We do not only cry when we are sad: we continuously produce tears to moisten our eyes constantly, to clean them and protect them from foreign bodies. These tears or tear film is a complex mixture of water, fatty acids, proteins, electrolytes, and antibacterial substances. This mixture keeps the surface of the eye clean and clear and prevents infections. Without tears, good vision would be impossible.
The syndrome of dry eye is usually due to a decrease in the secretion of tears or an imbalance between the various elements of the component, which can cause an increase in evaporation. In either case, ocular discomfort ensues and ulceration of the cornea results. It is estimated that 30% of optometry consultations involve, to varying degrees, dry eye syndrome.
Dry eye syndrome can also be the result of an eye blinker problem, or blepharitis, inflammation of the eyelid edge that alters the composition of the tears, increasing their evaporation. It follows a sensation of dryness and irritation.
Sometimes the tear glands react to dry eye, causing over-production of tears with paradoxical tearing. However, if the eye is dry, it is because these tears contain a lot of water and few fatty acids and mucus. They fail to keep the eye moist enough.
A dry eye is less well protected against pathogens. It is, therefore, more likely to present infections, the inflammations of the irritation or ulceration of the cornea.
When to consult?
Consult an optometrist, ophthalmologist or doctor if you experience prolonged eye discomfort. Remember that your eyes are precious.
Symptoms of Dry eye syndrome
In general, both eyes are affected by dry eye syndrome. The symptoms are as follows:
- the feeling of sand in the eye,
- eye discomfort,
- light burns;
- blurred vision in a fluctuating way;
- eye strain;
- mucus around the eyes;
- difficulty wearing contact lenses
- Sensitivity to light, wind, cold, smoke, etc.
- itching in the eyes
- and sometimes red eye (but not always)
- excessive tearing,
- want to close your eyes
There are sometimes dry eye or eye discomfort when the eye is not really dry. To objectify the dry eye, the doctor can do the Schirmer test consisting of placing a special paper towel at the corner of the eye for 2 minutes and measuring the length of paper impregnated with tears.
Risk factors for Dry eye syndrome
Several factors can influence the risk of suffering from dry eye syndrome:
- Age. As you get older, the tear glands do not produce enough tears or provide poor tears that cause dry eyes. Many people over the age of 60 have problems with dry eyes.
- Female sex: Women are twice as likely to have dry eyes as men.
- Hormonal changes. Women are more likely to suffer from the dry eye than men, especially during pregnancy or after menopause.
- Drugs. Some medications may cause dry eye, such as birth control pills, antidepressants, analgesics, anticonvulsants, antihistamines, decongestants, diuretics, angiotensin-converting enzyme inhibitors, sleeping pills, anti-acne drugs (Roaccutane) etc.
- Work in front of a screen. The work on the screen is associated with a decrease in the frequency of flutter of the eyelids, mechanism moistening the eye. Less blinking causes dry eyes and the accompanying feeling of irritation.
- Environment. Air pollution, cigarette smoke, dust, air conditioning, wind, pollution, can cause dry eye.
- Refractive surgery (LASIK). Laser treatment often results in a transient dryness that can last from 6 months to 12 months.
- Sjögren’s syndrome or dry syndrome. This autoimmune disease affects the salivary glands of the mouth and the lacrimal glands of the eyes, causing dryness of the mucous membranes.
- Other diseases, such as rheumatoid arthritis, Bell’s palsy, diabetes, and thyroid diseases can cause dry eye. Infectious conjunctivitis can also cause a temporary dry eye after healing, as allergic conjunctivitis or rosacea of eyelids.
One can help prevent dry eye syndrome by adopting certain habits:
- Avoid getting air directly in the eyes.
- Use a humidifier.
- Lower the heating.
- Wear sunglasses outdoors.
- Reduce the number of hours you wear contact lenses.
- Avoid smoking.
- Avoid polluted atmospheres,
- Take regular breaks during prolonged work at the computer, or while reading, looking a few seconds off and blinking.
- Read the leaflet of the drugs that you consume and ask the doctor if it is possible to replace them when they can cause dry eyes.
- Wear goggles to protect the eye from the harsh environment and maintain high humidity in the eye.
- Never go to the pool without wearing goggles because chlorine is irritating to the eyes.
Medical treatments of Dry eye syndrome
– The simplest and fastest initial treatment to relieve is the use of eye drops or artificial tears (moistening eye drops) that compensate for the deficit of tears. This approach usually provides relief for mild cases of dry eyes. A doctor or optometrist may recommend the appropriate type of drops, as the case may be because not all drops are equal. Some, such as saline, contain only water and mineral salts, while the tear film also contains lipids (lubricating greases). Lubricant gels provided against dry eye are therefore more effective.
– The re-education of the blinking of the eyes is simple, but sometimes very useful.
– Azithromycin, an antibiotic eye drops is likely to improve dry eye, not an antibiotic effect, but probably an anti-enzymatic effect to improve the quality of secretions. The dose is 2 drops a day for 3 days, 2 to 3 times a month.
Some oral antibiotics may also be used for the same purpose (azithromycin, doxycycline, minocycline, lymecycline, erythromycin, and metronidazole).- In some cases, anti-inflammatory drugs may have an interesting effect, corticosteroids, ciclosporin eye drops,
– The use of wet-chamber heating goggles improves dry eye (Blephasteam) may be proposed by the ophthalmologist.
– It can also prescribe scleral lenses to keep the cornea moist permanently.
– A new technique can cure some dry eye, those where the lipid film is no longer sufficiently produced by the Meibomian glands. It may be sufficient to warm the eyelids with warm compresses and then massage them daily, which stimulates or opens these glands. There are devices (lipiflow) used by ophthalmologists to heat the inside of the eyelids and massage them while protecting the surface of the eye. This method stimulates these glands resulting in better eye comfort and a decrease in the need for artificial tear film. The effectiveness of this treatment is about 9 months and it is still expensive.
Ophthalmologists can also perform meibomian gland probing and unblocking with single-use probes (Maskin probes)
– It is also possible to install microscopic silicone tear plugs in the tear-off holes in order to increase the amount on the eye. It is sometimes helpful to consider cauterizing the tear-off holes.
Sea buckthorn oil through oral. With 1 gram of this oil morning and evening capsules, in three months was observed an improvement of the dry eye symptoms compared to a placebo, especially the redness of the eyes and the sensations of burns and the ability to wear lenses of contact.
Omega-3’s associated with antioxidants: 3 capsules daily for 12 weeks of a dietary supplement containing omega-3s and antioxidants brought improvement to dry eyes. Antioxidants were vitamin A, ascorbic acid, vitamin E, zinc, copper, magnesium, selenium, and amino acids, tyrosine, cysteine, and glutathione.