Dry eye disease is a common condition wherein the eyes are unable to remain wet. This can cause the eyes to feel uncomfortable and may result in vision problems. Currently, there is no permanent cure for dry eye, but there are a number of options to manage and reduce the symptoms.
According to the American Academy of Ophthalmology (AAO), dry eye is more common in older adults and affects roughly 4.88 million people aged 50 years and older in the United States. Of these, over 3.2 million are females, and 1.68 million are males.
However, it can occur at any age, with the National Eye Institute estimating that nearly 16 million U.S. individuals have dry eye.
Many factors can contribute to dry eye, such as the tears drying too quickly, the body not producing enough tears, eyelid problems, the use of certain drugs, and some environmental factors.
Typically, treatment involves using eye drops or another medication to keep the eyes moist.
This article will discuss the causes and symptoms of dry eye disease and how people can manage the condition with medication and natural alternatives.
What is dry eye disease?
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Dry eye disease, also known as dry eye syndrome or keratoconjunctivitis sicca, occurs when the eyes do not stay wet due to problems with the tears. This may cause the eyes to become drier, which can lead to discomfort and, in some cases, result in problems with vision.
In one 2017 report, the researchers recognized that dry eye is a disease of the surface of the eyes, with many factors contributing to the condition. In particular, the authors note that dry eye is the result of the tear film not working optimally.
The tear film protects and lubricates the surface of the eye and is important for good vision. It has three layers:
- Outer layer: This layer is oily, reduces tear evaporation, and helps spread the tear film across the surface of the eye.
- Middle layer: This watery layer is a large constituent of tears. It helps wash away foreign objects such as grit.
- Inner layer: This sticky layer coats the cornea and helps spread the watery layer. It also helps keep the tear film stuck to the surface of the eye.
Blinking spreads tears across the eyes, which then drain into the nose. Several glands and systems are involved in keeping the tear film in its optimal state.
Some research suggests that dry eye disease occurs when the tear film is no longer in a state of equilibrium. This can happen if the body does not produce enough tears, for example, or if one of the tear layers does not work or spread out properly.
Is there a permanent cure for dry eye disease?
Currently, there is no permanent cure for dry eye disease. However, a number of options can help maintain moisture in the eyes. These can reduce symptoms and protect vision.
The management of dry eye disease centers on removing or minimizing environmental triggers and maintaining an adequate and functional tear film on the surface of the eyes.
If there is a single underlying cause that a doctor can treat or remove, the symptoms should resolve. However, it is also worth noting that dry eye disease is part of the normal aging process.
Symptoms of dry eye
Symptoms of dry eye can include:
- a stinging or burning feeling in the eyes
- a feeling of pressure in the eyes, or a feeling that something is in them
- redness
- blurred vision or sensitivity to light
- difficulty or discomfort when opening the eyes
Common causes of dry eye
Normally, the glands above the eyes that produce tears keep the eyes wet. Dry eye is usually the result of tears not working correctly. For example, this could either mean that tears are evaporating too quickly or that the quality of tears is poor.
Females are more likely to have dry eye disease. This is due to hormonal changes that can affect tear production. People’s bodies also tend to make fewer tears as they age, so dry eye disease is also more common in older adults.
Some other risk factors or common causes of dry eye disease may include:
- some skin conditions on or near the eyelids
- deficiency in vitamin A or omega-3 fatty acids
- laser eye surgery
- wearing contact lenses
- spending a long time looking at screens, as this can reduce blinking
- allergies that affect the eyes
- some long-term conditions, such as diabetes and Sjögren’s disease
- the gland that produces the oily layer not operating properly
- environmental factors such as smoke, wind, or dry air
- some medications, including treatments for depression and high blood pressure
Dry eye diagnosis
A doctor can check for dry eye as part of a comprehensive eye exam. This involves the doctor administering eye drops then checking eye health.
The exam could be one of the following:
- Slit lamp test: The doctor will use a microscope to see if the eyes are producing enough tears.
- Schirmer’s test: The doctor will use a small piece of paper to measure how moist the eyes are.
- Tear breakup time: The doctor will use this test to check how long the tear film remains after a person blinks.
Treatments for dry eye
Doctors may recommend or prescribe different treatments for dry eye disease depend on the underlying cause(s) and the severity of the symptoms.
Some options may include:
- Artificial tear solutions: These are common eye drops that people can buy over the counter without a prescription. These are the most common dry eye treatment, and doctors will usually recommend them first.
- Moisturizing gels or ointments: Instead of eye drops, a doctor may suggest over-the-counter gels or ointments to help the eyes feel better.
- Prescription eye drops: In more serious cases, a doctor may prescribe cyclosporine (Restasis, Cequa) or lifitegrast (Xiidra) eye drops to help increase tear production.
- Punctal plugs: These special plugs go in the openings of the tear ducts, which are called puncta. They can help relieve dry eye by keeping tears in the eye for longer.
- Surgery: In rare cases, a doctor may suggest surgery to tighten the lower eyelids and help the eyes retain tears.
- Changing medication: If a medication that a person is taking for another health condition is causing dry eye, a doctor may suggest changing to a different medication.
Self-care for dry eye
Similarly, depending on the possible cause(s) of dry eye, there are a range of self-help remedies or preventive measures to try.
These include:
- soothing inflamed eyelids with warm compresses, eyelid massages, or eyelid cleaners
- getting adequate sleep
- drinking plenty of water
- using a humidifier
- avoiding smoke, wind, air conditioning, and dry environments, if possible
- wearing wraparound sunglasses while outdoors
- reducing screen use, taking breaks, and remembering to blink
- consuming more vitamin A or omega-3 fatty acids through one’s diet or by taking supplements
Summary
Dye eye disease is a common condition, with research estimating that it can affect 5–50% of people in a population at any one time.
Multiple factors may contribute to the development of dry eye disease. People can try to manage the condition by minimizing any contribution from the environment, treating the symptoms, and aiming to increase tear production or retention.
Currently, there is not a permanent cure for this condition. However, people can use a variety of treatments and home remedies to reduce or manage the symptoms and protect their eye health and vision.
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