Dry Eye

If your eyes are constantly uncomfortably dry and a blink doesn't produce the necessary film over them for good vision, then you may have dry eye, also known as keratoconjunctivitis sicca. Either your tear glands have stopped producing enough lubrication to protect your eyes or the quality of your tears has diminished.

What are tears?

Have you ever tasted your tears? If so, you know that they aren't just made of water. Tears also include fatty oils, proteins, electrolytes, infection-reducing substances, and growth factors that aid in regulating various cell functions. Each teardrop is made up of three layers - the outer oily lipid layer, the middle watery layer, and the inner mucous layer - and each layer is manufactured by a different tear gland.

Symptoms

If you have dry eye, your eyes may:

• sting or burn;
• have trouble seeing occasionally;
• feel scratchy;
• feel like something's caught under the lids;
• contain stringy mucus around the edges;
• feel particularly uncomfortable when wearing contact lenses;
• be sensitive to anything like smoke or wind or dust.

Paradoxically, with dry eye, you may also have watery eyes; the excessive dryness can trigger the development of the watery component of your tears.

Severity of the symptoms may change from day to day, but having regular dry eyes can affect quality of life and increase risk of eye infection.

Causes

Dry eyes are a symptom of some underlying condition. For many people, it just means that they are growing older, and with age, hair and skin dry up and the tear glands stop making as much liquid as they used too. This is particularly true of women after menopause.

In addition, dry eyes due to less lubrication may be a side effect of over-the-counter or prescribed medications such as diuretics, sleeping pills, antidepressants, acne drugs, and antihistamines. So, get in the habit of being informed about any medication you are taking: Read the information that comes with the medication, and whenever you go on a new medication, always talk to your pharmacist, who will explain the medication's actions and potential side effects.

Dry eyes can also be a side effect of radiation therapy or a symptom of an autoimmune disease such as rheumatoid arthritis, lupus erythematosis, or Sjogren's syndrome (which includes a triad of conditions: lupus, dry mouth, and dry eye). It may also be related to diabetes or thyroid problems.

Treatment

If symptoms are mild, some measures may help to provide improvement:

• Apply warm compresses;
• Use an humidifier;
• Avoid the cause as possible (allergy, environment, smoke, etc.).

If, despite this, you find that your eyes don't seem to be producing moisture as easily as they once did, whether in response to irritation or emotion, ask your pharmacist to recommend an over-the-counter medication. The most common ones are eye drops called artificial tears, which moisten the eyes. If you need to use them frequently, choose preservative-free drops and you can use them as often as required.

If you continue experiencing uncomfortably dry eyes, consult your doctor or optometrist, who will advise you what you can do next. There are a variety of other treatment options that may be suggested, including:

• solid inserts that gradually release lubrication;
• plugs to prevent the tears you do make from draining away by plugging the canals that drain your tears to the nose;
• thermal cautery, a procedure which permanently obstructs the canals with scar tissue;
• medications to take orally.

You may also find it helpful to reduce environmental factors that may make your condition worse: stop wearing contact lenses or wear them for shorter periods; and keep your environment as humid and smoke- and dust-free as possible.