Dry eye — as the name suggests — is a condition that arises from a reduction in the tears that keep the eye moist, causing itching, burning and a stinging sensation in the eye.
Because the primary functions of the tears are to keep the eye moist and provide clear vision, to wash away microbes and foreign matter such as dust, to protect against infection and to nourish the eye, a reduction in tears — or a deterioration in their quality — is a risk to eye health. In the case of dry eye, you must consult a specialist for prevention and treatment. We will, however, share information on the most frequently asked questions about dry eye — what helps, how it is diagnosed, how it is treated.
Symptoms of Dry Eye
The most distinctive symptoms of dry eye are redness, burning, the stinging sensation as though something were in the eye, and itching. The following symptoms may also accompany it:
-
- Increasing discomfort when wearing contact lenses
- The upper and lower eyelids sticking together
- Difficulty seeing when driving at night
- Overall blurred vision
- Sensitivity to light, wind and smoke
- Watering and fatigue in the eyes
How Is Dry Eye Diagnosed?
For the diagnosis of dry eye, the patient’s symptoms are evaluated by the doctor, and the patient undergoes a detailed eye examination during which the eyelids and blinking dynamics are also assessed.
In addition to the examination, one or more of the following tests may be carried out to measure the quantity and quality of tears and to determine treatment: the Schirmer test, the Tear Break-Up Time test, Fluorescein, Lissamine Green, Rose Bengal staining and Impression Cytology.
What Causes Dry Eye?
This uncomfortable condition can arise from patient-related causes as well as from environmental factors. Spending long hours in front of screens such as computers, phones and televisions, or improper use of contact lenses, are among the most common causes of dry eye. However, vitamin deficiency, autoimmune disorders and — of course — ageing are the most common causes.
Let’s take a closer look at the most common causes, in answer to the question “what causes dry eye“:
- Prolonged exposure to screens
As part of modern life, all of us spend many hours each day on our mobile phones and computer screens. Yet while looking at a screen, the blink rate falls to as little as one third of normal. This prevents the eye from being adequately moistened.
For this reason, if you are going to spend long hours in front of a screen, it is very important to rest your eyes at regular intervals.
- Improper use of contact lenses
One of the most important causes of dry eye is the improper or unsuitable use of contact lenses. Not removing the lenses when sleeping at night, failing to clean them properly, or using lenses that are not oxygen-permeable disrupts the structure of the tears. This in turn leads to dry eye.
- Ageing
With ageing, as part of the changes in many bodily functions, tear production also decreases. Dry eye is a particularly common complaint in women during the menopause. For this reason, the risk of dry eye can be considered higher in people aged 50 and over.
- Side effects of medications
Cardiac medications, blood-pressure medications, allergy medications, sleeping pills, neuropsychiatric medications and pain relievers taken for other conditions may reduce the production of mucus, one of the three biochemical components of tears. Should this occur, it is recommended to check the patient information leaflet of the medication and consult your doctor.
- Irregular nutrition and sleep
What we eat is directly related to eye health. In particular, vitamin A — found in colourful vegetables such as tomatoes, carrots, green and red peppers, in spinach, broccoli and leafy greens, in fish oil, liver, milk, cheese and eggs — is essential for preserving the natural moisture and structure of the eye. Deficiency may cause a range of eye conditions, dry eye being foremost among them. Drinking enough water is also very important. Drinking at least 1.5 litres of water a day, particularly in continental climates and in very hot weather, will be beneficial for eye health.
Sleep, on the other hand, is essential for resting the eye after a day’s strain and allowing it to function naturally.
- Hot, cold, windy weather conditions and air-conditioning use
Dry eye is more common in cold climates with strong wind or in environments where air-conditioning is used intensively. Exposure of the eye to strong wind, heat or cold also causes changes in tear secretion. This can lead to dry eye.
- Other diseases
Non-ocular diseases, for example Sjögren’s syndrome (an autoimmune disease), diabetes, rheumatoid arthritis, lupus and thyroid disorders, can prevent the secretory glands from functioning fully. Consequently tear production may also be reduced.
- Inflammation or infection in the eye, previous surgeries
Inflammation and infections in the eye and eyelid are usually accompanied by dry eye. Treating the underlying condition will also resolve the symptoms of dry eye.
Previous laser eye surgery, or damage to the tear gland caused by inflammation or radiation, may also cause dry eye.
What Helps Dry Eye?
Some simple measures and lifestyle changes listed below can help prevent dry eye or reduce its symptoms:
- Wearing sunglasses in windy and sunny weather will protect the eye and its natural structure.
- Take care that the air in your environment is not too dry; if air-conditioning or heating has disturbed the humidity balance, take steps to correct it.
- Tobacco smoke in your environment can also adversely affect the eyes. Avoid it.
- Drinking at least 1.5 litres of water a day supports eye health.
- At least 6–8 hours of sleep per day is, among many other benefits, also beneficial for eye health.
- Limiting prolonged screen use, resting the eyes at frequent intervals or using filters will substantially reduce the risk of dry eye.
- Using contact lenses in the way and at the frequency recommended by your doctor, caring for them properly and giving your eyes a rest by wearing glasses now and then are also very important.
How Is Dry Eye Resolved?
Treatment of eye-related dry eye may be carried out in different ways depending on the cause:
- Medical Treatment: The most common treatment for dry eye is with artificial tears. Many artificial-tear options, in drop and gel form, are available for dry eye. However, you should not heed any “best drops for dry eye” recommendations from non-ophthalmologist written or verbal sources; only medications prescribed by a doctor should be used.
The cause of dry eye may also be inflammation or infection in the eye, in which case antibiotic solutions may need to be used. In this case, too, the use of the wrong drops may delay treatment.
- Punctal Occlusion: Commonly known as a tear plug or punctal plug, this method is used when medical treatment is not sufficient. Essentially, it involves closing the opening of the tear-drainage channel in the lower eyelid. In this way, the tears do not drain away but remain on the eye, keeping it moist.
If you have symptoms of dry eye, we recommend you have an examination as soon as possible. Otherwise, dry eye may become a lifelong chronic condition that will affect your quality of life.
Prepared by the Editorial Board of the Eye Foundation Hospitals.
