Dry Eye

Dry Eyes or Dry Eye Disease is relatively common and although it can be irritating and uncomfortable it is rarely anything to be concerned about. Anyone can suffer from dry eyes, however, you are more likely to suffer from dry eyes if any of the following apply to you:

• You are over the age of 50 years
• You are female
• You wear contact lenses
• You are not getting enough vitamin A or omega-3 from your diet
• You have an autoimmune disease such as lupus or Sjögren syndrome
• You take certain medications including those for high blood pressure or antidepressants

The tear film performs several essential functions to keep your eyes healthy. They not only help to maintain the eyes' lubrication but they also help to keep your eyes clean, protecting them from infections and helping to stabilise your vision. When you suffer from dry eyes you are likely to quickly notice your eyes are feeling irritated and uncomfortable.

Dry eyes are caused by a lack of moisture in your eyes due to either reduced production of tears or uncontrolled tear evaporation. Some people may also experience temporary dry eyes due to

Tear-deficient dry eyes

Tear-deficient dry eyes are caused by the glands that are responsible for keeping the eyes hydrated, not producing enough fluid or tears to keep the surface of the eye moist. People who suffer from tear-deficient dry eyes may notice that they cannot produce or produce very little tears when they cry.

Evaporative dry eyes (Meibomian Gland Dysfunction)

Evaporative dry eyes are the result of a lack of oil or lipid being produced by the glands in the eyelids. This oily substance creates a film over the surface of the eye preventing the watery tears from evaporating. When these glands do not function properly nothing is preventing the tears from evaporating which results in the surface of the eyes drying out.

You may also be more likely to develop temporary episodes of dry eyes due to certain environmental or lifestyle factors, which include:

• Spending long periods looking at a screen without a break
• You are exposed to air conditioning or heating for long periods
• You have been somewhere windy, dry, cold or dusty
• You are a smoker or drink alcohol

Regardless of whether you are suffering from tear-deficient, evaporative or dry eyes caused by environmental factors, many of the symptoms are the same.

These include:

• Redness
• Pain
• Itching
• Burning
• Grittiness as if you have sand in your eyes

If you are suffering from tear-deficient dry eyes you may also notice that:

• Your eyes feel tired
• You struggle to tolerate contact lenses
• You cannot produce tears when you cry

People who suffer from evaporative dry eyes may also experience:

• Swollen, watery eyes
• Sensitivity to light

Most people who suffer from symptoms of dry eyes can treat their symptoms with drops, ointments or gels under a self-diagnosis. It is, however, recommended that you speak to a doctor or an optician if you have been using over-the-counter treatments for a few weeks and there is no improvement in the condition of your eyes.

An optician will take a detailed medical history and perform diagnostic tests to try to confirm the cause of your dry eyes. These tests examine the overall health of your eyes as well as look at the volume, composition and quality of your tears.

There is no real cure for dry eyes, however, treatments are available that are efficient at managing symptoms, leaving the eyes feeling more comfortable. Most people who suffer from dry eyes, hydrate and lubricate the eyes effectively using over the counter drops, ointments and gels that are applied several times a day.

The type of eye drop that you choose to use or are advised to use by a doctor, pharmacist or optician will depend on whether your dry eyes are caused by tear-deficiency or tear evaporation.

Over the counter treatments for Tear-Deficient Dry Eyes and dry eyes caused by environmental or lifestyle factors most commonly rely on providing lubrication to the eyes through artificial tears.

Artificial tears treatments include:

• Hycosan Original Drops (Sodium Hyaluronate 0.1%) - suitable for use with contact lenses. For moderate to severe dry eyes.
• Hycosan Extra Drops (Sodium Hyaluronate 0.2%) - suitable for use with contact lenses. For moderate to severe dry eyes.
• Viscotears Liquid Gel (Carbomer 2mg/g) - do not use at the same time as contact lenses.
• Hypromellose Eye Drops (Hydromellose 0.3%) - not for use with soft contact lenses.
• Liquifilm Tears (Polyvinyl alcohol) - do not use at the same time as contact lenses.

If you are suffering from dry eyes caused by excessive evaporation the recommended treatments involve using daily eye drops that help to replace the oily, lipid layer that is essential in preventing moisture from 3being lost.

Lipid replacing eye drops include:

• Systane Ultra Drops - suitable for use with contact lenses.
• Hycosan Dual Drops - suitable for use with contact lenses.

If you are suffering from dry eyes that are caused by either a tear deficiency or excessive evaporation unfortunately the irritation is unlikely to be prevented altogether. However, there are certain lifestyle changes that you can make that may be effective in easing your symptoms. If your eyes are temporarily dry due to environmental reasons these recommendations may also be useful.

• Make sure you take the time to give your eyes a rest from prolonged screen time, including the TV and a computer.
• Ensure that you keep your eyes clean. Remove any makeup before you go to bed.
• Prioritise getting enough sleep. If your eyes are tired they are more likely to feel dry and uncomfortable.
• Use a humidifier to stop the air around you from becoming too dry and avoid rooms that are heated, have fans or are using air conditioning.
• Where possible, stay out of a strong breeze and wear sunglasses to offer your eyes extra protection.
• You should try not to smoke, avoid other people that smoke and especially in smoky rooms, including those caused by fires.

If you are unsure whether using eye drops is the right option for you, there is some evidence to suggest that heat masks and eyelid massage may offer some relief from dry eyes as alternative treatments to over the counter drops, gels and ointments.

Heat masks - applied for up to 30 minutes over closed eyes. They absorb moisture from the environment to hydrate the eyes. Examples include Optase Moist Heat Mask or you can make your own.

Eyelid massage - Massaging along the lash line towards the inner eye may help to unblock glands, which can offer relief from dry eyes caused by a tear deficiency.