Dry Eyes – Causes, Symptoms and Treatment

Overview  

When tears evaporate very quickly, or the eyes produce less than the required quantity of tears, it can lead to dry eyes. This condition is found in both humans and animals, which can affect one or both eyes and can also result in inflammation as well. This syndrome may occur at any age. Even healthy people may get affected at times by this condition. It is more common among women than in men, especially among women who are older in age and produce fewer tears. 

Dry eyes can aggravate in a variety of conditions, including on an aero plane, in an air-conditioned room, when riding a bike, or while staring at a computer screen. Treatments for dry eyes help the patient feel more at ease. These include dietary adjustments as well as eyedrops. To control the symptoms of dry eyes, the patient will probably need to use the medications indefinitely.  

What are the causes of dry eyes?  

Dry eyes are caused by a variety of factors that affect the tear film’s normal function. The three layers of your tear film are made up of  fatty oils, aqueous fluid, and mucus. They make your eyes stay hydrated. Issues with any of these layers might lead to dry eyes. 

The major causes of dry eyes are: 

Decreases in tear production

The following are the most common causes of decreased tear production:  

• Ageing  
• Vitamin A insufficiency 
• Antihistamines, decongestants, hormone replacement therapy, antidepressants, and pharmaceuticals for high blood pressure, acne, birth control, and Parkinson’s disease, to name a few.  
• Corneal nerve de-sensitivity can be induced by contact lenses, nerve injury, or laser eye surgery where the symptoms of dry eyes are usually very transitory.  

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Increased tear evaporation  

Increased tear evaporation can be caused by a variety of factors, including:  

• Blepharitis of the posterior eyelids 
• Blinking less frequently, which might happen if the patient has a condition like Parkinson’s disease or if you’re concentrating on anything for too long  like reading, driving, or working at a computer.  
• Allergies of the eyes  
• Topical eye drops containing preservatives 
• Wind, smoke, or an overly dry atmosphere  
• Vitamin A deficiency  

Medications  

Dry eyes can be caused by numerious medications, including:  

• Diuretics  
• Antihistamines  
• Decongestants  
• Sleeping tablets  
• Pills for birth control  
• Antidepressants  
• Various acne treatments  

What are the symptoms of dry eyes?  

The following are some of the symptoms that a patient with dry eye syndrome may experience:  

• A burning or stinging sensation in the eyes, as well as a feeling of dryness, grittiness, and pain  
• A sand-like sensation in the eyes  
• Mucus in or around the eyes  
• Sensitivity to smoke or wind  
• Having trouble keeping eyes open  
• Even if it is only for a short period, reading causes eye tiredness 
• Hazy vision, particularly at the end of the day  
• Light sensitivity  
• Using contact lenses causes discomfort  
• Tearing up
• Eyelashes stick together  

The discomfort can be excruciating for some people, resulting in irritation, worry, and trouble functioning in daily life. A worsening of eye redness and light sensitivity,  increased pain in the eyes, and impairment of vision are all possible complications.  

What are the treatment options available for dry eyes?  

Most people with mild dry eye symptoms can use over-the-counter eye drops daily. There are additional options like medication and surgery if the symptoms are persistent and serious.   

Medications  

You can manage dry eyes with frequent washing of eyelid and by using over-the-counter (OTC) eyedrops or other products to help lubricate the eyes. If the condition is chronic (long term), use eyedrops even when your eyes feel fine to keep them well lubricated.

The following prescription medicines can be used for the treatment of dry eyes:  

1. Medications to reduce eyelid inflammation: Inflammation along the edge of eyelids may keep the oil glands from secreting oil into the tears. Your eye doctor may suggest antibiotics to reduce the inflammation. 
2. Eyedrops to control cornea inflammation. 
3. Eye inserts which work like artificial tears: If you have moderate to severe dry eye symptoms and artificial tears do not help, your eye doctor may recommend another option –  inserting Lacrisert (hydroxypropyl cellulose), a tiny eye insert that looks like a clear rice grain, once in a day between your lower eyelid and the eyeball. The insert dissolves slowly to release a substance that is used in eyedrops to lubricate the eye.
4. Tear-stimulating drugs: Medications known as cholinergics (pilocarpine, cevimeline) help in increasing the tear production. 
5. Eyedrops made from your own blood: These eyedrops, known as autologous blood serum drops, can be an option for severe dry eye symptoms that do not respond to any other treatment.

Surgery  

A surgeon who specializes in eyelid difficulties can treat eyelid problems such as incomplete blinking. To conserve the tears, tear ducts may be stopped partially or totally. To restrict the tear ducts, silicone plugs can be inserted. Both natural and artificial tears last longer in the eyes as a result of this. 

Thermal cautery is an operation in which a surgeon uses a hot wire to shrink the tissues of the drainage area. A Boston Scleral Lens is a contact lens that sits on the eye’s sclera or white portion. It forms a fluid-filled layer on top of the cornea to keep it from drying out.   

Salivary gland transplantation is a surgical procedure used to treat persistent and severe cases. Some salivary glands are grafted or implanted into the side of the eyes after being removed from the lower lip. They use their saliva as a substitute for tears.  

Conclusion

Dry eye is a multifactorial disease of the tears and ocular surface, a system made up of multiple components that work together to protect the eye from environmental and biological stress. As a result, it’s vital to address both the primary pathogenic mechanism(s) involved in dry eye disease and the secondary processes that, if not properly managed, can contribute to the vicious cycle of dry eyes. Good and appropriate treatment will improve the eye surface, resulting in symptom reduction and a significant increase in quality of life.