A lot of people suffer from dry eye, which causes quite significant irritation of the eye. It is most common in the elderly, but can happen to anyone. Usually, easing the symptoms is achieved through soothing ointments, gels and artificial tears.
What Is Dry Eye?
Dry eye syndrome, or DES, or keratoconjunctivitis sicca, happens when the tear film in the eye malfunctions. This tear film is responsible for keeping the eye properly lubricated and moist. There are essentially two types of DES, one whereby the film does not contain enough water meaning the tears evaporate too quickly, and the other where it does not contain enough lubrication.
What Causes DES and Who Gets It?
Anyone can get DES, but the older you get, the more likely you are to suffer from it. On average, between 15 and 33 of every 100 people suffer from it and it is more common in women than what it is in men. Some of the causes include:
- Age, the older you get, the fewer tears you produce. Post-menopausal women are at particular risk.
- Medication, particularly antidepressants, diuretics, anxiety drugs, antihistamines, beta-blockers and acne treatments
- Illness, particularly Sjogren’s syndrome, system lupus erythematosus, and rheumatoid arthritis.
- The environment being excessively dry, be that inside a room or the outdoor environment
- Damage to the eye
- Skin problems like rosacea and seborrheic dermatitis
- LASIK eye surgery
- Unknown causes
Treatment Options – Artificial Tears
Artificial tears, available in gel and drop form, usually help with relieving the symptoms. These can be purchased over the counter but are also available on prescription. They may need to be used hourly in order to see a difference at first, but this can be slowly reduced after improvement becomes noticeable. Often, you will have to use the artificial tears for life, with DES flare-ups being common. The pros and cons of artificial tears are listed below.
Artificial tears are most effective for people who suffer from dry eye as a result of staring at a screen for too long. They often contain natural oils and glycerin. It is important that people with contact lenses search for ‘re-wetting drops’.
Treatment Options – Eye Ointment
The second type of treatment is an eye ointment. This should be applied to the eye before bedtime. They are available over the counter and on prescription. The pros and cons are listed below.
Treatment Options – Omega-3
There is some suggestion that omega-3 fish oils can also be beneficial for the treatment of dry eye. Because people should supplement with omega-3 anyway, as it is significantly lacking in our diet, this type of treatment won’t harm. However, the evidence of how it affects dry eye is not very conclusive yet. The pros and cons of omega-3 supplements are listed below.
It is known that omega-3 helps to reduce inflammation, which is often the root cause of dry eye. One study from the Harvard Medical School found that women who supplemented with omega-3 or consumer high levels of it in their diet reduced their chances of developing DES by 34%. A similar study at the University of Texas Southwestern Medical Center at Dallas showed that people who took both an omega-3 and a flaxseed oil supplement daily could increase their tear production.
Treatment Options – Prescription Drops
Prescription drops are generally only given to those who suffer from chronic DES. They must have tried other treatment options first, or a physician must have reason to believe that over the counter treatment will not be effective. The pros and cons are listed below.
||Only available on prescription|
The Korean Journal of Ophthalmology published a study in 2010 that showed patients who used Restasis, a prescription eye drop, saw up to a 100% improvement of their condition.
Treatment Options – Warm Compresses
These are often used by people who don’t like drops, or find no benefit from them. The idea is that a warm compress helps to open up the tear ducts, effectively liquefying the plugs, allowing oils to enter the tears. The pros and cons are listed below.
|Does not contain any artificial ingredients||May be an old wives’ tale|
Treatment Options – Eyelid Washes
A lot of people with dry eye wake up in the morning with crusty, flaking eyelids. This may be a sign of blepharitis, which is an inflammation of the follicles of the eyelids. Essentially, it is dandruff of the eyelashes, meaning too much oil is produced, blocking the glands and evaporating the tears very quickly.
||Only provides relief – does not cure the condition.|
Treatment Options – Ophthalmic Inserts
When all else fails, an ophthalmologist may insert plugs in the eyes. These are tiny beads made of a cellulose material, which dissolve very slowly. The material then lubricates the eye.
|Can be used for long periods of time.||Some people do not like to insert beads into their eyes.|
Treatment Options – Others
A number of other common treatments also exist, although artificial tears and eye ointments are the recommended options. Most other types of treatment are only available on prescription. They include:
- Steroid eye drops or tablets like tetracycline
- Pilocarpine or other medications that affect the tear gland
- Surgery, which prevents the drainage of tears
- Lacrimal duct plugs, which temporarily block tear drainage
- Autologous serum tears, produced using your own tears
If there is an underlying medical condition that causes dry eye, this must also be addressed.
Contact Lens Wearers
People who wear contact lenses are usually advised to remove them if they suffer from dry eye. This is also due to the fact that lenses can exacerbate the condition. The vast majority of eye drops can also not be used together with contact lenses. There are some eye drops that can be used together with contact lenses, but they are often not as effective. Additionally, since lenses can make the condition worse, it is often recommended to not wear them while symptoms persist, and to change contact lenses once the condition has improved, in case DES was caused by a bacterium on the lens itself, or if an infection is now on the contact lens, thereby re-infecting the eye.
Resources and References:
Dry Eyes – General information on dry eyes. (Mayo Clinic)
Dry Eye – Information on the dry eye syndrome. (American Optometric Association)
Dry Eye Syndrome – Guide on dry eye. (MedicineNet)
Dry Eye Syndrome Treatment & Management – Management and treatment of dry eye. (MedScape)