Dry eye syndrome happens when the eye has trouble keeping moisture. This may be caused by a lack of tears or having tears that cannot moisturize the eye. It may also happen when tears leave the eye too quickly. Dry eye syndrome may also be called dry eye disease or keratoconjunctivitis sicca (KCS).
What causes dry eye syndrome?
- Dry or windy environments that cause tears to evaporate
- Conditions that decrease the amount of tears the eye glands make
- Eye diseases that cause inflammation of the surface of the eye or eye glands
- Chemical or thermal burns of the eye
What increases my risk for dry eye syndrome?
- Age older than 65
- Pregnancy or menopause
- Medical conditions such as Sjögren's syndrome, hyperthyroidism, or graft-vs-host disease
- Eye surgery such as LASIK, cataract surgery, or cosmetic surgery to lift the eyelids
- Certain medicines, such as Parkinson disease medicine, hormone replacement therapy, or blood pressure medicine
- Wearing contact lenses
What are the signs and symptoms of dry eye syndrome?
- Stinging, burning, or itching in one or both eyes
- Red or watery eyes
- Eye pain when you look at light
- Feeling like something is in your eye
- Blurry eyesight or loss of vision
- Not being able to cry or make tears when you are sad or upset
How is dry eye syndrome diagnosed?
Tell your healthcare provider about your symptoms and any medicines that you take. Your healthcare provider will use a microscope to examine your eyes for swelling or injury. He will also look for problems with the glands that make tears. He may measure the amount of moisture in your eyes with a tiny test strip.
How is dry eye syndrome treated?
Your healthcare provider may change the type of contact lenses that you wear. You may need to stop wearing your contact lenses. Your healthcare provider may stop or change medicine that is causing your dry eyes. You may also need any of the following:
- Medicine may be given to decrease pain or swelling, or treat an eye infection. You may also need medicine to increase the amount of tears your eye makes. These medicines will be given as eyedrops.
- Lacrimal plugs can be placed into your lacrimal gland. Your lacrimal gland is where tears drain from your eyes to your nose. Plugs prevent tears from leaving your eyes. This may also prevent dry eye.
- Surgery may be needed if other treatments do not work. Surgery can be done to permanently close your lacrimal glands. This will prevent tears from leaving your eyes. This may also prevent dry eye.
What can I do to manage my symptoms?
- Use artificial tears, gels, and lubricating ointments as directed. They are available without a doctor's order. These products can replace tears and help add moisture to your eyes. Ask your healthcare provider how often to use these products. Also ask where to buy them.
- Apply a warm compress to your eyelids as directed. Use a soft washcloth soaked in warm water. Leave the compress on your eyelids for 5 minutes. Gently massage your eyelids after you remove the compress. These actions may help open your tear glands. Your tear glands can make oil that will help keep tears and moisture on the eye's surface.
- Wear glasses or sunglasses that cover the sides of your eyes and fit close to your face. These will protect your eyes from dry air. They may also help keep moisture in your eyes.
- Use a humidifier in your home. A humidifier may help keep moisture in the air and prevent dry eyes.
- Take vitamins and supplements as directed. Certain vitamins and supplements may help decrease eye dryness. Examples include fish oil and vitamin A. Ask your healthcare provider what supplements you need and how often to take them.
Eat foods with high amounts of omega-3 fatty acids. Examples include salmon, tuna, walnuts, and flaxseeds. Omega-3 fatty acids may help relieve dry eyes. Ask your healthcare provider for a list of foods that contain fatty acids and how much you should eat each day.
- Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung damage. Smoke from cigarettes and cigars can make dry eyes worse. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
When should I contact my healthcare provider?
- Your dry eyes do not get better with treatment or get worse.
- You have thick, yellow drainage from one or both eyes.
- Your eyelids or skin around your eyes is red and swollen.
- You have changes in your vision.
- You have questions or concerns about your condition or care.
The two most common methods of treatment are to replace tears or to conserve them. In most cases, you can use artificial tears, which mimic the composition of natural tears, and are available over the counter. Lubricating ointments can be used for more severe cases, but they tend to blur vision and so should be applied at bedtime.
If these do not relieve the symptoms, your doctor may try to conserve tears by plugging the tear drain holes, called puncta, with tiny plugs made of collagen or silicone. In the worst cases, the holes can be closed permanently using electric cauterization.