The fix for dry eyes

Heidi Godman
Heidi Godman, Executive Editor, Harvard Health Letter

There are two unopened boxes of contact lenses in the cabinet under my sink. I’m not using those tiny disposables anymore; wearing them makes my eyes so dry they feel like they’re being sucked out of their sockets. Actually, it’s not the contacts — those have many benefits, and I’ve worn some version of them since my teens. But as a middle-ager now, the contacts aggravate a condition I have that’s apparently pretty common: dry eye syndrome. “I’d say at least a quarter of my patients have some degree of complaint about dryness,” says Dr. Matthew Gardiner, an ophthalmologist with Harvard-affiliated Massachusetts Eye and Ear Infirmary.

The eyes have it

Our eyes have a few sources of moisture. One is the lacrimal gland in the upper outer quadrant of the eye. That’s the gland that produces buckets of tears if you cry or something gets in your eye.

Other sources include

  • a network of glands embedded in the conjunctiva (the white surface of the eye and the undersurface of the eyelids) that produces water and mucus
  • glands at the edge of the lids that produce an oily substance.

The cocktail of water, mucus, and oil from these last two sources make up the tear film on the eye surface. We need it to see properly. “Each time you blink, you reapply a new wet surface,” explains Dr. Gardiner.

No more tears?

As we age, our tear production slows. If the lacrimal glands don’t make as many tears, you’ll have a problem with tear quantity. If some of the other glands slow, such as those that produce oil, you’ll have a problem with tear quality, since you need all three tear components for the tear film. The result is dry eye syndrome, with symptoms that include burning and a feeling of grittiness in the eyes.

But it’s not just aging that can cause dry eye syndrome. Other causes include

  • side effects from medications (such as antihistamines or blood pressure medications)
  • underlying conditions (such as thyroid problems; diabetes; rheumatoid arthritis; Sjögren’s syndrome, an immune system disorder; or Parkinson’s disease)
  • your environment (exposure to dust, smoke, and other pollutants)
  • eye surgery
  • contact lens use
  • looking at electronic gadgets too long without blinking (if you go too long without blinking, you’re not giving your eyes a chance to replenish the tear film).

This last condition linked to electronic gadget use is known as computer vision syndrome, and Dr. Gardiner is seeing it more often. “People tend to stare at their screens and blink less. Their eyes get dry because they’re open more of the time, and they dry out because there’s not as much blinking to refresh the surface the eye,” he explains. Computer vision syndrome can also include symptoms such as blurry or double vision.

Don’t let dry eyes go untreated

Taking care of dry eyes not only relieves discomfort but can help you avoid infection or even scarred corneas. Treatment is pretty simple, too.

For people who make enough tears but have dry eye symptoms, Dr. Gardiner recommends

  • warm compresses
  • gentle eye massage to stimulate the oil glands on the lid margins.

For people who aren’t making enough tears, Dr. Gardiner recommends

  • artificial tears (there are many types and brands)
  • medicines that increase tear production, such as ophthalmic cyclosporine (Restasis)
  • an in-office procedure to block tear drainage by inserting plugs into the tear drainage ducts.

Some research has even suggested that caffeine can help dry eyes. “Caffeine does increase the production of the lacrimal glands,” says Dr. Gardiner, “but be careful about increasing your caffeine intake. Too much caffeine can cause jitters and insomnia.” In other words, don’t guzzle coffee in an attempt to fix dry eyes.

My own fix for dry eyes has been using artificial tears, leaving my contacts in their boxes (except for special occasions), and wearing eyeglasses. It’s not as convenient as wearing contact lenses, but it’s a lot more comfortable on these middle-aged eyes.

Comments:

  1. Dry eyes

    i found that eye drops, restasis and compresses only provide temporarily relief. I felt i needed to address the problem from a different angle, i even thought about spending thousands for Lipiflow. I realized nutrition was the missing link for me. I started taking Theratears and Nordic Naturals ProDHA.

  2. drbrian Dunnmd

    THERE is special gel for dry eye your Ophthalmologist will show& discuss with you he/she will apply;that you may find quite refreshing…..
    and not petroleum jelly,as we want your eye to breathe through the gel and not end up with edema ;see your Dr.you want to be safe and comfortable,

  3. VICKI Levine

    If you have used for Restasis twice a day and still feel as if your eyes are dry you might want to increase it to 4 times a day. There was a study done that shows it does make a difference if you use it 4 times a day.

  4. Jared

    I’m only 20 and my dry eyes are extremely severe. It’s too bad we don’t have a cure for this. I’ve spent thousands of dollars on treatments that haven’t worked for the pain.

  5. John G

    I treat my dry eye problems by taking a small amount of Vaseline or petroleum jelly on a clean finger tip and brushing horizontally along my eye lashes enough to lubricate the edges of the lids. This works well for a much longer period of the day compared to eye drops, which tend ti irritate my eyes if used too much.

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