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A short guide to dry eyes and what to do

Imagine you're at the beach on a windy day and you get a grain of sand stuck in your eye. Your eye will probably feel gritty, it will definitely feel sore and it might even cause your vision to be temporarily blurred. Now imagine having to spend most of your day, every day with this feeling.

For a lot of people, this is their reality because of the condition commonly referred to as ‘dry eye'. Many people across the UK and worldwide live with dry eyes, and a lot of us don't even realise that we have it, or think we can do anything about it.

Read on for more information about dry eyes: about its causes, symptoms, treatment and what to do if you have it.

What is dry eye?

We normally associate tears with unhappiness— with crying or being upset— but did you know that they actually play a key role in keeping our eyes feeling comfortable and working well?

In fact, you could say you're constantly crying; each time you blink, your eyelids help spread tears across the surface of your eye, in a layer known as your ‘tear film'. This tear film keeps your eyes moist, healthy and also helps them focus. Furthermore it acts as a defence barrier to foreign objects.

Dry eye occurs when your eyes don't produce enough tears, they aren't spread properly, or they aren't of the necessary quality resulting in the tear later evaporating too quickly. It's a common condition and can happen at any age, but the risk developing the condition increases as you get older — NHS England1 estimates that 1 in 3 people over the age of 65 suffer from the condition.

Dry eye is a common and increasing phenomenon in the UK population, with some experts describing it as an epidemic. Contributory factors to this condition include lifestyle, environment and nutrition. Dry eye signs and symptoms are found with patients regardless of whether they have had eye surgery or not. Dry eye whilst uncomfortable can also cause fluctuations in a patients' visual acuity.

Dry eye was defined by the Tear Film and Ocular Surface Society International Dry Eye Workshop II (TFOS DEWS II) as “a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles”. 2

In the general population (independent of surgery) epidemiologic studies identified prevalence rates ranging from 7% in the United States to 33% in Taiwan and Japan. Risk factors include advanced age, female gender, smoking, extreme heat or cold weather conditions, low relative humidity, use of video display terminals, refractive surgery, contact lens wear, and certain medications.3 There are different sub-classifications of dry eye with the most prevalent being Evaporative Dry Eye (EDE), resulting from Meibomian Gland Dysfunction (MGD)4, a condition which is wholly unrelated to Laser Eye and Intraocular Lens surgery.

Symptoms of dry eye

Dry eye isn't your standard eye condition— it's actually a syndrome which means it's a collection of particular symptoms that usually appear together. Most people find that their dry eye symptoms will be fairly mild, but sometimes they might be bad enough to cause a lot of discomfort and impact on your daily activities. Some of the common symptoms of dry eye include:

  • A burning sensation in your eye
  • Red eyes
  • A sore, gritty, uncomfortable or dry feeling in your eye
  • Eyelids that stick together often
  • Ocular fatigue
  • Temporarily blurred vision that gets better immediately following a blink

What causes dry eyes?

Dry eye can be caused by a lot of things. Some of the most common causes include:

  • The ageing process
  • Hormonal changes in women related to pregnancy, menopause or the contraceptive pill
  • Extreme climatic environments
  • Environmental conditions, such as those experienced in the modern day air conditioned office combined with prolonged near visual tasks
  • Underlying medical conditions
  • Eye Surgery

Why and how is it treated?

It doesn't make any sense to just suffer in silence if you have dry eyes— especially when treatments exist that can reduce the effects of the condition. Why suffer with uncomfortable eyes when you could solve the problem fairly easily and with fairly little hassle?

Luckily, the condition isn't usually serious and in most cases it can be easily treated. Most cases of dry eye are mild and can actually be easily managed with lubricating eye drops and other forms of medication.

In some cases hot compresses or lid wipes, plus Omega 3 supplements are of benefit. Therapeutic procedures, such as Lipiflow, a heat and massage treatment of the Meibomian glands of the eyelids which is available at Optical Express, can provide a prolonged reduction in symptoms and reduce the reliance on alternative therapies.

These treatments will generally help to improve the lubrication of your eyes and reduce their grittiness.

Tips for coping with dry eyes

If you have dry eyes, there are lots of easy ways that you can improve the comfort of your eyes and improve their moisture levels. Here are a few ways that you can reduce the impact of symptoms and make your eyes feel more comfortable:

  • 1. Avoid dry and dusty environments

    Particularly dusty and dry environments can make the symptoms of dry eye a lot worse. If you have dry eyes, try to limit your exposure to these types of conditions.

  • 2. Blink more

    Even something as simple as blinking more often can help to improve the comfort of your eyes. This technique is particularly useful if you're staring at a computer screen or mobile phone for prolonged periods in a day. Try to make it a habit, for example each time you look at your screen or down to your keyboard, blink.

  • 3. Healthy Diet

    Ensure your diet is rich in Omega 3 oils and that your intake of water is high. Many foods can have an effect on your tear film.

  • 4. Consult a professional

    If your dry eyes are stopping you from living your life properly, you should really seek special medical advice, firstly from your Optometrist. There are a range of short-term and long term treatments available for dry eye. For instance, at Optical Express we offer a specialist treatment called Lipiflow that uses thermal pulses and pressure to relieve the symptoms of dry eyes caused by blockages in your eyelid glands— known as Meibomian Gland Disorder. In fact, 9/10 cases of dry eye can be caused by this disorder5.

    For more information about the symptoms, causes and treatment of dry eye, please have a look at our dedicated dry eye page on our eye conditions section.

References

  1. http://www.nhs.uk/conditions/Dry-eye-syndrome/Pages/Introduction.aspx
  2. TFOS DEWS II Introduction; Nelson JD et al; The Ocular Surface 2017; 15: 269-275.
  3. Etiology, prevalence, and treatment of dry eye disease; Gayton JL; Clinical Ophthalmology 2009; 3: 405–412.
  4. Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort: a retrospective study; Lemp MA; Cornea; 2012 May; 31(5):472-8.
  5. https://www.opticalexpress.co.uk/eye-health/dry-eye