Dry eye disease, or dry eye syndrome, is a medical condition that develops when your tear (lacrimal) gland doesn’t make enough tears. It can also develop if tears don’t contain enough oil, which causes them to evaporate too fast.
The tear film covers the cornea — the clear, front part of the eye. It’s made up of water, oil, and mucus. And it provides a protective barrier for your eye. Without enough tears, you can experience eye pain. In extreme cases, this can cause eye damage and even vision loss.
There are several things that can increase your chances of developing dry eye disease. These are discussed below.
Your tear glands naturally make less tears as you get older. This increases your chances of developing dry eye. Also hormone changes during menopause lower the oil content in tears, which can trigger dry eye.
Certain autoimmune conditions — especially Sjögren’s syndrome and rheumatoid arthritis — can affect the tear gland and cause dry eye disease. COVID-19 infection can also cause dry eye disease.
Some eye conditions also affect the tear gland. Blepharitis, or inflammation of the eyelids, is one example. Also, previous eye surgery, including LASIK surgery, can cause dry eye.
Some medications lower your tear gland’s ability to make tears, which can lead to dry eye. For example, medications to treat blood pressure, anxiety, heartburn, and allergies can cause dry eye.
Dry and windy environments cause tears to evaporate more quickly. You’re more likely to develop dry eye disease if you live in a dry or windy climate.
Dry eye can cause symptoms like:
Eye pain and discomfort
Burning sensation in one or both eyes
Temporary blurred vision, often with reading
Gritty sensation in the eye
Watery eyes
It may seem odd that your eyes can feel watery if you have dry eye disease. This is because your tear gland will try to relieve irritation from dry eye by making more tears. But these lower-quality tears aren’t able to completely relieve dry eye, so other symptoms don’t go away.
An eye doctor (ophthalmologist) can diagnose dry eye during a complete eye exam. Your eye doctor will examine the surface of your eyes using special tools, like a slit lamp. This will allow them to see if your tears are strong enough to protect your cornea and whether your cornea has damage.
They may also collect a tear sample using a small paper strip to see if you’re making enough tears. They may also measure the amount of oil in your tears.
There are several ways to treat dry eye. Most people need to use a combination of treatments for complete relief.
Artificial tears are the first-choice treatment for dry eye. There are many different types of artificial tear drops available over the counter (OTC).
Some artificial tears are thicker and prevent the tear film from evaporating as quickly. If you need artificial tear drops frequently during the day, try preservative-free artificial tears. These can be safely used multiple times a day. Make sure to throw away your single-use vial within 24 hours after opening it.
There’s evidence that omega-3 supplements can improve dry-eye symptoms. Omega-3 supplements are available OTC and are safe for most people. But it’s not clear how much people need to take for best results. Your eye doctor can help you determine the right dose for you.
These are plugs that your ophthalmologist can place in your tear ducts. They keep tears from draining, so the tears can stay on your eye longer.
Punctual plug placement is a short medical procedure that’s done in the ophthalmologist’s office. It doesn't require anesthesia. But your eye doctor may use numbing medication on your tear ducts. Some punctual plugs dissolve on their own, so you don’t need another procedure to remove them.
Prescription medications can help when other treatments aren’t enough to relieve dry eye disease. Some options are described below.
Restasis (cyclosporine) and Xiidra (lifitegrast) are medicated eye drops that stop eye inflammation and can keep it from coming back. Miebo (perfluorohexyloctane) is a medicated eye drop that stops tears from evaporating. All three options are FDA approved to treat dry eye disease.
Tyrvaya (Varenicline) is a nasal spray that’s FDA approved for the treatment of dry eye. It works by increasing tear production.
Autologous serum tears aren’t a prescription treatment you can pick up at a retail pharmacy. These eye drops are created in a lab from a sample of your blood. Autologous serum tears can be a good option when other options haven’t worked. They can also be helpful for people who have dry eye from an autoimmune condition.
There are steps you can take to keep dry eye from getting worse. Some of these are discussed below.
The air stream from a fan evaporates tears, worsening dry eye. Always position your fans so they aren’t blowing toward your face.
Prolonged screen time can cause eye strain and dry eye. Use the 20-20-20 rule: Every 20 minutes, take a 20-second break and look at something 20 feet away.
Humidifiers increase moisture in the air, keeping tears from evaporating too quickly. This can help lessen dry eye symptoms.
Contact lenses can disrupt the tear barrier and lower the amount of oxygen reaching your cornea. Make sure you don’t sleep with your contacts in place. Your eye doctor may also recommend limiting your contact use to a set number of hours a day.
Smoke can trigger dry eye — including cigarette and wood smoke. Avoid smoke as much as possible.
A warm compress lets more oil flow into tears so they evaporate slower. Place a warm eye mask over both eyelids for about 10 minutes a day.
To clean your eyelids, use baby shampoo or OTC pads like Ocusoft lid scrubs. Gently clean the base of the eyelashes on your upper and lower lid while keeping the eye closed. Try this a few times a week.
There are many treatments for dry eye disease, like artificial tears, prescription eye drops, and nasal sprays. What works well for one person might not work well for another. Over time, you might need to change your routine or add new treatment options.
Some medical conditions can trigger or worsen dry eye. Getting treatment for these conditions can also lessen dry eye symptoms.
Dry eye disease doesn’t usually get better or go away on its own. Sometimes, you can reverse dry eye disease.
For example, if medications are causing your symptoms, talk to a healthcare professional about switching to another option. This may improve your dry eye symptoms. Don’t stop taking prescribed medications without first talking to your healthcare team.
Contact lenses can worsen and trigger dry eye disease. You can consider other options for treating your nearsightedness (myopia), like glasses or surgery such as PRK and LASIK.
Severe and untreated dry eye disease can cause permanent vision loss. Without proper treatment, dry eye can lead to other serious eye conditions. You can develop corneal abrasions and keratitis. These conditions can lead to serious eye injuries and even vision loss.
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