dry eye can be promptly diagnosed and appropriately treated if you consult an experienced dry eye specialist. Identifying the underlying cause is critical to finding the best way to alleviate discomfort associated with dry eye.
It is essential to learn about possible causes of dry eyes, how a diagnosis is made, and the different treatments available for chronic dry eye today. This information will be outlined below.
Dry Eye Causes
Symptoms of dry eye can differ from one person to another because underlying causes tend to vary. These include, but are not limited to, the following:
- Natural process of aging
- Hormonal imbalance (which explains why dry eye is common in women, particularly those who are menopausal, pregnant, or taking oral contraceptives)
- A side effect of certain medications, such as antidepressants, decongestants, antihistamines, and anti-hypertensive drugs
- Medical conditions such as autoimmune disorders (Sjögren’s syndrome, rheumatoid arthritis, diabetes, and thyroid problems)
- Inflammation of the eyelids
- Chronic exposure to dry climates, smoke, and dry wind
- Long-term use of contact lenses
- Staring at digital screens for long periods of time
- Post-refractive eye surgeries such as LASIK
Dry Eye Diagnosis
Dry eye syndrome is usually diagnosed with a thorough evaluation of the patient’s history, careful physical assessment, comprehensive eye examination, and ocular surface tests. Testing may include the following:
- Schirmer test
- Tear osmolarity
- Corneal sensation test
- Corneal staining
Other testing methods may be used to rule out medical conditions that can cause dry eye symptoms.
Your Options for Dry Eyes Treatment
If an underlying condition causes your dry eye symptoms, recommended treatments will be focused on the condition itself. You can also discuss medications, surgical procedures, and non-surgical methods with your eye doctor.
Dry Eye: Non-surgical Approach
- Warm Moist Compresses: When applied to your eyelids, this approach helps stimulate the meibomian glands to produce more lipids, a component of our tears.
- Punctal Plugs: Punctal plugs are often made of silicone, acrylic, or hydrogel. They are inserted into the tiny ducts where tears drain. These plugs help keep the tears on your eye’s surface and prevent them from evaporating quickly.
- Blinking: Frequent blinking while reading or working on a computer helps alleviate symptoms of mild dry eye. This can be hard to remember to do while performing focused tasks.
- Intense Pulsed Light Therapy (IPL): IPL is recommended for dry eye caused by ocular rosacea, a condition in which tiny blood vessels along the eyelid margin are abnormally dilated. IPL helps restore blood vessels to their standard size, reducing the appearance of redness. It also heats the eyelids, allowing the meibomian glands to open and release lipids.
- Meibomian Gland Expression: Recommended for dry eyes caused by meibomian gland disease. A forceps-type device is used to squeeze out the clogged contents of the meibomian glands gently. Once the clogged contents are removed, natural oil production will return to normal, helping tears evaporate more slowly.
- LipiFlow Thermal Pulsation System (TearScience): This patented device combines the results of warm compress and meibomian gland expression.
Dry Eye Medications
A few basic medications can be used for mild dry eye. They can also be used after procedures to keep the eyes moistened. These include:
- Eye lubricating drops, also known as artificial tears. Ask your doctor for recommendations or prescriptions. Brands have different sets of ingredients, depending on what is missing in the layers of your tear film. Eye drops range from oil-based to hypotonic. Consider using preservative-free brands if you plan to use these drops more than 4 times a day.
- Nonsteroidal prescription drops: Eye drops like Restasis or Xiidra are the treatment of choice for dry eyes caused by inflammation of the surface of the eye.
- Serum tears: This formulated teardrop is typically used in moderate-to-severe cases and contains the clear portion, or serum, of the patient’s blood. The formula comprises saline, as well as other nutrients and growth factors.
Dry Eye: Surgical Approach
Often, surgery is the last resort to treat dry eye syndrome. Punctal cautery is a quick procedure that permanently closes the tear drainage holes to keep tears within the eye’s surface for an extended period of time.
Preventing Dry Eye Syndrome
While there are cases when dry eye syndrome is a secondary condition from an underlying cause, there are also things most people can do to prevent it from happening:
- Take frequent breaks when working for long periods in front of the screen.
- Wear wraparound sunglasses when going outdoors, particularly in dry climates.
- Use a humidifier during winter to help moisten the air
- Avoid smoking or going near people who smoke
- Strive for a diet rich in omega-3s (e.g., flaxseed oil, chia seeds, fish, cod liver oil)
Ignoring dry eye symptoms can lead to corneal inflammation, conjunctivitis, and, in extreme cases, permanent vision loss. Surgery is not the automatic first choice, but it is nevertheless critical to get in touch with an eye specialist immediately once you notice early signs of dry eye symptoms.