Dry Eye Disease is a disorder of the tear film, caused either by a low tear production or excessive evaporation or both.
• Ocular discomfort – stinging, burning, itching, sandy, gritty or foreign body sensation “as if there is something in the eye”.
• Fluctuating vision – becomes clear and then blurry often improving with blinking or the use of artificial tears for a short period of time.
• Watery Eyes – Many patients with Dry Eye complain of the excess tearing. This is a natural response of the eye to a poor tear film. In that case, the problem is not the quality of the tears.
• Red Eyes – Sometimes patients however will notice red eyes on awakening or later in the day while “staring” (watching TV, reading, computer use).
• Eyelid Disease – Patients with Dry Eye Disease frequently have a second condition affecting the eyelid margin called Blepharitis – an inflammation of the eyelids. There may be symptoms of crusting, red rimmed eyes, loss of eyelashes or less obvious changes affecting the meibomian glands of the eyelids (small glands that produce the oily of the tears which decreases evaporation). Inflammation affecting these glands results in an abnormal quality and quantity of the lipid layer of the tears leading to increased tear evaporation and symptoms of dry eye.
• Allergies – patients with Dry Eyes may also have allergies affecting the skin or their eyes with itching being a major complaint. These allergies may be seasonal or last throughout the year.
• Artificial tears – These can help supplement the tears you make and prevent the surface of your eye from drying out more. Some patients with severe allergies may find that they are sensitive to the preservatives in most artificial tears supplements and will find more relief with preservative-free artificial tears.
• Goggles – Patient with severe Dry Eye Disease find that the smallest breeze outdoors aggravates their condition and can find comfort with wraparound sunglasses to shield the eyes. They may find relieve in wearing specialty goggles that seal around the eyes and look like regular sunglasses.
• Life Style Changes
o A diet rich in omega-3 fatty acids may improve functioning of the lipid glands and help to reduce the progression of dry eye disease.
o Reading, computer use and other tasks requiring concentrated vision decrease the blink rate so limiting time to perform these tasks is helpful.
• Warm Compresses – Compresses improve the circulation to the eyelids and can liquefy the lipids produced by the meibomian glands improving symptoms. Use either a warm damp facecloth or a microwaveable hot pad (wrapped in a damp tea towel) and place over both eyes for 10-15 minutes once or twice a day. Follow with gentle massage of the eyelids both upper and lower to improve the quality of the tear film. Make sure the compresses are warm as possible without burning the skin.
• Punctual Occlusion – Blocking one or more of the puncta (small openings in the corners of the eyelids near the nose, through which tears drain away) may improve the lubrication of the eye by keeping tears/tear supplements on the surface of the eye and reducing the drainage of tears into the nose.
As a patient with Dry Eye Disease you must understand that most of the options available to you are meant to control your disease not cure it. For many patients these treatments are quite successful if you continue them. This will be a lifelong issue for you and with your help your doctor will be able to establish a regimen that will provide you with optimal results.