It’s an epidemic—as many as 25 million Americans are suffering from dry-eye syndrome. They’re complaining to their doctors of irritated and burning eyes. In fact, it’s the second-most-common eye complaint after vision problems.
One reason dry eyes are so common is that the mucous membranes that produce a key component of tears get drier as we age. About one-third of adults ages 65 and older suffer from dry eyes.
Another key factor is that electronics aren’t kind to eyes. If you spend a good part of your day in front of a computer or squinting at your smartphone or watching TV, you “forget” to blink. Your blink rate, as well as how completely you blink, affects eye moisture.
That’s because tears consist of oil as well as water. The oil is squeezed from the meibomian glands in the upper and lower eyelids when you blink. It allows tears to cling to the surfaces of the eyes and also slows their evaporation. If you aren’t blinking enough and, as a result, secreting little or no oil, the tears evaporate quickly. This condition, known as evaporative dry eye, is the most common cause of dryness.
Other conditions that can lead to eye dryness include medication side effects (from some antihistamines and antidepressants, for example)…autoimmune diseases, such as Sjögren’s syndrome, lupus and rheumatoid arthritis…and vision-correcting surgery (such as LASIK). Diabetes, too, can contribute to eye dryness by causing a decreased sensation of dryness, thus reducing your blink rate.
Before recommending a treatment, your doctor will want to know why your eyes are dry. Once the underlying cause—for example, medication use, autoimmune disease or diabetes—is identified and treated, the dryness may start to improve.
But even if medication use or a chronic illness is not to blame, you don’t have to suffer from dry eye. There are steps you can take to relieve the discomfort…
If your symptoms are mild, the following steps that you can take on your own may be enough to relieve dry eye. If your symptoms are more severe, these steps can augment other treatments (see below) that your doctor may suggest…
Blink better. People normally blink between six and 15 times a minute. (You blink less when you’re reading or concentrating and more when your eyes are relaxed.)
If you watch a lot of TV or use a computer for more than an hour at a time, your eyes probably are drier than they should be. This also happens to long-distance drivers (such as truckers) and people who stare at anything for long periods of time. Important: Remind yourself to blink even when you don’t feel that you need to.
Also helpful: Take a “blink break” at least twice an hour. Shut your eyes for 10 seconds, and move your eyeballs under the closed lids to bathe and lubricate them.
Try omega-3 fatty acids. These healthful fats, found in walnuts, flaxseed oil and fish, can help reduce gland inflammation and improve the quality of your tears. Fish-oil supplements—a typical dose is 1,000 milligrams (mg) daily—aren’t a replacement for other treatments, but they can slightly improve dryness.
Oily, cold-water fish, such as tuna and salmon, may be even better. A study at Harvard’s Brigham and Women’s Hospital found that patients who ate tuna five to six times a week had a 68% reduced risk of developing dry eye, compared with those who had only one serving a week.
Use warm compresses to unclog tear glands. Use them two to four times a day for five minutes at a time.
Try artificial tears. Sold over the counter, products such as Blink and TheraTears are very helpful for short-term relief. They work quickly and are soothing, particularly if you keep them chilled in the refrigerator. The liquid drops are mainly used for mild cases of dryness. Gel-containing drops are recommended for more severe dryness. If you use drops more than three or four times a day, get a product without preservatives, which can cause some discomfort.
Avoid foods high in omega-6 fatty acids, such as margarine, mayonnaise and oils made from corn and soybeans. Also, reduce the salt in your diet and avoid alcohol.
If the steps above don’t help you, see your ophthalmologist. He/she may recommend the following…
Restasis (cyclosporine ophthalmic emulsion) is the only FDA-approved medication for increasing tear production. This prescription eyedrop reduces inflammation and helps prevent blockages in the tear-secreting ducts. It’s a good choice for dryness that’s caused by vision-correcting surgery, cataract surgery or postmenopausal declines in estrogen, among other conditions.
Punctal plugs. After tears wash across the eyeballs, they drain into small openings. These tear duct openings, or puncta, are located on the inner corners of the eyelids. Their job is to divert “used” tears into nasal cavities and from there to the back of the throat. Your doctor might recommend that you block these openings to keep more of your tears in your eyes.
It’s a simple office procedure that takes less than an hour. Your doctor might recommend that you start with temporary plugs. Made from collagen, they last about three months and then dissolve. If you’re satisfied with the improvement, you can get another set of temporary plugs.
Another option: Permanent punctal plugs. If you get nondissolvable, silicone plugs, you won’t have to replace them. However, they stick out a little more than temporary plugs. You might not see them, but you will feel them with your finger when you touch the eye.
Gland expression. Blockages in the oil-producing meibomian glands will decrease the quality of your tears and lead to dryness. You can express (empty) the glands by using a cotton-tipped swab to push the lower edges of the eyelids against the eyeballs. It’s like popping a pimple. The pressure pushes the oil out. Don’t try this unless your doctor shows you how—you don’t want to injure your eye.
You might have to do this every day—preferably after a shower, when heat and steam have softened the accumulated oil.
If you are considering vision-correcting surgery: Millions of Americans have had LASIK, one of the less expensive forms of vision-correcting surgery. It is a generally safe procedure, but it can reduce the frequency of your blinks for several years. In the meantime, many patients will have dry eyes as a side effect.
Ask your doctor about other forms of corrective surgery, such as PRK or LASEK. They are less likely to cause blink problems, so you have less chance of developing dry eye.
