Dry eyes

What is dry eye?

Dry eye is a common condition with many possible causes. From allergies to conditions such as conjunctivitis and blepharitis, the familiar symptoms of itching and blurred vision can range from mildly uncomfortable to genuinely life-altering. In the condition known as dry eye syndrome, the underlying problem is a lack of the eye’s natural lubrication: tears.

In some cases, the eyes fail to produce enough tears. In others, the tears that are produced are of poor quality.

There are many reasons why people develop dry eyes. Alongside specific diagnosed conditions, environmental factors, lifestyle, age and certain medications can all affect the eye’s ability to lubricate itself effectively. Other conditions that can mimic some of the symptoms of dry eye syndrome include injury to the corneal epithelium, chalazion, blepharitis, allergies and the various forms of conjunctivitis.

How do I know if I need to see a dry eye specialist?

Dry eye can be a passing condition that you can manage yourself with over-the-counter eye drops from a pharmacy. But if your symptoms worsen or persist for more than a few days, you are likely to need more specialised help from an ophthalmologist who specialises in dry eye. Reasons to seek treatment include the persistence or worsening of some or many of the following symptoms:

• Stinging, burning or itching in the eyes
• A gritty feeling in the eyes
• Redness
• Watering
• Blurred vision
• Pain
• Photophobia (sensitivity to light)
• Tired eyes
• Difficulty wearing contact lenses
• Problems with vision when driving at night
• Mucus in or around the eyes
• Crusting around the eyes or in their corners

What happens during dry eye treatment?

Although there is currently no definitive cure for dry eye syndrome, many different treatments are available. Because the underlying problem is the eye’s inability to produce enough tears, or tears of the right quality, first-line therapies focus on giving the eye adequate lubrication and on removing or avoiding triggers. A dry eye specialist will take a step-by-step approach that includes:

• Addressing mechanical factors: switching from contact lenses to glasses or to a different type of contact lens, avoiding windy and dusty conditions, reducing time spent at a computer screen, and so on
• Using lubricating eye drops known as artificial tears
• Using ointments at night

If these measures fail to control the symptoms, other options are available:

• Placing inserts under the eyelids that gradually release artificial tears
• Using plugs (temporary or permanent) to block the tear duct, the drainage channel through which tears flow away. This means that even if your eyes do not produce many tears, they can make the most of the tears you do have.
• Laser treatment or surgery to close the tear duct permanently.