Dry eye disease is a common problem that many people face for a variety of different reasons. In some circumstances, this condition occurs as a temporary irritation that has happened as a result of overexposure to irritants like dust and pollen. On the other hand, other people may struggle with dry eye because of a defect or a more significant problem.

Question 1: What Is Dry Eye?

Answer: Dry eye is a wide-spread term that can be used to refer to abnormalities in the tear layer used to protect the surface of the eye, defending sensitive surface tissues and providing clear vision. Other common terms for dry eye syndrome include chronic dry eye, dry eye syndrome, and keratoconjunctivitis sicca.

Importantly, dry eye doesn’t necessarily mean that your eyes are dry. In fact, many people find that they suffer from dry eyes and still experience chronically watery eyes. What dry eye does mean is that there is something wrong with your tear film. The tear film is a complex combination of different layers, which include water, oil and mucus. Each of the three layers in typical tear films come from different sources, and disruption to any of these sources can disrupt routine lubrication and lead to dry eye.

Question 2: What Causes Dry Eye?

Answer: There are a number of different causes or factors that can lead to dry eye syndrome, including:

• Aging
• Excessive computer use
• Environment (air pollution, dry climates, wind)
• Auto-immune diseases (lupus, rheumatoid arthritis, Sjogren’s syndrome)
• Surgeries on the eyelids or eyes
• Medication side effects

Question 3: What Are the Typical Symptoms of Dry Eye?

Answer: The symptoms of dry eye can vary greatly. Some symptoms such as watery eyes are highly common but also quite surprising. Some of the most common symptoms that are experienced by dry eye patients include:

• A feeling of grittiness and sandiness in the eye
• Aching or sore eyes
• Burning or painful eyes
• Sensitivity to light
• Tired eyes
• Contact lens discomfort
• Watery eyes
• Blurred vision

Question 4: How Are Dry Eyes Diagnosed/Tested?

Answer: The most commonly used test for dry eye is the Schirmer test, which uses a small strip of paper placed in the eye which can measure the aqueous tear production by seeing how much moisture accumulates over time. The tear break-up time test can also help doctors to determine tear film instability. At this time, experts widely acknowledge that there is a poor degree of correlation between clinical testing for dry eye and the symptoms that most patients experience. In other words, you may be suffering from severe dry eye disease without having any test results that would back a diagnosis up.

Question 5: Which Treatments Are Available for Dry Eye?

Answer: The kind of treatment that you receive for your dry eye condition must be tailored to the type of condition you are dealing with. While some of the treatments given for dry eye attempt to treat the source, with severe varieties of the condition it is usually necessary to use treatments that reduce the symptoms. Some of the best known treatments for dry eye include:

• Punctal plugs
• Lubricants
• Restasis
• Lid hygiene
• Topical steroids
• Warm compresses
• Protective eyewear

There are also a number of other lesser-known treatments that range from the Boston Scleral prosthetic lens, to the autologous serum eye drops.

Question 6: What Is the Role of Gels, Ointments, and Artificial Tears?

Answer: The health of the eye relates directly to the ability of the surface to remain lubricated. A dry ocular surface can result in severe injuries, abrasions, and erosions, which can progress into ulceration in some cases, and may even compromise vision. Nearly all patients of dry eye syndrome will need to use lubricants, drops, and ointments to help protect their eyes and reduce discomfort.

Question 7: What Are Punctal Plugs and Cautery?

Answer: There are four main drains connected to the eye that are known as puncta. Through these drains, tears can exit. The drains are located in the upper and lower corners of the eyelid close to the nose. For patients who suffer dry eye symptoms primarily as a result of water deficiency in their tears, stopping the drains with a process known as punctal occlusion can help to resolve symptoms.

Question 8: How Is Lid Therapy Helpful?

Answer: For numerous patients of dry eye syndrome, all or part of the problem that causes the condition may be a result of Meibomian gland dysfunction, which is a deficiency within the oilier part of the tears responsible for slowing the evaporation of tears. This can be treated by improving the secretions from the Meibomian glands. Many patients find lid therapy to be helpful, which involves massaging the Meibomian glands to get secretions moving and liquefied.

Question 9: How Can My Watery Eyes Be Dry?

Answer: Though it seems contradictory that dry eyes could be watery, irritated, painful eyes can stimulate the production of tears. Excessive production of tears that are too watery can make the tear film problem worse, because it can sometimes wash away the healthier part of the tear that the eye has been able to produce.

Question 10: Why Does It Feel Like There’s Something in My Eye?

Answer: The sensation of dry eye that leads to a sense of grittiness or sandiness in the eye is very common. The issue is known as foreign body sensation and it can either be very localized or occur throughout the entire eye. Dry spots or small injuries on the cornea can cause a gritty or painful sensation that feels as though there is something in the eye.

Question 11: Are Dry Eyes Dangerous?

Answer: If left untreated, dry eyes can sometimes be dangerous. Excessive dry eye can scar the cornea, impairing your vision, or damage tissue. Dry eye can also make contact lens wear a lot more difficult since tears may be inadequate to keep lenses lubricated and wet. This can lead to a greater chance of eye infection.

Question 12: How Serious Can Dry Eye Get?

Answer: Moderate or mild conditions of dry eye can sometimes be managed well with punctal plugs, supplements, and other common treatments. Moderate or severe dry eye can affect vision more, and can also affect the quality of life through eye sensitivity, chronic pain, and other restricted activities. Significant dry eye can lead to ulceration desiccation of the corneal epithelium, or perforation of the cornea.

Resources and References:

Dry eyes – General symptoms of dry eyes. (Mayo Clinic)