When the topic of vision problems comes up in a conversation, chances are people will talk about the gritty and uncomfortable condition known as dry eye. Fortunately, thanks to advance in medicine and treatment, there is help available for people plagued by this condition. 

Tears are necessary for maintaining the healthy front surface of the eye and providing clear vision. Clinically speaking, dry eye is a condition where a person doesn’t have enough quality tears to lubricate and nourish the eye. Dry eye is a common and often chronic problem, particularly in older adults.

Basically, people with dry eyes either do not produce enough tears or their tears are of a poor quality. For those suffering from:

Inadequate amount of tears. Tears are produced by several glands in and around the eyelids. Tear production tends to diminish with age, with various medical conditions, or as a side effect of certain medicines. Environmental conditions — such as wind and dry climates — can also contribute to increased tear evaporation. When the normal amount of tear production decreases or tears evaporate too quickly from the eyes, symptoms of dry eye can develop. 

Poor quality of tears. Tears are made up of three layers: oil, water, and mucus. Each component protects and nourishes the front surface of the eye. A smooth oil layer helps prevent evaporation of the water layer, while the mucin layer spreads the tears evenly over the surface of the eye. If the tears evaporate too quickly or do not spread evenly over the cornea due to deficiencies with any of the three tear layers, dry eye symptoms can develop. The most common form of dry eyes occurs when the water layer of tears is inadequate. This condition, called keratoconjunctivitis sicca, is also referred to as dry eye syndrome.

People with dry eye may experience irritated, gritty, scratchy, or burning eyes; a feeling of something in their eyes; excess watering; and blurred vision. Advanced dry eyes may damage the front surface of the eye and impair vision. 

Treatments aim to restore or maintain the normal amount of tears in the eye to minimize dryness and related discomfort and to maintain eye health.

What causes dry eyes?

Dry eyes can develop for many reasons, including: 

  • Age. Dry eyes are a part of the natural aging process. The majority of people over the age of 65 experience some symptoms. 
  • Gender. Women are more likely to develop dry eyes due to hormonal changes caused by pregnancy, the use of oral contraceptives, and menopause.
  • Medications. Certain medicines — including antihistamines, decongestants, blood pressure medications, and antidepressants — can reduce tear production.
  • Medical conditions. People with rheumatoid arthritis, diabetes, and thyroid problems are more likely to have symptoms of dry eyes.
  • Environmental conditions. Exposure to smoke, wind, and dry climates can increase tear evaporation. Failure to blink regularly — staring at a computer screen for long periods of time, for example — can also contribute to dry eyes.
  • Other factors. Long-term use of contact lenses can be a factor. Refractive eye surgeries, such as LASIK, can decrease tear production and contribute to dry eyes. 

How are dry eyes diagnosed?

 Dry eyes can be diagnosed through a comprehensive eye examination. Testing — with emphasis on the evaluation of the quantity and quality of tears produced — may include:

  • Patient history to determine symptoms and note any general health problems, medications, or environmental factors.
  • External examination of the eye, including lid structure and blink dynamics.
  • Evaluation of the eyelids and cornea using bright light and magnification.
  • Measurement of the quantity and quality of tears for any abnormalities. Special dyes may be put in the eyes to better observe tear flow and highlight any changes to the outer surface of the eye caused by insufficient tears.

With the information obtained from testing, your optometrist can determine if you have dry eyes and advise you on treatment options.

How are dry eyes treated?

Dry eyes can be a chronic condition, but as an optometrist, I can prescribe treatment to keep your eyes healthy and comfortable and to prevent your vision from being affected. 

The primary approaches used to manage and treat dry eyes include adding tears using over-the-counter artificial tear solutions, conserving tears, increasing tear production, and treating the inflammation of the eyelids or eye surface.

Adding tears. Mild cases of dry eyes can often be managed using over-the-counter artificial tear solutions. These can be used as often as needed to supplement natural tear production. People with dry eyes that don’t respond to artificial tears alone will need to take additional steps to treat their dry eyes. 

Increasing tear production. An optometrist can prescribe eye drops that increase tear production. Taking an omega-3 fatty acid nutritional supplement may also help.

Remember, there is hope for people who are dealing with dry eye. Please feel free to contact me so we can help you see clearly and comfortably. 

Dr. Carlton Hicks is a past president of the 700-member Georgia Optometric Association and a past recipient of GOA’s prestigious Optometrist of the Year Award. Committed to staying abreast of developments in research and education that enable him to protect the vision and eye health of his patients, Dr. Hicks is also a past winner of the SECO International Optometrist of the Year Award. Contact Dr. Hicks of Coastal Eye Care, 312 Redfern Village, St. Simons Island, Georgia 31525 at 912-638-8652 or on Facebook.