Dry eye occurs when there is a problem with our tear film. The tear film coats the surface of our eyes to provide nutrients, moisture, and comfort. A healthy tear film is composed of a good balance of aqueous tears, mucus, and oils. An imbalance in this composition can lead to the evaporation of tears and inflammation on the surface of the eye.

There are two types of dry eye: Aqueous deficient dry eye which is where you do not produce enough aqueous tears from your lacrimal gland, and evaporative dry eye which is where you do not produce enough oils from your eyelid’s meibomian glands. Most commonly, dry eye syndrome is caused by a combination of these two types.

What symptoms may you have with dry eye?

• Blurred or fluctuating vision

• Scratchy or sandy feeling in your eyes

• Heaviness or tired eyes

• Redness

• Burning, itching, stinging sensations

• Watery eyes

• Light sensitivity

• Contact lens discomfort or intolerance

What causes dry eye?

• Environmental and lifestyle factors: too much sun exposure, low humidity, lack of sleep, or reduced blink time due to increased screen time

• Certain medications: beta-blockers, diuretics, anti-anxiety medications, antihistamines, or acne medications

• Autoimmune diseases: thyroid disease, lupus, or Sjögren’s syndrome

• Diabetes

• Parkinson’s

• Age: the prevalence of dry eye increases with age, however, we are seeing younger patients with symptoms due to the higher demands of screen use today

But doc, my eyes water all the time, how can they possibly be dry?

This is one of the more common questions we hear. Watery eyes are a result of an over-production of tears. The eyes can sense a dry ocular surface and compensate by over-producing aqueous tears which are composed of mainly water and salt, but not oils. These watery tears overflow from the corners of the eye and may actually wash away some of the natural oils, resulting in stinging and burning eyes.

What can I do now to help with dry eyes?

• Stay hydrated

• Blink more frequently, and take frequent breaks from screen time and reading

• Start over-the-counter artificial tears 2 to 4 times per day. These tears have oils that try and mimic the natural tear-oil composition to coat the surface of the eye and lock in moisture

• Consider Preservative-free options if you want to use artificial tears more often than 4 times a day, or are not having relief with the preserved type

• Do not smoke

• Use a humidifier

• Be careful on using redness relievers, as they only constrict the blood vessels to reduce the appearance of redness in the eyes. They do not actually treat dryness

If you are unsure of which over-the-counter options to choose from, all of our offices are supplied with trusted products you can purchase.

When to see your eye doctor

If these initial treatments do not manage your symptoms, it is recommended you schedule an appointment with your eye doctor. You may have other associated eye conditions like meibomian gland dysfunction, blepharitis, ocular rosacea, and allergic conjunctivitis. Further over-the-counter treatments like warm compresses, lid sprays or scrubs, and fish oil supplements may be needed.

Additionally, stronger management options may be right for you, including prescription anti-inflammatory drops, oil gland expression, tear duct plugs, or intense pulsed light treatments.

Dry eye disease is very common, but treatable, and all of our doctors here at Arbor Eyecare are trained to treat dry eye. Call to schedule an appointment at any three of our offices to get the education and care you need.