Dry Eye Syndrome

Dry eye syndrome is one of the most common conditions that an ophthalmologist can confront. Usually is caused by issues of the tear film that hydrates our eyes.


Dry Eye SyndromeDry Eye Syndrome 


Tear film is consisted by 3 layers:

• The outer layer creates an oily (lipid) film that covers the tear layer and prevents evaporation.
• The middle aqueous layer, which provides moisture and carries oxygen, as well as nutrients to the cornea. This layer consists of 98% water, minor amounts of sodium chloride (salt), proteins and other components.
• The mucin layer covers the cornea (the outer surface of the eye), creating a low adhesion to him, offering tears stability on the eye.

Tears are created by many eye glands. The 2nd layer (aqueous layer) is produced by the lacrimal gland, which is located in the base of the upper eyelid. Many small glands among the bases of the eyelids are producing lipid and mucin layer.

With each blink, the eyelids spread the tears over the ocular surface. The residual tears flow into the two small pores on the edge of the eye, which are located near the nose. These pores lead to the canaliculi that leads to the nasal cavity.

The communication between the lacrimal pores and nasal cavity explain why when we cry, our nose run!

Apart from eye hydration, the tear production is reflective to external stimuli such as emotion or injury. However, this kind of tears offer little relief to a patient with dry eye syndrome and that’s why a patient with “wet” eyes may still complain of irritations.

The dry eye syndrome has many causes, with the most common one, that of aging. As we become older, our body produces less fat substances-60% less at age of 65 than at the age of 18. This is more evident in women, who tend to have drier skin than men. Lack of oily substance, affects tear film too. Without the essential oily substance, the oily (lipid) layer of the tear film cannot supply all the tear film. Thus, the entire tear layer evaporates more quickly and makes several corneal areas dry.

Other factors such as heat, drought, wind, high altitude, cigarette smoke, usage of certain medication can also cause dry eye. Many people feel their eyes dry when reading or working on the computer. Short, often breaks between work, provide hydration to the eyes and relieve from the dry eye symptoms.

Contact lens wearers can also suffer from dry eye, because contact lenses absorb the tear film, creating long formation of protein deposits on contact lenses. Also, certain drugs, thyroid problems, lack of vitamin A can also cause dryness.

In addition, patients with Parkinson or Sjogren syndrome suffer from dryness. Hormonal changes to women after 50 can cause dry eye too.

Dry eye symptoms

• Irritation
• Burning
• Redness
• Itchy eyes
• Blurred vision that becomes better when blinking
• Tearing
• Increased symptoms when reading, working on the computer or watching T.V

Dry eye diagnosis

Dry eye can be diagnosed with several methods. The ophthalmologist will assess the condition by measuring the quality, the quantity and the evaporation of the tear film. Special drops that highlight the condition, which otherwise would remain unknown, are extremely useful to diagnose the presence and extent of the dry eye syndrome.

Dry eye treatment

A therapeutic approach is the usage of artificial tears. It is essential though, to determine each patient’s needs. Many patients are relieves by the daily usage of artificial tears. Some of these products can offer relief for a short period of time. Others, consist of "thicker" materials and the patients are benefit from them for longer period of time. the preservative-free artificial tears are a better option because their substances don't provoke irritations to the eyes. Avoid to use products that relieve for redness and don't provide the necessary moisture, because most of the times, they aggravate the symptoms.

Another therapeutic treatment is the occlusion with special caps, which are called "punctal plugs". These plugs are putted in the lacrimal puncta, so that to stop the drainage of the tears and keep them as moist as we can. This can be achieved temporarily by putting absorbable collagen plugs or permanently by putting silicone plugs.

There are also some easy daily tips for changing our habits, so as to improve our dry eye irritation.

• Drinking 8-10 glasses of water daily, keeps your body well hydrated and removes all the metabolized waste.

• Trying to blink more often, especially when watching TV, or working on the computer or tablet, can avoid the fast evaporation of the tears.

Last but not least, we should not forget to rub our eyes, as this bad habit deteriorates the condition.


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