Dry Eyes: The Ultimate Guide

Dry eye disease is a fairly common condition that occurs when your tears are not able to provide adequate lubrication for your eyes.

• This lack of tear production can be problematic for a number of reasons. For example, dry eyes may occur if you aren’t able to produce enough tears or if the tears you do produce are of poor-quality.
• This lack of proper tear production can lead to damage and inflammation of your eye’s surface.
• Your dry eyes can be caused by a variety of reasons that disrupt your healthy tear film, which has three layers: fatty oils, aqueous fluid, and mucus. This combination normally keeps the surface of your eyes lubricated, smooth, and clear, but problems with any of these layers can result in dry eyes.
• In addition, decreased tear production (which can occur when you’re unable to produce enough aqueous fluid) and increased tear evaporation (when the oil film produced by meibomian glands on the edge of your eyelids become clogged) are common instigators of a dry eye diagnosis.

Everyone who has dry eye symptoms wants to know, “What causes dry eyes?” Here are additional, common causes of dry eyes:

• Inadequate amount of tears/tear production
• Poor quality of tears
• Age
• Gender
• Medications
• Medical conditions (Examples: Rheumatoid arthritis, diabetes, and thyroid problems)
• Environmental conditions (example: Exposure to smoke, wind and dry climates)
• Long-term wear of contact lenses or eye surgeries, such as laser surgery*
• Allergies**

*It’s important to note that contact lenses and surgery do not directly cause dry eyes, but they can make symptoms considerably worse. With contact lenses specifically, eyes that already have trouble keeping the cornea moist struggle when there is an added top layer of lens material.
**Researchers have discovered a link between spring allergens, like pollen, and dry eyes.
Pollen counts and dry eye diagnosis reach an annual peak in April, when approximately 21% of patients are diagnosed with dry eye.
While spring consistently sees a spike in dry eye and allergy diagnosis, winter also sees a spike, probably due to the low humidity caused by indoor heating.
If you take antihistamines for the allergies and you are experiencing uncomfortable dry eyes, you may have to stop taking them. Antihistamines can make dry eye symptoms worse.

We understand that it’s hard for the possible cause of your dry eyes to be so vague. That’s why it’s always best to not play the guessing game and get in to see an eye doctor.

Through a quick and painless eye exam, we can identify the cause and triggers of your dry eyes, ensure your vision is healthy, and discuss a treatment route that you’re comfortable with.

Schedule an appointment to discuss dry eyes (and related health conditions) with your eye doctor at iCare Vision:

Your tears are quite complicated, being composed of many elements including proteins, natural antibiotics, minerals, water, mucus, and oil to name a few. While issues related to tear production directly impacts a dry eye diagnosis, a dry eye condition can also be caused by changes elsewhere in your body.

If you live with a health condition, your dry eyes may be linked. Conditions, such as the ones listed below, are all commonly associated with dry eye syndrome.

• Diabetes. This disease has been shown to cause changes in the nerve tissue. Tear secretion is controlled by conversations between the corneal nerves and the lacrimal gland nerves. This feedback loop becomes interrupted when peripheral neuropathy or diabetes-related nerve damage occurs, causing your eyes to become excessively dry.
• High blood pressure. With high blood pressure, dry eyes have more to do with the medications used to treat hypertension than with the actual disease process.
• Autoimmune diseases, such as lupus, rheumatoid arthritis, and Sjögren’s syndrome. With autoimmune disorders, the same autoantibodies that attack your joints can target your eyes – preventing normal tear production. We talk about each of these more in-depth below:
• Lupus. For someone who develops lupus, dry eye syndrome is the most common symptom they will experience. Dry eye disease develops in an individual with lupus because of autoimmune antibodies and immune system debris that build up in the eye tissues. This causes a dramatic reduction in the water component of the tears and instability problems with mucus production inside the tears.
• Rheumatoid arthritis. Several inflammatory conditions, such as scleritis and iritis, often develop with arthritis. These conditions can be painful and difficult to treat, resulting in an inflammatory component that may cause inflammatory cells and debris to build up in the lacrimal gland. This can change the eye’s surface, causing significant dryness that can lead to visual compromise and corneal scarring.
• Sjögren’s syndrome. This disease is a complex and chronic inflammatory ailment that causes dry eyes, dry mouth, joint pain, swelling, stiffness, swollen salivary glands, dry throat, coughing, ​and fatigue. The condition typically affects females more than males and tends to occur in the fourth and fifth decades of a person’s life. Most individuals develop dry eye symptoms long before a real diagnosis of Sjogren’s syndrome is made.

Homeopathic/natural treatment approaches for dry eye syndrome have been proven effective due to their ability to stimulate your eyes, helping them naturally produce more tears.

Homeopathic medicines for dry eyes stimulate the lacrimal glands and are able to produce more tears.

Some options include:

• Warm compresses with messaging
  Two times per day, apply a warm washcloth to the eyes and hold for five minutes, rewetting the cloth each time it cools. After about 10 minutes, gently rub the washcloth over your eyelids, including the base of the upper eyelashes.
• Artificial tears
  Artificial tears are eye drops used to lubricate dry eyes and help maintain moisture on the outer surface of your eyes. These eye drops can be used to treat dry eyes that result from aging, certain medications, medical conditions, eye surgery and environmental factors.
• Drink one gallon of water every day
  Like the rest of your body, your eyes need water to maintain their health. Water helps keep your eyes moist and produces healthy tears. Lack of tear production is a sign of dry eye syndrome, so drinking enough water is a simple way to manage your dry eye syndrome.
• Omega 3-fatty-acid pills
  These can be 2000mg and/or you can eat fish three times per week, like cold water salmon, trout, cod and other similar fish. In multiple placebo-controlled clinical trials, consuming fish oil was linked to significant improvement in dry eye syndrome symptoms and overall improvement in irritation.
• Nighttime mask for eyes
  Some people with dry eye syndrome use a dry eye sleep mask at night. It can work well for individuals with dry eyes who experience nighttime eye irritation due to leaking air from a CPAP machine (or similar device) as well as those who sleep under a fan or near a draft from an air conditioning unit that dries out the eyes at night.
• Treat allergies

It is estimated that nearly 50% of the population deals with dry eyes on a regular basis. While the condition can be caused by medical issues as well as environmental factors, it is good to know how to ease your pain and discomfort without the necessity of prescription medication.

Here are a few more natural remedies to try:

• Massaging lid devices
  Research has shown that eyelid massaging devices can improve symptoms of dry eye by enhancing stability and uniformity of the tear lipid layer. The device is designed to express the meibomian glands by a massaging, vertical motion, as a treatment for meibomian gland dysfunction and is meant to be used by individuals at home twice a day.
• Bead eye masks for heat massage therapy
  Eye inflammation from chronic dry eyes can cause the meibomian glands, which produce the oil in your tears, to get clogged. To relieve these symptoms, it is often recommended you use warm compresses or heated dry eye masks to thin the oil, loosening the clogs in your glands and allowing the oil to flow out of the glands and into the tear film.
• Place a humidifier in rooms where you’re spending more time
  Using a humidifier to add moisture to your environment can help with the itching and burning sensations associated with dry eye syndrome. Dry air can dry out your eyes but introducing moisture into the air and purifying it can keep your eyes from getting as irritated and dry.

Dry eye syndrome can become a serious quality of life concern if left untreated. Fortunately, treatment for dry eye is improving, which means your quality of life can improve, as well.

If you’re experiencing dry eye syndrome, schedule an appointment with us at iCare Vision to see if the following medications may be appropriate for you:

• Tobradex drops anti-inflammatory
  Tobradex eye drops are used to treat inflammation, corneal injury and bacterial infections in the external part of the eye. Before prescribing Tobradex, your eye doctor will have to examine your eyes to decide if the medication is right for you.
• Restasis/ xiidra drops
  Restasis is a medication that works to reduce inflammation in the tear glands, helping to prevent further damage. Some people also report recovered tear production after using this medication for long periods of time. This medication is also used to treat eye symptoms related to Sjogren’s syndrome.
• Oral doxycycline
  Recent studies have shown improvements in dry eye symptoms for individuals with chronic MGD who used refractory to conventional therapy, including warm compression, lid massage and topical antibiotic use, after ingestion of low-dose doxycycline.
• Punctual lid plugs
  These tiny plugs are about the size of a grain of rice and are inserted into the tear ducts of the eyelid to prevent tears from draining out of the eyes. The plugs force the liquid from tears to remain in the eyes, increasing the natural tear film and lubricating the cornea of the eye.

Good to know: In addition to antihistamines, high blood pressure medications – such as beta-blockers or diuretics – sleeping pills, anxiety medications, and other medications can cause dry eyes and lead to frustrating symptoms and irritabilities.

If you live with dry eyes, it’s always best to disclose all medications to your eye doctor so he/she knows all possible links and causes.

Schedule an appointment to discuss dry eyes (and related health conditions) with your eye doctor:

Laser treatments and therapy options effectively treat the underlying cause of meibomian gland dysfunction and dry eye syndrome, providing long lasting results for millions of people struggling with chronic dry eyes.

• Embryonic membrane therapy
  Embryonic membrane therapy has become a popular procedure in the last two decades. This treatment allows for a biological bandage to be applied to the ocular surface to promote surface reconstruction and healing.
• Laser PRK
  This type of laser surgery corrects refractive errors such as nearsightedness (myopia), farsightedness (hyperopia), astigmatism, or presbyopia (age-related farsightedness) and can help improve dry eye syndrome.
• New drugs coming on to the market
  For people frustrated with their current dry eye treatment options, hope is on the horizon. Innovative drugs for ocular surface diseases of all kinds, including dry eye, are showing promise in clinical trials. Eye doctors are optimistic about expanding their arsenal of treatment tools.