August 24 2021
The condition of the dry eye results when either the tears get dried up very quickly or when the products of the tears themselves are extremely low. Dry eye can occur in one or both eyes and if left unattended, it can also cause inflammation. When we experience any emotion and even when we yawn, tears are produced by the eyes which also occurs normally and this forms a film on the eyes known as a tear film. This year’s film protects the eye and prevents it from getting dry and ensures that the vision is clear.
When the ability to produce adequate tears by the eyes decreases, the delicate tear film breaks down and forms dry spots on the surface of the eyes causing difficulty in vision. Tears consist of water, fatty oils, protein, and electrolytes which help in clear vision. Some of the common causes of dry eye include an imbalance in the constitution of tears which cause them to get dried up at a faster rate, insufficient production of tears, malnutrition which often leads to the deficiency of vitamin A, problems associated with the eyelids, side effects of some medications as well as environmental factors.
Imbalances in the rear mixture
Any kind of abnormalities in the three layers of the tears which are oil, water as well as mucus, may be associated with the occurrence of the symptoms of dry eye. The topmost layer which is formed by oil has a smoothening effect on the surface of the tear and it is also responsible for decreasing the rate of drying up of the tears. Conditions such as blepharitis as well as rosacea are forms of skin disorders where inflammation of the eyes occurs which causes the blockage of the meibomian gland which usually leads to dry eye.
The middle and thicker layer is composed of water and salt which is formed by the lacrimal gland. These constituents help cleanse the eyes and also help in the removal of various impurities that causes eye irritation and dry eye. Problems with this layer generally contribute to dry eye as when the water layer thins out, the layers containing oil and mucus come in contact with each other which in turn causes discharge characteristic of dry eye. Mucus, which is the innermost layer, can cause dry patches on the eye in cases of abnormalities.
Reduced production of tears
When the production of tears decreases, the eyes get dried up easily which is more common in individuals after the age of 40 years along with women mainly after menopause. Various other underlying conditions of reduced tear production include lupus, scleroderma, and rheumatoid arthritis which are autoimmune disorders, side effects of radiation therapy, diabetes, deficiency of vitamin A and side effects of badly performed refractive laser eye surgeries which may also lead to the symptoms of dry eye.
Problems of the eyelids and side effects of medications
Some of the eyelid problems such as ectropion which is characterized by the eyelids turning outwardly and inflammation of the eyelids along with prolonged use of contact lenses can all contribute to dry eye. Dry eye can also be caused by the side effects of medications such as diuretics, angiotensin-converting enzyme (ACE) inhibitors, antihistamines, decongestants, sleeping as well as birth control pills and antidepressants.
The symptoms of dry eye are stinging or burning sensation, feeling of dryness and soreness in the eyes, feeling of stringy mucus and sand in the eye, redness of the eye, difficulty in keeping the eye open, eye fatigue on reading, blurred vision, sensitivity to light, discomfort while wearing contact lenses, frequent tearing, double vision and sticking together of the eyelids on waking up.
Treatment of dry eye
Some of the treatment modalities for dry eyes include increasing the production of tears, using artificial tears or eye drops, and reducing the drainage of the tears. In individuals with existing underlying eye disorders such as ophthalmic or other associated systemic disorders like infections of the eye, treating the cause will also cause relief from dry eye. The effective medication for those suffering from dry eye includes cyclosporine eye drops which help in decreasing the inflammation on the surface of the eye and also promotes the formation of tears.
The problem of eyelids such as incomplete blinking need surgical intermittent to provide relief to the dry eye. In some individuals, the reason for dry eye can be due to the partial or complete blockage of the tear ducts which can be corrected surgically to conserve tears. In severe cases of dry eye which are not responsive to medical management can be rectified with salivary gland transplantation where some of the salivary glands are replaced from the lip into the sides of the eyes for the production of tears.
Using natural tears
Natural tears can be obtained by consciously blinking at a faster pace and by using moisture chamber spectacles which help in retaining the moisture in the eyes and preserve the tears effectively. Being adequately hydrated also helps in improving the symptoms of dry eye.
Artificial tears and eye drops
For maintaining the lubrication in mildly dry eyes, artificial tears or eye drops can be used such as Restasis as well as xiidra which help in reducing the inflammation of the eyes thereby decreasing the symptoms of dry eye. ointments can also be applied during the night time to increase the production of tears. Lacrisert which is a sterile and slow-releasing lubricant that can be placed under the eyelid helps in keeping the moisture in the eye intact for the whole day.
Insertion of punctal plugs
Punctal plugs are used in the treatment of dry eyes to keep the tears in the eye last longer by inserting them into the tear ducts that are present in the eye.
Regular intake of foods that are rich in omega 3 fatty acids such as cold-water fish like salmons, sardines, herring, and cod. Consumption of Alvizia omega 3 fatty acids rich fish oil supplements also helps in relieving the symptoms of dry eye.