Dry eye disease is defined as a ‘multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and subacute inflammation of the ocular surface’. 

Essentially, it’s when the eye doesn’t produce enough tears, when they evaporate too quickly, or when there’s an abnormality in the production of mucus or lipids normally found in the tear layer 

Dry eye is a common condition that occurs when the eye does not produce enough tears, when tears evaporate too quickly, or if there is an abnormality in the production of mucus or lipids normally found in the tear layer. 

A chronic disease, dry eye is more common in older adults but can occur at any age and the National Eye Institute NIH warned that patients that suffer from dry eyes find it more difficult to perform certain activities, such as being on a computer or reading for prolonged periods of time. Suffering from dry eyes can decrease tolerance for dry environments.  

Although permanent loss of vision from dry eye is uncommon, ophthalmology specialists, doctors Anushree Sharma and Holly Hindman explained in Aging: A Predisposition to Dry Eyes (published in Journal of ophthalmology Vol. 2014) that, “patients with dry eye experience blurred vision, foreign body sensation, pain, injection, epiphora, and, in severe cases, loss of vision. While high-contrast visual acuity may not be affected or may be only minimally reduced, individuals with dry eye can suffer from discomfort and/or functional vision changes that can be debilitating. 

CAUSES 

Dry eye can be a temporary or chronic condition caused by a number of different factors, including: 

Age: Dry eyes are a part of the natural aging process. The majority of people over age 65 experience some symptoms of dry eyes. 

Gender: Women are more susceptible to develop dry eyes due to hormonal changes that are caused by pregnancy, the use of oral contraceptives, and menopause. 

Medication: Certain medicines including antihistamines, decongestants, blood pressure medications, and antidepressants, can reduce tear production. 

Medical conditions: People with rheumatoid arthritis, diabetes, thyroid problems are more likely to have symptoms of dry eye. Dry eye can be associated with immune system disorders such as Sjögren's syndrome, lupus, and rheumatoid arthritis. Both excessive and insufficient dosages of vitamins can contribute to dry eye. 

Environmental conditions: Exposure to smoke, wind and dry climates can increase tear evaporation resulting in dry eye symptoms. 

Other factors: Long-term use of contact lenses, infrequent or incomplete blinking, laser and cataract surgery, and any trauma to the eye. 

TREATMENT  

Artificial tears: Patients with mild to moderate cases of dry eye syndrome can usually be, successfully treated using eye drops that contain artificial tears, a liquid that is designed to mimic the properties of tears. Artificial tears that have a high viscosity are more gel-like and can provide longer-lasting lubrication. 

Steroid eye drops: Over the past year’s inflammation has been recognised as a significant cause of dry eye. Steroid eye drops are used to help patients manage the underlying inflammation associated with dry eye. Steroid eye drops are generally used as a short-term treatment to quickly manage symptoms. 

Punctal plugs: Used to treat dry eyes by helping tears remain on the surface of the eye for longer, a punctal plug is a small sterile device that is inserted into the eye’s tear duct and prevents tears from being drained. This results in tear film remaining intact longer on the surface of the eye thus relieving dry eye symptoms. 

Ointment: When a patient is asleep, if their eyes don’t fully close the tears can evaporate which leaves their eyes very dry once they wake up. Ointments help stop the eyes from drying out overnight and are usually used before bedtime because they are sticky and cause blurry vision. 

Other treatment options: 

• Remember to blink often when using a computer, watching television, and reading. 
• Avoid dusty, windy, and smoking areas, and make use of wrap-around glasses when exposed to these environments. 
• Include flax seed and foods that contain omega 3 and 6 such as oily fish, nuts, and eggs into daily diet. 

If a patient wears contact lenses, they may need a break from wearing contact lenses if they experience dry eyes or explore different types of lenses which may be more suitable for dry eye.