Dry Eyes

Dry eye syndrome or keratoconjunctivitis sicca can cause eye irritation and it primarily affects the elderly people. This occurs when the tear film in the eyes is heavily damaged. The tear film is a structure that keeps the eyes lubricated and moist all the time. This eye syndrome can also occur as a secondary condition to a variety of illnesses.

Tear Film

This structure is composed of three layers:

  • The middle watery layer - this is the main part and is considered as ‘tears'. The fluid is secreted through the lacrimal glands which are located above and near the outer portion in both eyes. These lacrimal glands would continuous secrete minute quantities of watery fluids that are drained to the upper portion of the eyes. When a person blinks, eyelids would spread the tears in the front surface of the eyes.
  • The outer lipid layer – this is a thin oily section where small meibomian glands are located. These glands secrete an oily lipid fluid that covers the tear film's outer layer. This lipid layer helps in keeping the tear surface as smooth as possible to reduce the evaporation of tears.

 

  • Inner mucus layer – this is also a thin section where the conjunctiva cells found at the front and inner portions of the eyelids can also secrete minute amounts of mucus-like liquid. This mucus-like liquid also allows for the tears to evenly spread to the eye surface. The watery tears drain small canaliculi channels in the inner part of the eyes into the tear sac. After that, the tears go down the tear duct or the naso-lacrimal duct and go to the nose.

Risks and Causes for Dry Eye Syndrome

This is a condition that can affect everybody, anyone but the elderly people are at a higher risk than the rest of the population. This syndrome can affect about seven in a hundred people who are in their fifties and about fifteen in a hundred people in their seventies. Women are at a higher risk of contracting this syndrome than men.
The causes for dry eye syndrome would include:

  • Aging. When a person grows older, the tears that they can produce become lowered. Older women notice that they develop dry eye syndrome after experiencing menopause.
  • Medication. A few drugs can cause dry eye syndrome as a side effect or it can make the dry eye symptoms worse. Drugs that can have this effect are:
    • anti-depressants
    •  diuretics
    • Contraceptive pills
    •  anti-histamines
    • drugs that treat psychological and anxiety problems.
    • Beta-blockers like atenolol and propranolol
    • Some eye drop drugs that are used for other eye problems.
  • Illness. Dry eye syndrome can be a secondary illness from other general diseases such as in:
    • Systematic lupus erythematosus (SLE)
    • Rheumatoid arthritis
    • Sjogren's syndrome
  • Elevation in the evaporation of watery tears. This can be caused by any of the following:
    • Blink rate is low and when the patient opens their eyes broader than usual.
    • Low humidity
    • The inability to cover your eyes because the eyelids cannot completely close. This is true for those who have thyroid diseases and for those who sleep with part of their eyes open.
    • When the weather is windy.
  • When there is damage to the eyelids or to the outer portion of the eyes because of surgery, disease or injury.
  • The inflammation of the eyelids or blepharitis.
  • Unknown causes. A number of young people are not able to produce normal amounts of tears for no apparent reason.

Symptoms for Dry Eye Syndrome

Dry eye syndrome usually affects both eyes and the symptoms may not even mean having ‘dry' eyes. The symptoms are the following:

  • Eye Irritation – the person may feel a burning or gritty season in their eyes. The eyes will not become red and if they do, this a result due to another eye problem or complication.
  • The sight is blurred – the dry eye syndrome does not affect the seeing portion of the eyes and it does not cause any permanent damage in eyesight.
  • Looking at bright lights may become an unpleasant experience.
  • Wearing contact lenses can become uncomfortable.

Complications for Dry Eye Syndrome

Complications that arise from dry eye syndrome are very uncommon, although inflammation of the cornea (keratitis) and conjunctiva (conjunctivitis) may occur. In some severe cases, minute corneal ulcers may also occur as well as the puncture of the cornea.
Always remember to see a doctor if your vision will be affected even in a small ways. Watch out for eye pain that would develop when you have dry eye syndrome. This may mean that another eye complication is also present.

Diagnosis for Dry Eye Syndrome

A specialist or a doctor can officially diagnose a person with dry eye syndrome based on the symptoms. But dry eye syndrome can also become a symptom for Sjogren's syndrome. A test called the Schirmer tear test should be done for the eyes to properly diagnose it. This test gauges the amount of watery tears a person can produce. A special type of filter paper is put below the lower lid for five short minutes.  

Treatments for Dry Eye Syndrome

  • Artificial tears. These artificial tears can be applied as eye drops or in gels. These are very effective to relieve symptoms. These can be bought from pharmacies or be prescribed by doctors. The first couple of applications should be done every hour until the symptoms are relieved. If the symptoms get better, then the patient will only need to apply them for three to four times in a day. This can also be used regularly.

Some patients may have allergic reactions to some of the artificial tears since these products are made with a variety of chemicals such as benzalkonium hexachloride.  This chemical may damage the cornea. If some irritation should occur, be sure to tell your doctor about it as they may be able to prescribe a better and more suitable artificial tear product for your needs.

  • Eye ointment. This can help soothe and lubricate the eyes. This can be bought at pharmacies or by prescription from your doctors. This type of eye ointment should be used in the day because it can lower the affectivity of some artificial tear product drops. It can also blur the patient's vision when used in the day.
  • Other treatments. Drugs can be prescribed if the patient does not respond well with artificial tears and eye ointments. Drugs that are capable of boosting the amount of tear being produced can help. Surgery to block the watery tears from being drained away can also be advised. Remember that if dry eye syndrome can cause additional pain, it indicates that it can be a symptom for other eye complications. 

For those who wear contact lenses:

Patients who will use any form of eye drops should never wear contact lenses or else consult with your doctors first. The complication may stem out from the preservative in the eye drops. Some eye drop products do not have preservatives and this can be used by those who wear contact lenses.

Important notice