Dry eye syndrome is very common and affects many people as we get older. Tears are important to keep our eyes healthy and moist. Our tears are made of 3 layers, an outer oily layer, a middle watery layer and a thin inner mucus layer. Dry eyes occur when either the tear production is inadequate, or when the quality of tears is poor. Abnormalities in any of the 3 tear layers can result in poor quality of tears and dry eyes.
A person with dry eyes may complain of:
Fortunately, besides the eye discomfort, dry eyes are usually not associated with serious complications.
Rarely, if the eyes are very dry, this can result in infections of the cornea, the transparent structure in front of the eyes.
The causes of dry eyes include:
Many people notice that their eyes get drier as they become older. Women often have dry eye symptoms after menopause.
Blepharitis means inflammation of the eyelids, including the tiny oil glands in the eyelids called the meibomian glands. These glands release oil which forms the outer layer of tears. When the meibomian glands are blocked, this changes the amount and composition of oil in the tears. Poor quality tears do not coat the surface of the eye well, leading to dry eye symptoms.
Certain medications, medical conditions and previous refractive surgery are also associated with dry eyes.
A warm and windy environment with low humidity increases tear evaporation and makes the eyes dry. Staring at a computer screen for a long period of time and wearing contact lenses can also result in dry eyes.
We can reduce the symptoms of dry eyes by supplementing tear production and lubricating the eyes. Artificial tear eyedrops are available over-the-counter. Preservative-free eyedrops are recommended because they contain fewer additives which can further irritate the eyes. Lubricating ointments are also available, which are thicker and stay on the eye longer than eyedrops. However, they can make the vision blurry for a few minutes, so you may prefer to use them at night just before you sleep.
Increasing your intake of omega-3 fatty acids, either from fatty fish or supplements, may help to increase tear production.
You may consider using plugs that block the tear ducts to reduce tear drainage from the eye and increase the amount of tears on the eye surface, relieving dry eye symptoms.
For those with blepharitis, regular eyelid hygiene is important. A daily routine of warm compress, massage and cleaning is often sufficient to keep symptoms at bay. Apply a warm compress for 5 to 10 minutes to soften the oily secretions. This is followed by an eyelid massage to push the oil from the glands. Massage downwards for the upper eyelids, and massage upwards for the lower eyelids. This will move the oily secretions to the gland openings. After this, clean the eyelids, especially the eyelid margins where the gland openings are. Make this a part of your daily routine and do it at least twice a day. For more severe cases of blepharitis, topical or oral antibiotics may be required.
There is no quick one-off cure for dry eyes or blepharitis. The aim is to manage these conditions with regular treatment, so that you can carry on with your daily activities without much eye discomfort.