Dry Eye Syndrome
What Causes Dry Eye?
Tear production normally decreases as we age. Although dry eye can occur in both men and women at any age, women are most often affected. This is especially true after menopause. Dry eye can also be associated with arthritis and accompanied by a dry mouth. People with dry eyes, dry mouth and arthritis are said to have Sjogren’s syndrome.
A wide variety of common medications, prescription and over-the-counter can cause dry eye by reducing tear secretion. Be sure to tell your ophthalmologist the names of all the medications you are taking, especially if you are using:
- Medications for nerves
- Sleeping pills
- Pain relievers
Since these medications are often necessary, the dry eye condition may have to be tolerated or treated with artificial tears. People with dry eye are often more prone to the toxic side effects of eye medications, including artificial tears. For example, the preservatives in certain eye drops and artificial tear preparations can irritate the eye. Special preservative-free artificial tears may be required.
The usual symptoms include:
- Stinging or burning eyes
- Stringy mucus in or around the eyes
- Excess tearing
- Eye irritation from smoke or wind
- Difficulty wearing contact lens
Excess tearing from dry eye sounds illogical, but if the tears responsible for maintenance lubrication do not keep the eye wet enough, the eye becomes irritated. When the eye is irritated, the lacrimal gland produces a large volume of tears which overwhelms the tear drainage system. These excess tears then overflow from your eye.
The Tear Film
A film of tears, spread over the eye by a blink, makes the surface of the eye smooth and clear. Without our tear film, good vision would not be possible. The tear film consists of three layers, an oily layer, a watery layer and a layer of mucus The oily layer, produced by the meibomian glands, forms the outermost surface of the tear film. Its main purpose is to smooth the tear surface and reduce evaporation of tears. The middle watery layer makes up most of what we ordinarily think of as tears. This layer, produced by the lacrimal gland, cleanses the eye and washes away foreign particles or irritants. The inner layer consists of mucus produced by the conjunctiva. Mucus allows the watery layer to spread evenly over the surface of the eye and helps the eye remain wet. Without mucus, tears would not adhere to the eye.
Adding Tears – Eye drops called, “artificial tears” are similar to your own tears. They lubricate the eyes and help maintain moisture. Artificial tears are available without a prescription. There are many brands on the market, so you may want to try several to find the one you like best. Preservative-free eye drops are available if you are sensitive to the preservatives in artificial tears. If you need to use artificial tears more than every two hours, preservative-free brands may be better for you. Solid artificial tear inserts that are placed inside the lower lid on a daily basis and gradually release lubricants may be beneficial to some people. You can use the tears as often as necessary—once or twice per day or as often as several times per hour. Conserving the tears – Conserving your eyes’ own tears is another approach to keeping the eyes moist. Tears drain out of the eye through a small channel into the nose (that is why your nose runs when you cry).Your ophthalmologist may close these channels either temporarily or permanently. The closure conserves your own tears and makes artificial tears last longer.