Dry eye syndrome

Almost everyone's eyes become irritated from time to time. For individuals with dry eye syndrome, this irritation is part of every day life.

Dry eye syndrome is caused by a decline in the production of tears. This causes irritation, burning, or a scratchy feeling in the eye. Sometimes mucus accumulates, causing a sticky sensation. When the problem is severe, it can feel like sand is in the eyes. People with dry eye syndrome may become sensitive to light, have trouble wearing contact lenses, or even find it difficult to cry.

Dry eye syndrome affects more than eight million people in the United States. It is more common in women and usually starts in middle age. People with allergies are more susceptible to dry eye syndrome. The condition may accompany autoimmune diseases such as lupus or rheumatoid arthritis. A shortage of tears is also one of the symptoms of Sjögren's syndrome, a disorder of the immune system that causes dryness of the mouth, eyes, and mucous membranes.

Dry eye syndrome may also develop in people with posterior blepharitis, an inflammation of the inner eyelid that is common in people with allergies or in those with the skin disorders rosacea or seborrheic dermatitis. In people with blepharitis, the oil glands in the eyelid become inflamed and clog. As a result, the eyes are not bathed in the usual fine sheen of oil, and water from tears evaporates more rapidly than normal.

Symptoms of dry eye syndrome

The most common symptoms of dry eye syndrome include:

  • a persistent sensation of grittiness in the eyes
  • difficulty wearing contact lenses
  • difficulty shedding tears
  • a burning sensation in the eyes in low humidity or polluted air

Diagnosing dry eye syndrome

An ophthalmologist can diagnose dry eye syndrome with a slit lamp and can test the amount of tear production.

Treating dry eye syndrome

Treatment usually involves some type of topical medication.

When dry eye syndrome is caused by a reduction in natural tear production, artificial tears may provide some relief (see Over-the-counter options for dry eye syndrome).

An alternative offered by some doctors is tears made from your own serum, which is the clear liquid separated from clotted blood.

To minimize evaporation of tears, try to stay away from dust, pollen, cigarette smoke, and other pollutants, stay out of the wind, and keep away from hair dryers and air conditioner currents.

Humidifiers may help by adding moisture to indoor air.

In severe cases of dry eye syndrome, inserting plugs into the tear drainage ducts can help. The plugs keep natural and artificial tears in the eye longer by preventing them from draining out of the opening in the inner corner of the eyelid.

Wearing special soft contact lenses that help hold in moisture may help, as may wearing goggles at night to retain moisture, especially if the eye does not fully close in sleep.

If you have blepharitis, your ophthalmologist may advise you to apply warm compresses to your eyelids and massage them periodically to free oil from the glands. Oil-based emulsion drops are helpful, and the prescription medication cyclosporine (Restasis) can be an option.

Over-the-counter options for dry eye syndrome

Known as artificial tears or ophthalmic lubricants, these products relieve dryness and discomfort by adding moisture and lubrication to the eyes. People who find they need to use them more than four times a day should use a preservative-free version, which many brands offer. However, be aware that multiple-use containers may contain ingredients that cause irritation if the drops are used frequently. Single-dispense vials are truly free of preservatives and provide the best option for people who use these remedies frequently or who have extremely sensitive eyes. The thicker gel formulations and ointments are best used just before bedtime, as they tend to blur vision during the day.

Active ingredient

Brand names

carboxymethylcellulose

Refresh Optive, Refresh Tears, Refresh Liquigel, Refresh Celluvisc, Refresh Plus, TheraTears

glycerin

Soothe Lubricant Eye Drops, Moisture Eyes

hydroxypropyl methylcellulose

Bion Tears, Tears Naturale, Genteal Mild, Genteal Gel

oil-based emulsion

Soothe XP

polyethylene glycol

Systane, Systane Ultra, Blink

polyvinyl alcohol

Tears Again, Akwa Tears, Murine Tears