What causes dry eye?
Dry eye is a condition in which there are insufficient tears to lubricate and nourish the front of the eye. Tears are necessary for maintaining the health of the front surface of the eye and for providing clear vision. People with dry eyes either do not produce enough tears or they have tears of poor quality. With each blink of the eyelids, tears are spread across the front surface of the eye, known as the cornea. Tears provide lubrication, reduce the risk of eye infection, wash away foreign matter, and keep the surface of the eyes smooth and clear. At Vista Eye Care in Thornton, Colorado, our eye doctors take a preventative approach to dry eye treatment.
What are the two main types of dry eye?
- Inadequate amount of tears – Tears are produced by several glands in and around the eyelids. When the normal amount of tear production decreases, or tears evaporate too quickly from the eyes, symptoms of dry eye may develop.
- Poor quality of tears – Tears are made of three layers: oil, water, and mucus. Each component serves a function in protecting and nourishing the front surface of the eye. A smooth oil layer helps to prevent evaporation of the water layer, while the mucin layer functions in spreading the tears evenly over the surface of the eye. If the tears evaporate too quickly, or do not spread evenly over the cornea due to deficiencies with any of the tear layers, dry eye symptoms may develop.
Who gets dry eyes?
There are seven main causes of dry eyes:
- Age – Dry eye is part of the aging process. The majority of people over age 65 experience some symptoms of dry eyes.
- Gender – Women are more likely to develop dry eyes due to hormonal changes caused by pregnancy, oral contraceptives, and menopause.
- Medications – Antihistamines, decongestants, blood pressure medications, and antidepressants may reduce the amount of tears produced.
- Medical conditions – Persons with rheumatoid arthritis, diabetes, and thyroid problems are more likely to have symptoms of dry eyes. Problems with inflammation of the eyelids (blepharitis), inflammation of the surfaces of the eye, or the inward or outward turning of eyelids can result in dry eyes.
- Environmental conditions – Exposure to smoke, wind, and dry climates (like Colorado!) can increase tear evaporation resulting in dry eye symptoms. Failure to blink regularly, such as when staring at a computer screen for long periods of time, can also contribute to drying of the eyes. If you live in Thornton, Brighton, Westminster, or North Denver, you’re already predisposed to have dry eyes.
- Contact lens wear – Long term use of contact lenses can be a factor in the development of dry eyes. Certain contact lenses, such as CooperVision’s Avaira lens (which as of April 2011 is available in a toric lens) and Acuvue’s Oasys lens, allow for great comfort and vision. In patients with extremely dry eyes, daily disposable lenses offer the most comfortable and convenient contact lens experience. Ciba Vision’s Dailies Aqua Comfort Plus lens is a fantastic contact lens option for patients with dry eyes.
- Refractive surgery – Refractive corneal surgeries, such as PRK and LASIK, can cause decreased tear production and dry eyes.
How are dry eyes treated?
There are four main ways to treat dry eyes:
- Artificial tears – Mild cases of dry eyes can often be managed using over-the-counter artificial tears. These can be used as often as needed to supplement natural tear production, or increase the thickness of existing tears, allowing them to stick to the front of the eye between blinks. Use of eye drops that “get redness out” are not recommended as they introduce irritating chemicals into the eye. Our optometrists, Dr. Abert and Dr. Pedroza, recommend preservative-free artificial tear solutions because they contain fewer additives that cause further irritation. Some of our doctor’s favorite drops are Systane Ultra and Refresh Tears.
- Punctal plugs – The tear ducts can be blocked with tiny silicone or gel-like plugs that can be removed if needed. In either case, the goal is to keep the available tears in the eye longer to reduce dryness-related issues.
- Increasing tear production – Restasis is a prescription eye drop that can increase production of tears. Omega-3 fatty acid nutritional supplements (found in fish oil) have also been shown to increase tear quality and production by reducing tear gland inflammation as well as improve tear quality.
- Treatment of the contributing eyelid or ocular surface inflammation – Prescription eye drops or ointments, warm compresses, lid massage, and eyelid cleaners may be recommended to help decrease inflammation around the surface of the eyes.
Please contact our office today to schedule a dry eye evaluation.