DRY EYE: CAUSES AND MANAGEMENT
Dry eye is also known as Keratoconjunctivitis sicca. It is a common condition that occurs when there is a homeostatic imbalance with the tear film above the ocular surface of the eyes causing either a reduction in tear production or an accelerated tear evaporation. There are many factors that can make one susceptible to this condition which will be discussed as we move further in this text. Dry eye symptoms can range from as mild as just a sandy sensation and tearing to as severe as corneal ulcer or even blindness in worse cases.
The following are some of the things an individual experiencing dry eye may complain of:
- Eye irritation in form of sandy or peppery sensation (a common symptom of dry eye).
- Tearing as the eyes negative feedback to contain the situation.
- Blurry vision in some cases
- Light sensitivity may be present.
Causes of Dry Eye
The primary causes of dry eyes are:
- Reduction in Tear Production
The tear film is a tiny film that covers the outer surface of the eyes that keep the eyes moist and is usually replaced with each blink that we make. The film consists of three major layers, the outer lipid layer (which is makes up the oily component of our tears), the middle aqueous layer (which is the water component) and the inner mucus layer (which consists of sebum). Any threat to the glands producing these components can cause a deficient, which can result in dry eyes.
- Accelerated Tear Evaporation
A deficient in the adequate supply of any of the tear film components will also cause the tears to evaporate faster, which can also present symptoms of dry eyes.
The other risk factors that expose one to dry eye syndrome includes:
- Environmental factors such as exposure to dry humidity, smoke, wind, or dust.
- Heat emitting devices such as heavy plants are used in food processing companies and construction companies.
- Overtime exposure to computer screen. This reduces blinking rate and will in turn cause eye discomforts.
- Age factor: individuals above 50years are more prone to this condition. This is because our eyes naturally reduce their ability to produce tears with age.
- Females are more prone to the condition than males. This is due to different hormonal changes that females undergo, from menstruation to pregnancy to childbirth to menopause.
- Side effects of some medications like birth control pills, antidepressants, antihistamines, carbonic anhydrase inhibitors, etc.
- As a secondary condition to systemic diseases such as: diabetes, thyroid disease, rheumatoid arthritis, etc.
- May also be experienced in individuals with pinguecula and pterygium (benign growths of the conjunctiva of the eyes).
- A chronic contact lens wearer can also develop dry eye syndrome.
Diagnosing Dry Eye
- Schirmer’s test; to determine if the tear quantity is adequate or not.
- Corneal staining: using fluorescein dye to rule out corneal abrasion.
- Slit Lamp Biomicroscopy; can be used together with corneal staining to determine if there is any scar or ulceration on the eye. It can also be used to measure the tear break up time to ascertain the velocity of tear evaporation.
Treatment/ Management of Dry Eyes
- Use of lubricant eye drops or lubricant gels. This helps to artificially add extra moisture to the eye and gives the eye comfort.
- Use of lacrimal or punctal plugs. This form of management includes using plugs to block the tear ducts. It is often used together with the eye drops and lubricants to ensure retention and adequate absorption.
- Surgical corrections in severe cases of dry eyes.
Prevention and Recommendation
- Avoiding environments with smoke, heat, and dust.
- Treatment of underlying condition. For instance, it is advised that you keep your blood sugar in check if you have diabetes.
- Understand the medication you are allergic to and discuss with your doctor to know what medication will give you the least or no side effects.
- If you are a regular contact lens wearer, you may want to consider reducing the frequency of wear and the use of a rewetting drop with it.
- For a constant computer user, it is advised that you take breaks in between your screen time, to encourage a better blinking rate.
- For elders above 50years and women in their menopausal age, intake of omega-3 fatty acids is recommended to supplements the eyes' moisture content.
- Finally, a visit to an eye clinic is highly recommended because many of the symptoms of dry eyes are like that of other eye conditions. It will be a good idea for your eye doctor to confirm that it is dry eye and recommend the best treatment option for you.