Dry eye is a condition in which the tear film fails to adequately cover the front surface of the eye, leading to areas of desiccation. Symptoms include unstable vision (blurring), stinging, burning and tearing (reflex tearing which occurs in response to irritation). A healthy tear film is important for preserving clear and stable vision, fighting infection, maintaining tolerance of contact lens wear and promoting a healthy ocular surface. In a general sense the tear film is made up of a watery layer (produced by the lacrimal gland) and an oily layer (produced by oil glands in the eyelids) and a mucous layer (produced by cells on the ocular surface). The oil sits on top of the watery layer to minimise evaporation, and the mucous layer promotes the spreading of tears across the ocular surface. Thus the two main mechanisms for dry eye are 1) inadequate production of the watery layer and/or 2) evaporative loss of tears due to impaired production of the oily layer.
Common causes include decreased tear production due to aging, certain medications and systemic diseases, menopause and loss of nerve supply to the front surface of the eye (e.g. through trauma). Evaporative loss of tears is exacerbated by eyelid infections (e.g. blepharitis), inflammation of the ocular surface (e.g. conjunctivitis), air conditioning and poor oil quality. Other contributing factors include abnormal blinking and/or decreased blink rates (occur whilst reading or staring at computer screens).
Treatment depends on the cause. Often there is no cure and treatment regimens are ongoing. Some handy hints to remember:
Artificial tear supplements replenish the ocular surface and offer symptomatic relief. Non-preserved varieties are ideal.
Ocular surface inflammation or lid disease (Blepharitis) should be treated appropriately and treatment is usually ongoing. Your optometrist can advise you on appropriate management.
Omega-3 supplements (fish oil, krill oil, flaxseed oil etc) have anti-inflammatory properties and may aid the quality of oil secretions.
Wearing spectacles whilst in air conditioned environments helps to prevent tear evaporation.
Inform your optometrist of any new medications or diagnoses of systemic disease.
If you think you may be suffering from dry eye, consult your optometrist for a comprehensive eye exam to find out the best treatment options for you.
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