Have you ever experienced a time where your eyes get itchy and red after staring at a computer screen or for just no apparent reason? While some may akin these symptoms to be because of eye fatigue or the dusty air, the most probable reason could be more common than expected — Dry eyes.
In fact, Dry eye disease (DED) is one of the most prevalent eye conditions globally, affecting up to 5% to 50% of the population, depending on the geographic region. Despite it's high prevalence in modern society, the effects of dry eyes are seen as not-so-serious and more often than not, overlooked. Ask anyone you know how to treat dry eyes, and the solution you'll hear the most would be to get some lubricating eye drops. Yes, this solution works, but only for some. Does it treat all types of dry eyes? Unfortunately no.
In this case, the tear film plays an important part to prevent the eyes from drying up.
The tear film consists of 3 layers — lipid, aqueous and mucin layer. In normal and healthy eyes, the tear film should be smooth throughout with no breakages (left of diagram). However when tear film production and quality is compromised, tear film stability is affected, leading to faster evaporation of the tear film (right of diagram).
There are several factors that could cause dry eyes, but can be divided into 2 main categories: External and Systemic factors.
External Factors
This includes environmental factors and lifestyle habits, such as...
- being in an air conditioned room — cool and dry environments will increase rate of evaporation
- usage of digital devices for prolonged periods — rate of blinking significantly decreases when using digital devices, hence tear film becomes unstable
- long hours of contact lens wear — tear film is split into pre- and post-tear film in front of and behind the lenses, thus destabilized
Internal Factors
This includes ocular conditions or underlying systemic conditions which might have affected tear production and quality.
- Meibomian Gland Dysfunction (MGD) — blockage of the meibomian gland which affects quality of the lipid layer in the tear film
- Vitamin Deficiency — Vitamin A, D, B12, Omega-3 deficiencies
- Systemic conditions such as Diabetes Mellitus, Rheumatoid Arthritis, Sjögren syndrome et cetera.
Dry eyes can be uncomfortable and disruptive, but there are various treatments and lifestyle changes that can help manage the condition. Here are several solutions to treat dry eyes:
1. Artificial Tears (Eye Drops)
Over-the-counter artificial tear drops are commonly used to lubricate the eyes and provide relief from dryness. They come in different forms:
- Preservative-free drops are recommended for frequent use, as preservatives can irritate the eyes over time.
- Gel or ointments may provide longer-lasting relief but can blur vision temporarily.
2. Warm Compresses
- Applying a warm compress to your eyes can help to open up blocked oil glands in the eyelids (meibomian glands), which are essential for keeping the eyes lubricated.
- You can use a warm, damp cloth or a commercially available eye mask designed for this purpose.
3. Eyelid Hygiene
- Keeping your eyelids clean can help prevent inflammation and ensure proper oil production. You can gently wash your eyelids with mild soap or use eyelid wipes (often containing tea tree oil or other cleansing agents) to remove debris, oils, or crust.
4. Omega-3 Fatty Acids
- Incorporating more omega-3 fatty acids into your diet can help improve the quality of your tear film. Sources include:
- Fatty fish (salmon, mackerel, sardines)
- Flaxseeds, chia seeds, and walnuts
- Omega-3 supplements (e.g., fish oil or algae-based supplements)
5. Prescription Medications
- Cyclosporine A (Restasis): This prescription eye drop helps reduce inflammation and increase tear production.
- Lifitegrast (Xiidra): Another prescription eye drop that works by blocking a specific protein to reduce inflammation in the eyes.
- Corticosteroid eye drops: In certain cases of inflammation, short-term use of corticosteroid drops may be recommended, but they should be used cautiously.
6. Punctal Plugs
- Punctal plugs are small devices inserted into the tear ducts to block drainage and help retain moisture on the surface of the eye. This can be a more long-term solution for severe dry eyes.
7. Humidifiers
- Using a humidifier in your home or office can add moisture to the air, which can help prevent the evaporation of tears, especially in dry or air-conditioned environments.
8. Environmental Modifications
- Avoid direct airflow, such as from fans, air conditioning, or heaters, as they can cause your tears to evaporate faster.
- Consider wearing wraparound sunglasses or special glasses designed to protect the eyes from wind and dust, especially outdoors.
9. Blinking Exercises
- Blinking regularly is essential to spreading the tear film across the surface of the eyes. If you spend long hours in front of a screen, remember to blink more often or try the 20-20-20 rule: Every 20 minutes, look at something 20 feet away for at least 20 seconds.
10. Lifestyle and Diet Changes
- Stay hydrated by drinking enough water throughout the day.
- Avoid smoking and exposure to secondhand smoke, as this can worsen dry eyes.
- Reduce caffeine intake, which can sometimes contribute to dehydration.
11. Avoiding Certain Medications
- Some medications can contribute to dry eyes, including antihistamines, decongestants, antidepressants, and certain blood pressure medications. If you suspect this is a cause, discuss alternative options with your doctor.
12. Regular Eye Exams
- Regular visits to an eye care professional will help monitor the condition and adjust treatments as needed. They can also recommend further treatment options, such as special eye drops or surgical interventions, if necessary.
**If dry eye symptoms persist or worsen, it's important to consult an eye care specialist or ophthalmologist for a comprehensive evaluation and personalized treatment plan.