Dry eye refers to a disruption in the quality of the tear-film that normally covers the front surface of the eye. Tears are produced by glands around the eye in order to lubricate the cornea (the clear ‘window’ on the front of the eye), provide nourishment to the cornea, and to help focus light on the back of the eye. Disruption to the tear-film may result in irritation, redness, excessive mucus production, or blurred vision. Dry eyes may also lead to excessive tearing of the eye; this occurs when the eye over-produces tears in response to being irritated. Dry eye is a fairly common problem, affecting approximately 10 percent of adults, with women twice as likely to suffer from dry eye as men.
Different factors can cause a disruption to the tear film:
- Decreased tear production may be caused by menopause, medication (e.g. antihistamines, the pill), general health conditions (e.g. arthritis), contact lenses, or by dehydration. Decreased tear production may be more prominent following laser refractive surgery.
- Increased tear evaporation may be caused by environmental factors (e.g. air-conditioning), eyelid problems (e.g. an eyelid infection or a ‘droopy’ eyelid), corneal disease, or by anything that causes a person to blink less (e.g. looking at a computer screen).
- Poor spreading of tears across the eye may be caused by eyelid problems or by lumps on the conjunctiva (the white of the eye).
The best type of treatment for a dry eye depends upon the cause. Often, the first step is to treat any underlying eyelid or corneal disease: this may involve using special solution to help clean the eyelids. Other treatment options involve:
- Artificial tears: These are the most common first line of treatment and are used to nourish the tear-film. There are many different types of artificial tears, with particular types better for different patients. Your optometrist will be able to advise you on the best type of artificial tear for you.
- Nutritional supplements. There is evidence to suggest that people who have a high percentage of Omega 3 fatty acids in their diet are less likely to suffer from dry eye. Omega 3 can be found in ‘oily’ fish, fish oil capsules, or flaxseed oil. Patients need to take approximately 1000-2000mg of fish oil a day to help alleviate dry eye. Patients on blood-thinning medication should speak to their family doctor before taking fish oil supplements.
- Medication. In some cases of dry eye it may be necessary to use a short course of topical steroid eye drops or oral antibiotic medication. Both of these medications may cause unwanted side effects, and so these treatments are usually reserved for severe cases of dry eye.
- Punctal plugs. Punctal plugs reduce the escape of tears from the eye, thereby increasing the amount of tears on the eyeball. Punctal plugs come in two forms: temporary punctal plugs dissolve after a couple of days, while permanent punctal plugs last many months.
- Increasing fluid intake. Increasing the amount of water you drink can often help with dry eye.
- Adequate sleep.
- Eyelid surgery. If there is an eyelid abnormality it may be necessary to perform eyelid surgery to treat the dry eye. Our optometrists can refer you to an eye specialist if surgery is indicated.
- Turning down the air-conditioning. This may help to increase the humidity of the workplace and decrease the symptoms of dry eye.
Lastly, blink more and focus better! Research shows that a person’s blink rate decreases when they are staring at the computer screen; this may be worse if a person has an uncorrected glasses prescription. Simply remembering to wear your computer glasses and remembering to blink when working on the computer can sometimes help with a dry eye problem.