Atrium Health Navicent Ophthalmology Macon

Dry Eye Symptoms, Causes, and Treatment

Doctor examines a young woman's eyes

Most of us have suffered from dry eyes at some time in our lives. With the demands, we put on our eyes with computers, tablets, and cell phones; it can be a common occurrence. The most common symptoms of dry eyes include:

  • Stinging, burning, gritty, or scratchy feeling
  • Sticky mucus in your eyes or lashes
  • Sensitivity to light
  • Difficulty driving at night
  • Blurred vision
  • Watery eyes

To understand the causes of dry eyes, it may help to know a little about the eye's natural lubrication: human tears. The purpose of tears is to keep the eye moist and wash away dust and debris.

Tears are made of three layers each of which has an important function. The outer layer, made of oil produced by the Meibomian glands in the eyelids, works to smooth the tear surface and reduce the evaporation of tears. The middle, watery layer cleanses the eye and washes away foreign particles. The inner layer is made of mucus and allows the watery layer to spread evenly over the surface of the eye to help the eye remain moist.

One reason for chronic dry eyes is aqueous tear-deficient dry eye due to a decrease in tear production. Common causes of this decrease are:

  • Aging
  • Medical conditions: diabetes, rheumatoid arthritis, lupus, scleroderma, Sjogren's syndrome, thyroid disorders and vitamin A deficiency
  • Medications such as antihistamines, decongestants, hormone replacement therapy, antidepressants, and drugs for high blood pressure, acne, birth control and Parkinson's disease
  • Laser eye surgery, although this is usually temporary
  • Damage to tear glands from inflammation or radiation

Another cause is evaporative dry eye caused by inflammation of the glands that produce the oil layer of tears. When this layer is missing, tears become unstable and evaporate too rapidly.

An ophthalmologist through an examination usually diagnoses dry eyes. Sometimes, however, further testing is necessary. A test called the Schirmer tear test entails placing filter-paper strips under the lower eyelids to measure the rate of tear production under a range of conditions.

Another way your ophthalmologist can diagnose dry eye is by putting special dye drops in the eye to study how long it takes the cornea to develop dry spots. The dye test is also be used to look for staining patterns that show any damage to the cornea's surface.

Once diagnosed, the first step your doctor may advise for chronic dry eye treatment is over-the-counter artificial tears, gels, and ointments. These can help relieve symptoms and provide an important source of tears, especially in people with low tear production. Keeping the air in your home moist using a humidifier is also helpful. Wrap-around sunglasses to help decrease tear evaporation and warm, moist eye compresses to stimulate oil production are useful to those with too little oil in their tears. Your doctor could also recommend taking supplements of omega 3 fatty acids, which might also provide dry eye relief.

Should these efforts prove to offer little relief; your doctor can discuss some other dry eye treatment options such as prescription medication. Cyclosporine is a prescription drug available to treat dry eye. It reduces corneal damage, increases tear production, and helps with symptoms of dry eye. Cyclosporine could take three to six months to reach full effectiveness. Steroid eye drops can also be prescribed, but are usually not recommended for long-term treatment. Now there is another prescription medication on the market called Lifitegrast ( Xiidra). Xiidra is the first prescription eye drop approved by the FDA for both the signs and symptoms of dry eye disease.

Conserving your own tears, either temporarily or permanently, is another approach to dry eye treatment. We have small openings in the inner corners of our eyelids through which our tears drain. The doctor can insert lacrimal or punctal plugs into these openings preventing the tears you have from draining. The plugs are considered temporary, as they are removable. Your doctor may choose to block the drains permanently through punctal cauterization using heat to seal them closed.

Do not let your dry eye symptoms persist without relief. See an ophthalmologist for a professional evaluation to determine the best course of treatment for your dry eyes.