Dry Eye Syndrome

What is Dry Eye Syndrome?

Dry Eye Syndrome is one of the most common eye conditions which have often been overlooked. Dry Eye Syndrome is characterised by the lack of adequate lubrication for the eyes. Tears which compose of water, fatty oils and mucus play an important role in lubricating and nourishing the outer surface (cornea) of the eye. Dry eye syndrome may occur if you don't produce enough tears or if you produce poor quality tears.

What are the symptoms of Dry Eye Syndrome?

The symptoms of dry eye syndrome can be seen in both eyes and may include:

  • Red eyes
  • Burning
  • Irritation of eyes
  • Watery eyes
  • Foreign body sensation
  • Eye fatigue
  • Light sensitivity

Patients with dry eyes are more likely to be contact lens intolerance and may have blurred vision.

What cause Dry Eyes?

Dry Eye Syndrome is commonly caused by a lack of adequate tears. For some people, the cause of dry eye syndrome is decreased tear production. For others, it may be due to increased tear evaporation and an imbalance in the makeup of tears.

Decreased Tear Production

Possibly caused by any of the followings:

  • Aging (insufficient tear production occurs after age 50)
  • Medical conditions, such as diabetes, rheumatoid arthritis, lupus, scleroderma, Sjogren's syndrome, thyroid disorders and vitamin A deficiency
  • Medications, such as antihistamines, decongestants, hormone replacement therapy, antidepressants, and antihypertensive drugs, acne, oral contraceptive and Parkinson's disease
  • Laser vision surgery
  • Tear gland damage from inflammation or radiation

Increased Tear Evaporation

Common causes of increased tear evaporation include:

  • Exposure to dry wind, smoke or dry air
  • Reduced Blinking, which tends to occur when you are concentrating, for example, while reading, driving or continuous working at a computer
  • Eyelid problems, such as out-turning of the eyelids (ectropion) or in-turning of the eyelids (entropion)

Imbalance in Tear Composition

As mentioned, the tear film has three basic layers: oil, water and mucus. Problems with any of these layers can lead to dry eyes.
For example, the oil film produced by small glands on the edge of the eyelids (meibomian glands) might clog up. Blocked meibomian glands are more common in people with inflammation along the edge of their eyelids (blepharitis), rosacea or other skin disorders.

How is Dry Eye Syndrome diagnosed?

Diagnosis of dry eye syndrome involves:

  • Detailed review of medical history
  • Comprehensive examination of the eyes
  • Tears volume (Schirmer test) evaluation
  • Tears distribution (using special fluorescent dyes) assessment

These tests involve:

  • A small strip of blotting paper is placed under your lower lid for five minutes, and measured for the extent to which it is soaked by your tears
  • A special fluorescent dye will be instilled into your eyes to view the flow of tears and ocular surface changes due to dryness

In addition, there are new diagnostic tests which can evaluate the meibomian gland function and tear film osmolarity.

What are the best treatments for Dry Eye Syndrome?

The basic approach of treating dry eye syndrome is:

Artificial Tears

These eye drops help to improve the quality and quantity of tears by conserving tears and increasing tear production. The artificial tears approach includes the use of eye drops or eye ointments to retain the moisture of the eyes.

Eye Hygiene

In addition, your ophthalmologist may ask you to perform:

  • Warm compresses
  • Eyelid massage in order to control blepharitis

Tear Duct Occlusion

If conservative treatments are ineffective, your ophthalmologist may help conserve your tears by surgically blocking the tear ducts with tiny silicone plugs to reduce tear loss. It is a reversible procedure and can be done in the office.

What are the potential complications of Dry Eye Syndrome?

Dry Eye Syndrome does not usually produce any serious complications, but it can sometimes increase the risk of:

  • Eye infection,
  • Eye inflammation,
  • Corneal scarring
  • Decreased vision

Also, dry eyes may affect the quality of life as it can increase the difficulty in performing everyday activities.

Dry Eye Preventive Measures

The following instructions may help to reduce symptoms of Dry Eyes Syndrome:

  • Maintain adequate humidity in the air at home or workplace (A humidifier can add moisture to the dry indoor air in winter)
  • Avoid direct air blowing in your eyes (car heaters, air conditioner or air dryer)
  • Wear wraparound sunglasses to prevent direct exposure to sun and dry wind
  • Blink frequently and take breaks during long tasks.
  • Close your eyes for several minutes or blink repeatedly for a few seconds to help spreading tears evenly over your eyes.
  • Take nutritional supplements rich in omega 3 fatty acids or flaxseed oil
  • Drink plenty of water daily
  • Quit smoking. If you don’t smoke, stay away from people who do as smoke can worsen dry eye symptoms.
  • Regular use of artificial tears.
  • American Academy Of Opthalmology
  • ASCRS
  • Cornea Society
  • ESCRS
  • FRANZCO
  • uOttawa
  • ISRS
  • NSW
  • Epping Surgery Centre
  • HSS
  • The Sydney Private Hospital
  • Warners Bay Private Hospital