Dry Eye Syndrome is a common condition that occurs when your tears are not able to provide adequate lubrication for your eyes. This might happen because you do not produce enough tears, or if you produce poor quality tears.

You may first notice Dry Eye Syndrome by recognizing that your eyes simply feel uncomfortable at times. Other more obvious symptoms include:

  • Stinging or burning sensation
  • Tired eyes
  • Redness to the white part of the eyes (conjunctiva)
  • Feeling that something is in your eye (gritty or sandy feeling)
  • Mucus or discharge in your eyes
  • Occasional blurry vision, especially with night driving
  • Sensitivity to bright light
  • Difficulty wearing contact lenses
  • Tears / watery eyes *

* Patients often wonder how they can possibly have Dry Eye when they come in complaining about overly watery or teary eyes. The eyes have a protective response called reflexive tearing. This happens when the front surface of the eye is dry. The gland responsible for watery tears is stimulated to produce more tears in order to help coat the front surface of the eyes. This is a reflexive response to help fight the immediate dryness, but it will not cure the cause of Dry Eye.

Causes of Dry Eye Syndrome

Decreased Tear Production

As we age, we produce less tears. Age is the most common cause of decreased tear production. Medical conditions such as diabetes, arthritis and thyroid imbalance are also strong contributors to dry eyes.

There are many medications that can also affect tear production, including hormones, birth control pills, medications for acne and other skin conditions, antihistamines, decongestants and antidepressants.

Increased Tear Evaporation

Our tears evaporate more readily when we blink less. This happens when we are using the computer (see Computer Vision Syndrome), reading or driving. Evaporation also happens quickly when the air is dry (especially in the winter), wind or smoke.

Poor Quality Tear Film

Our tear layer is actually composed of three layers; oil or lipid, water and mucus. A deficiency or imbalance in any one of these layers will cause Dry Eye Syndrome.

The Lipid or oily layer of the tears is formed by oil-producing Meibomian Glands. The main job of the oily layer is to stop evaporation of the tear layer. The oil glands run the full length of our lid margins (upper and lower lids) and they empty oil through openings close to the base of our lashes. If the Meibomian Glands become inflamed or blocked, they can stop producing the essential oil we need to keep our eyes lubricated. See images of Meibomian Gland Dysfunction (MGD) in Diagram C.

MGD is commonly found during a routine eye exam. Eye doctors see this a lot and are able to point out treatment strategies to patients before they are even symptomatic, in order to prevent discomfort and vision loss in the future.

The Watery (aqueous) layer is formed by the Lacrimal Gland, located above the eye (see Diagram D). Its job is to wash away particles and prevent infection.

The Mucin layer is formed by specialized cells in the conjunctiva and cornea. This layer helps the watery tears adhere and spread out on the front surface of the eye.  It also nourishes the underlying part of the eye called the cornea.

Treatment for Dry Eye Syndrome

Artificial Tear Drops

There are many different types of lubricating tear drops, but the best tear drops are preservative free. Avoid using drops with extra chemicals that are not healthy for the eyes. Please ask us which are the most appropriate to use in your situation.

Omega-3 Supplements

Supplementing with Omega-3 can decrease dry eye symptoms and the inflammation that is found in dry eyes. It is important to know that not all Omega-3 supplements are the same. The amount of the important ingredients (DHA and EHA) can be significantly different from one brand to another, and some forms of Omega-3 are made to absorb better in the body. Please ask us for recommendations on the most professional grade available, as this will give you the most healthy relief from dry eye symptoms.

Punctal Plugs

Tears are drained away from the eye via a small canal called the nasolacrimal duct. It is sometimes beneficial to put a temporary collagen plug in one of these canals to stop this drainage and preserve the body’s natural tears on the surface of the eye. These plugs dissolve away after a few months so are often a wonderful dry eye solution during the dry winter months.

Blepharitis Treatments

Blepharitis means inflammation of the eyelid. This inflammation is very common and easy to treat if picked up early. Eyelid inflammation leads to dry, uncomfortable eyes.

For lids that show dryness or Meibomian Gland Dysfunction, we recommend warm heat with lid massage. An eye mask that is heated in the microwave is applied to the eyelids for 3-10 minutes a day. This heats the oil glands responsible for lubricating the eyes and gets the natural oil production flowing more smoothly. If there are blockages of the glands, lid scrubs will be prescribed to cleanse the gland area and allow for oil production. A blepharitis treatment can be done to the lids in our office to help kick start the treatment of moderate to severe blepharitis.

thermaLid Treatment

The best treatment for Meibomian Gland Dysfunction (where the oily layer of tears is deficient) is the thermaLid procedure. This involves heating the lids with a radio frequency device called TempSure. This safe, effective procedure can give the best resolution of dry eye symptoms to those suffering from moderate to severe dry eyes.

Dry Eye Syndrome will get worse if left untreated. If you have any symptoms, please book an appointment and talk with one of our eye doctors about appropriate treatment strategies.