Dry eyes

DEFINITION

Dry eye syndrome (keratoconjunctivitis sicca) or Dry eye, is a
condition where the eyes do not make enough tears, or tears
evaporate too quickly. Dry eye is a common cause of eye
irritation.

DESCRIPTION

Our eyes are covered by a thin layer of liquid, known as a
tear film. Tears lubricate and protect our eyes against infection.
Tears also aid sight by helping to stabilise vision. A person
suffering from Dry eye does not have enough of the right kind of
tears to keep the eye comfortable. This can happen if not enough
tears are produced to keep the eye surface moist, or if the tears
do not stay on the eyes long enough. Over time, the resulting
dryness can damage the surface of the eyeball. There is no cure for
Dry eye, but its symptoms can be alleviated.

CAUSE

Dry eye can occur at any age, but is more common in older
people as smaller volumes of tears are produced. During the
menopause, changes that occur in hormone levels may explain why
older women are more susceptible to Dry eye.

Other factors which contribute to Dry eye include;

The environment e.g sun, wind, dry, hot blowing air and high
altitude. The combination of a dry climate, and warm air
conditioning can cause Dry eye in some people.
Occupation. Constant reading, writing, or working with a
computer, causes a person to blink less frequently, increasing the
risks of Dry eye.
Medicines e.g antihistamines, beta-blockers, antidepressants
and diuretics.
Laser eye surgery. This may cause temporary Dry eye in some
people.
Contact lenses. Changing lenses or limiting use may resolve Dry
eye.
Illness. Some people develop Dry eyes as a symptom of disease.
For example, Dry eyes may occur with rheumatoid arthritis, SLE
(systemic lupus erythematosus), and Sjogren’s syndrome.

SIGNS AND SYMPTOMS

The symptoms of Dry eye may include:

Feelings of dryness, grittiness, or soreness, in both your
eyes, which worsens throughout the day
Eye redness
Watering eyes, particularly when you are exposed to wind
Eyelids stuck together on waking.

Dry eye can produce complications that cause more severe
symptoms such as deterioration of vision, extreme sensitivity to
light and severe redness and eye pain. If you experience these
symptoms, see your GP as soon as possible.

TREATMENT OPTIONS

As with all medical conditions, consult your Doctor for an
accurate diagnosis and treatment. Dry eye does not usually cause
permanent damage, however complications arising from the condition
could permanently affect your sight.

Dry eye can be a recurring condition. Treatment aims to manage
the symptoms rather than cure the condition. If an underlying
medical condition is causing Dry eye, your GP will prescribe
treatment for it. Most people with Dry eye also have blepharitis
(inflammation of the rims of the eyelids). This can be managed by
keeping the eyelids clean, and massaging any trapped material out
of the glands in the rim of the eyelid.

Mild to moderate cases of Dry eye can normally be successfully
managed with eye drops that contain ‘tear substitutes’ or
‘artificial tears’, a liquid that is designed to mimic the
properties of tears. These eye drops are available from a pharmacy
without prescription.

In more severe cases your GP may recommend anti-inflammatory
medicine and specialised eye-wear. If the condition fails to
respond to treatment, surgery may be required.

NOTES

Some types of artificial tears contain preservatives such as
benzalkonium hexachloride. Used for long periods, this preservative
may damage the front of the eye (the cornea). Therefore, if you use
artificial tears more than four times per day, long-term, it is
best to use a preservative-free brand which does not contain
benzalkonium chloride.

PHARMACIST’S ADVICE

Ask your Pharmacist for advice

Your Pharmacist can provide you with tear supplements that add
to your natural tears and provide a substitute coating to protect
and nourish your eyes.
Preservative-free tear supplements are available for patients
with corneal and conjunctival epithelium conditions and people who
experience a reaction to the preservatives in the tear
supplements.
Eye ointments, drops and gels may be used for severe cases of
Dry eye. They are usually applied at bedtime as they may blur
vision.
Dispose of all eye drops and ointments which have been opened
for one month regardless of how much has been used. The
preservative in them may not protect against contamination for more
than twenty eight days.
Ask your Pharmacist about tear supplements in single-use vials.
Each vial has enough lubricant to treat both eyes once, which means
only what is needed is used.
Dry eye in menopause may be helped by hormone replacement
therapy.
If Dry eye is being caused by the swimming, an eye lubricant is
more appropriate than eye drops.
Sometimes Dry eye is attributed to a lack of Vitamin A. Your
Pharmacist might suggest taking Vitamin A.
Gently dab watering eyes with a clean tissue. Avoid roughly
wiping or rubbing the eyes as this can damage the delicate tissue
surrounding the eye.
If dryness persists, contact your Doctor or an
ophthalmologist.

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