Dry eye is a fairly harmless-sounding condition to most people but for many it can actually be a debilitating disease with significant impact on an individual’s quality of life. The symptoms of dry eye can range from a mild gritty sensation from an obvious source, such as having an air conditioner blow directly in your face, to a constant burning and stinging of the eyes that affects a person’s ability to engage in normal daily activities. The impact of dry eyes has become so significant as to now be considered a disease, termed dry eye disease or dry eye syndrome.
The prevalence of dry eye disease ranges from 5 to 50% with a high rate of under-diagnosis. As the symptoms of dry eye can be minimal, many patients do not seek proper assessment or treatment from an eye care practitioner, instead opting to self-treat with over-the-counter lubricants or simply to ignore the symptoms.
While this approach can provide sufficient, though short-lived, relief from the symptoms of dry eye in many cases, undergoing a comprehensive dry eye assessment can direct more targeted therapy for those who find lubricant eye drops are not enough.
What Are the Symptoms of Dry Eye?
Dry eye disease is becoming increasingly recognised as a complex condition involving multiple underlying factors. At a basic level, it involves a loss of normal balance, or homeostasis, of the tear film that covers the front surface of the eye.
Instability of this layer exposes the eye’s surface to the environment and diminishes its ability to act as α source of protection and nutrients, sparks inflammation of the eye, and leads to many of the commonly identifiable symptoms of dry eye.
- Dryness: unsurprisingly, many people with dry eye disease will identify their eyes as feeling dry. This sensation can range in severity.
- Grittiness, foreign body sensation: some patients may feel like there is a physical particle stuck in the eye, such as an eyelash or grain of sand or dirt.
- Stinging and burning: as the tear film is unstable, the surface of the cornea may become exposed to the environment as the layer of tears covering it dissipates. The exposure of the sensitive cornea to the air can cause the sensation of stinging or burning. Underlying inflammation of the eye’s surface as a result of dryness can also relate to the burning sensation.
- Red eyes: due to the inflammation at the surface of the eye, the whites of the eye may take on a red tinge from enlarged blood vessels. The margins of the eyelids may also appear red as they contain oil glands which supply the tear film; in dry eye disease, dysfunction of these glands may lead to inflammation that presents as redness around the rims of the eyes.
- Blurry or fluctuating vision: the tear film over the cornea is the first surface that light must pass through to reach the back of the eye in the process we call vision. An unstable, uneven tear film will scatter light as it enters the eye, resulting in unclear vision.
With each blink the tear film is replenished, so people with dry eye may find their vision is transiently clear immediately after blinking. However, as the tear film quickly dissipates again the vision will gradually become blurrier until the next blink.
- Glare sensitivity: also known as photophobia, the symptom of glare sensitivity is due to a similar reason for blurry vision. Light scattered by an uneven tear film can be perceived as glare or light sensitivity, leading to discomfort both indoors and outdoors.
- Tired eyes: amongst other functions, the tear film acts as a cushioning or lubricant between the surface of the cornea and the underside of the eyelid. If this layer is depleted as is in the case of dry eye, there is more friction between these two surfaces with each blink. The energy and effort required to blink the eyelid over the dry surface of the eye can cause the sensation of fatigue or tiredness and will tend to be worse later in the day.
- Watery eyes: this may sound counterintuitive but a watery eye may in fact be a product of dry eye disease. When the surface of the eye feels dry, it reflexively produces more tears to try and replenish the tear film.
Dry eye disease is more common than you think. If you are concerned that you may have dry eyes and regular over-the-counter lubricant eye drops are not sufficient, a comprehensive dry eye examination with an eye care professional can help you to formulate a more targeted management plan. Call us today at 1300 297 583 for a consultation.