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Dealing with chronic dry eye

By Jenilee Matz, M.P.H., Staff Writer, myOptumHealth

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Tears aren’t just for crying. They help moisturize the eye to help you see. But sometimes the eyes don’t produce the right amount or right quality of tears. If your eyes always feel dry, irritated and uncomfortable, you may have a condition known as chronic dry eye.

No more tears?

Tears are needed for good eye health and vision. They spread across the surface of the eye with each blink. Tears:

  • Keep the surface of the eye lubricated, smooth and clear
  • Help wash away debris
  • Protect the eye from infection

Tears are a combination of water, oils, mucus and proteins. They are secreted by glands around the eye.

Chronic dry eye occurs when there is an imbalance of these substances or when there are not enough tears to lubricate the eye. Symptoms include:

  • Stinging or burning feeling in the eye
  • Pain or redness in the eye
  • Feeling like something is in the eye
  • Having extra tears followed by periods of dry eyes
  • Stringy discharge coming from the eye
  • Blurry vision
  • Heavy eyelids
  • Inability to cry
  • Pain when wearing contact lenses
  • Eye fatigue
  • Sensitivity to light or smoke

Who’s at risk?

The following factors raise your risk for chronic dry eye:

  • Women. Hormonal changes from pregnancy, birth control use and menopause may contribute to chronic dry eye.
  • Being age 50 or older. Tear production declines with age. Most people over age 65 have signs of chronic dry eye.
  • Some medicines like antihistamines, decongestants, Parkinson’s medicines, certain blood pressure drugs and some antidepressants can cause fewer tears to be produced.
  • Certain medical conditions, including rheumatoid arthritis, diabetes and thyroid problems, can raise the risk for dry eye.
  • Other eye problems. Swelling of the eyelids (blepharitis) or eye surfaces and inward or outward turning of the eyelids can lead to dry eye.
  • Environmental factors like smoke, wind and dry climates can increase tear evaporation.
  • Previous surgery. Side effects of LASIK and cosmetic surgery can lead to a decrease in tear production.
  • Long-term use of contact lenses may cause dry eye.
  • Not blinking enough,such as when staring at a computer screen for long hours, may contribute to dry eye.

Getting relief

Chronic dry eye just causes discomfort in most sufferers. Rarely, though, it can be severe and lead to vision problems. If you have any symptoms of chronic dry eye, see your doctor for a full evaluation.

There is no cure for chronic dry eye, but there are treatments to help relieve symptoms. The type of treatment depends on the cause of your dry eye.

The goal of most treatments is to restore tears and give relief:

  • Artificial tear drops, gels and ointments are sold over-the-counter (OTC) without a prescription. They temporarily help moisten your eyes. Use preservative-free solutions because they contain fewer ingredients. Your doctor can suggest a specific brand.
  • Prescription eye drops.Your doctor may prescribe an eye drop (called Restatis) that helps your eye produce more of its own tears.
  • Punctal occlusion. This procedure blocks the area of the tear ducts where tears drain. It’s blocked with silicone or gel plugs that can be removed. This keeps the eye’s natural tears in the eye longer.
  • Surgery. Your doctor may suggest surgery to permanently close the tear ducts. This allows more tears to remain around the eyes.

Other ways to ease symptoms

These tips may also relieve dry eye discomfort:

  • If you wear contacts, ask your doctor what types are best. There are several made for people with chronic dry eye. You may need to change to glasses.
  • Take frequent breaks and blink your eyes when reading or using a computer.
  • Wear wraparound sunglasses to keep wind from blowing into your eyes.
  • Use a humidifier to keep the air moist.
  • Use an air filter to rid your home of dust and other irritants.
  • Don’t rub your eyes.
  • Avoid cigarette smoke.
  • Take an omega-3 fatty acid nutritional supplement. It may help ease irritation in some people. Ask your doctor if it’s right for you.
  • Stay hydrated. Drink eight to 10 glasses of water each day.

View the original Dealing with chronic dry eye article on myOptumHealth.com 

SOURCES:

  •  National Eye Institute. Facts about dry eye. Accessed: 11/18/2009
  • Tu EY, Rhienstrom S. Dry eye. In: Yanoff M, Duker JS, eds. Ophthalmology, 3rd ed. Philadelphia, PA: Mosby Elsevier; 2008.
  • American Optometric Association. Dry eye. Accessed: 11/18/2009
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