Dry eye, or dry eye syndrome, is a condition that occurs either on a short term basis as a response to external factors such as exposure to wind and sunlight or excessive computer usage, or in a chronic manner. When dry eye occurs, this is because the person in question is unable to produce the right amount of quality tears required to properly nourish and lubricate the eye. In order for the outer surface of the eye to remain healthy, tears are required to provide clear vision. Unfortunately, dry eye is recognized today as a common and sometimes long-lasting condition that occurs particularly often in older adults.
Understanding Dry Eye
Every time a person blinks, tears are spread across the surface of the eye as evenly as possible, lubricating and protecting the cornea. These tears help to get rid of any external debris that may have come into contact with the eye, while maintaining the health of the eye for clear vision. Excess tears typically drain into small ducts located within the inner eyelid corners, which drain moisture into the back of the nose. However, dry eye can regularly occur when there is poor balance between drainage and tear production.
People with dry eyes either do not produce enough tears, or have tears that are poor in quality:
| Reason | Explanation |
| Too few tears | Tears can be produced by a number of glands around and inside of the eyelids. Tear production can diminish naturally with age, and may also occur as a result of various medical conditions, or as a side effect to certain medications. Environmental factors, such as dry climates and wind can also decrease the natural volume of tears due to greater amounts of evaporation. |
| Poor quality tears | Tears are made up of a number of different layers, including mucus, oil, and water. Each component in a tear helps in nourishing and protecting the front eye surface. For instance, the mucus layer allows for even spreading, while the oil layer helps to prevent the evaporation of moisture. If the components of the tears are not properly balanced, they may not spread evenly, or could evaporate too quickly, leading to dry eye symptoms. |
Most commonly, the typical form of dry eye occurs when the water layer in tears is not adequate. This condition, which is also known as Keraconjunctivitis sicca, is also referred to as dry eye syndrome. Most people who suffer from this particular syndrome will experience burning, scratching, and gritty sensations in their eyes. Sometimes, symptoms can also include:
- Sensitivity to light
- Blurred vision
- Excessive eye watering
- Damage to the surface of the eye
Treatments for dry eye aim to maintain or restore the natural flow of tears in the eye, minimizing dryness and all related discomfort.
Treatment for Dry Eye Syndrome
At this time, there is no cure for dry eye syndrome, and some people suffer from recurring episodes that cause them discomfort throughout their lives. Fortunately, there are treatments that can help to control some of the symptoms associated with dry eye. The treatment that people can be given for their dry eye condition will depend largely on whether their symptoms are being caused as a result of decreased tear production, or because the tears that are being produced evaporate too quickly. The first thing to consider with any medication is whether it may interact with other medications, or whether the drugs the patient is already taking may be contributing to the dry eye issue.
If the symptoms of dry eye that patients are experiencing have been caused by underlying medical conditions, then their GP will generally prescribe treatment for that condition, and refer them onwards to the appropriate specialist. In many cases, your doctor will recommend that certain changes to your environment and lifestyle may help you to manage the symptoms of dry eye. For example, drinking plenty of water and eating foods that are high in omega-3 can be helpful.
Lubricating Dry Eye Treatment
Perhaps the first treatment option any health expert will recommend for people suffering from mild to moderate cases of dry eye syndrome is a lubricant. This lubricant may come in the form of drops, an ointment, or a gel. Often referred to as artificial tears, these lubricants work by helping to replace the missing water in the tear film, but they do not contain the nutrients, vitamins and antibodies that are generally found in typical tears, and can be essential to eye health. Some lubricants may be available without a prescription, whereas others require a pharmaceutical prescription to access.
Because there is a large number of different types of gels and eye drops on the market today, it can be worth trying out a number of different options to find the one that best addresses your symptoms. However, it is also important to ensure that your doctor is aware of any changes that you may want to make you to your treatment.
Different Types of Eye Drops
There are a number of different types of eye drops that your doctor may start you on in an attempt to manage your dry eye condition. For example, some eye drops contain extra preservatives intended to ensure that bacteria cannot grow inside the medicine bottle. Often, if your condition requires you to use drops more than six times a day, you will be recommended to use these kinds of drops. This is particularly important if you have been told that you are suffering with severe dry eye disease. The reason for this is that exposure to preservatives over a long period of time can damage the delicate cells that make up the eye surface and lead to further inflammation. When using eye drops with preservatives, you will need to use a lubricant with your contact lenses that contains no preservatives, as the other preservatives may attach to the lens and damage the eye.
Another form of eye drops that your doctor may recommend are known as oily artificial tears. These eye drops are designed to help replenish the oily part of the tear film, reducing evaporation from the eye surface. These options include liposomal sprays, and guar gums. Liposomal sprays do not require a prescription because they can be obtained over the counter, and work by spraying onto the edges of your eyelids when your eyes are closed. When you open your eyes, the solution spreads outwards across the eye surface. Many doctors consider oily eye drops to be useful for patients suffering from blepharitis, which is an inflammation of the eyelids.
Finally, eye ointments can be used to help lubricate the eye surface and keep them moist overnight. This is because your tears can easily evaporate overnight if your eyes cannot fully close due to inflammation. Usually, ointments are used overnight because they lead to blurred vision. Keep in mind that you cannot use ointments and wear contact lenses at the same time.
Prescription Drug Treatment for Dry Eyes
Although many over the counter remedies do exist for the treatment of dry eyes, they are generally recommended for people who are suffering with very mild cases of dry eye, or issues that are only temporary. With that in mind, many patients who suffer from chronic dry eye syndrome, or experience severe discomfort as a result of their symptoms, may require prescription drug treatment to be given by their doctor or optometrist.
The most common drug for people with dry eye syndrome is known as Restasis, and this comes in the form of drops that can be applied directly to the eye surface. Restasis drops contain a drug called cyclosporine, which can be helpful at naturally increasing the production of tears in the body. Restasis drops are intended for use twice a day, and experts have commented that it is possible for patients to use these drops indefinitely so long as they receive consistent care from an eye doctor.
Anti-Inflammatory Treatments
When offering pharmaceutical prescription treatments, your doctor is likely to address the fact that one of the most common underlying problems with long-term dry eye syndrome comes from inflammation around and in the eye. Therefore, your treatment may include a drug designed to address that inflammation.
For example, corticosteroid eye drops and ointments are powerful forms of anti-inflammatory medication that can be given either in the form of eye drops or ointments in severe dry eye syndrome cases. Usually, these medications can come with some possible side effects, but when used properly for a short period of time, the risk levels can be minimized significantly.
Another option is oral tetracycline. Low doses of these medications can be used for anti-inflammatory purposes for a minimum of between three and four months. Some patients are required to continue treatment for much longer. The most common form of tetracycline used is known as doxycycline, but others are sometimes prescribed, such as lymecycline.
Cyclosporin eye drops are another solution. Cyclosporin is a type of medication used to suppress the activity of the immune system. It is sometimes used in the treatment of dry eye syndrome. However, this treatment is only available through a hospital eye department.
Finally, your doctor may recommend autologous serum eye drops, however these are only given in rare cases wherein all other medications have been ineffective. In these circumstances, special eye drops are created using components in your own blood.
Resources and References:
Dry eye syndrome – Treatment – Information about treatment for dry eye syndrome. (NHS.uk)
Dry Eyes – General information about dry eye syndrome – the condition, causes, and risks. (WebMD)
Dry Eye Syndrome – Information about dry eye syndrome, including treatment. (Drugs.com)
