Dry eyes are becoming an increasingly recognised health concern, so much so that the condition has been termed dry eye disease or dry eye syndrome. As dry eye symptoms can vary widely, even presenting with no symptoms at all, people with dry eyes may not identify their eyes as being dry, making the first hurdle to effective dry eye treatment simply an accurate diagnosis.
Dry eye symptoms may present as:
- Dryness of the eyes
- A gritty sensation or the feeling of a particle being stuck in the eye (also known as a foreign body sensation)
- Red eyes, either on the whites of the eye or the rims of the eyelids, or both
- Blurry, variable vision that often fluctuates with blinking
- Sore eyes
- Tired eyes
- Watery eyes; though counterintuitive, a dry ocular surface may trigger the tearing reflex, resulting in the overproduction of tears
Dry Eye Disease
Effective dry eye treatment revolves around appropriate diagnosis of not only the fact that dry eye is responsible for your discomfort, but also what type of dry eye you have.
There are two broad categories underlying dry eyes – aqueous deficiency causes and evaporative causes. More often than not, dry eyes arise from a combination of these two classifications.
Aqueous deficiency dry eye (ADDE) relates to the aqueous component, produced by the lacrimal gland, of the layered tear film that covers the surface of the eye. The predominant cause of ADDE is Sjogren’s syndrome, an autoimmune disease, which can affect the function of the lacrimal gland. Other non-Sjogren’s causes of ADDE include damage or an obstruction of the lacrimal gland, or the use of certain systemic medications.
Evaporative dry eye (EDE) may be divided into internal and external factors. The most common cause of EDE is dysfunction of the oil glands in the eyelids, known as Meibomian glands, but may also be a result of factors such as poor eyelid positioning and function, vitamin A deficiency, topical medications or the preservatives in them, contact lens wear, and ocular surface conditions such as allergies.
Dry Eye Treatment
Once the underlying causative factors of your dry eyes have been properly identified, dry eye treatment may be more appropriately directed.
The obvious first step in the treatment of dry eyes is to remove or adjust any exacerbating factors. The solution for alleviating your dry eyes may be as simple as environmental modifications, such as redirecting air-conditioning or heating vents away from your face, or turning on a humidifier in the room. If you and your eyecare provider have identified a certain systemic or topical medication as contributing to your ocular discomfort, it makes sense to either change the formulation or type of medication where possible. If contact lenses are the culprit, being refitted into a more hydrated material or reserving contact lens wear for special occasions only may be the solution.
Beyond these easy steps, many patients turn to eyedrops for relief of their dry eyes. Lubricating eye drops, also known as artificial tears or tear supplements, are designed to rehydrate a dry ocular surface, stabilising the tear film and adding a layer of protection against the external environment. If you’ve ever walked down the eyecare aisle of the pharmacy, you’ll have noticed a confusing multitude of eyedrop brands – aim for a lubricant for dry or irritated eyes, rather than an eyedrop for red or itchy eyes, unless you actually have dry eyes due to allergy. Artificial tears are not considered a medication and can be used regularly throughout the day as needed, however, if you know you have particularly sensitive eyes you may want to find a preservative-free lubricant.
You may have found that a simple warm compress can often soothe your tired, dry eyes. This is because the heat helps to soften any solidified oils in the Meibomian glands, allowing them to be expressed more freely, improving the quality of your tear film. An effective treatment, particularly in the case of Meibomian gland dysfunction-related dry eye, is to apply a warm compress to the closed eyelids, followed by gentle lid massage with your fingers to encourage expression of these softened blockages.
As we continue to advance our understanding of dry eye disease, we are also seeing the development of more novel dry eye therapies. These include the use of intense pulsed light (IPL) applied to the eyelids and surrounding areas, eye gel or drops based on natural manuka honey, using a patient’s own blood serum to formulate tear supplements, and prescription immunosuppressant eyedrop medications. As this area of eyecare is constantly evolving, keep an eye on this space.
Call us at 1300 297 583 for more dry eye treatment guides.