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Dry eyes: Causes, Symptoms, and Treatments

  • Dry eyes can happen when tears evaporate too quickly, or if the eyes produce too few tears. It is common in humans and in some animals. It can affect one or both eyes, and it can lead to inflammation.
  • Dry eye syndrome can occur at any age, and in people who are otherwise healthy. It is more common with older age, when the individual produces fewer tears. It is also more common in women than in men.
  • It is more common in places where malnutrition results in a vitamin A deficiency.

Causes:

  • The eyes produce tears all the time, not only when we yawn or experience emotion. Healthy eyes are constantly covered with a fluid, known as a tear film. It is designed to remain stable between each blink. This prevents the eyes from becoming dry and enables clear vision.
  • If the tear glands produce fewer tears, the tear film can become unstable. It can break down quickly, creating dry spots on the surface of the eyes.
  • Tears are made of water, fatty oils, protein, electrolytes, substances to fight off bacteria, and growth factors. The mixture helps keep the surface of the eyes smooth and clear, so that we can see properly.

Dry eyes can result from:

  • An imbalance in the tear mixture, so that it evaporates too fast
  • Insufficient tear production for good eye health

Other causes include eyelid problems, some drugs, and environmental factors.

Symptoms:

A patient with dry eye syndrome may experience a range of symptoms, including:

  • A stinging or burning sensation, and a feeling of dryness, grittiness, and soreness in the eyes
  • A feeling like sand in the eye
  • Stringy mucus in or around the eyes
  • Eye sensitivity to smoke or wind
  • Redness of the eyes
  • Difficulty keeping the eyes open
  • Eye fatigue after reading, even for a short time
  • Blurred vision, especially towards the end of the day
  • Sensitivity to light
  • Discomfort when wearing contact lenses
  • Tearing
  • Double vision
  • Eyelids sticking together when waking up

Some people find the pain very strong, and this can lead to frustration, anxiety, and difficulty functioning in daily life.

Complications may include a worsening of eye redness and light sensitivity, increasing painful eyes, and deterioration of eyesight.

Treatments:

  • A doctor will do a physical examination and ask the patient about symptoms, their medical history, any current medications, and about their occupation and personal circumstances.
  • Tests can reveal the quantity of tears behind the eyelid, whether the tear film is functioning properly, and the rate of evaporation.

Treatment aims to keep the eyes well lubricated, but the approach depends on the underlying cause.

Three ways of keeping the eyes lubricated are:

  • Making the most of natural tears
  • Using artificial tears or eye drops
  • Reducing tear drainage

Surgery

Eyelid problems, such as an incomplete blink, may be treated by an oculoplastic surgeon, who specializes in eyelid problems.

In more severe cases, tear ducts, which drain away the tears, may be deliberately blocked, partially or completely, to conserve tears. Silicone plugs can be placed in the tear ducts to block them. This helps keep both natural and artificial tears on the eyes for longer.

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