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The cause and treatment of dry eyes

by KATHY HUBBARD Contributing Writer
| September 16, 2020 1:00 AM

Your eyes feel gritty like there’s something in there. They itch, they’re a little red, and your vision is blurry. You find yourself blinking a lot and sensitive to light. What’s going on? Is it the smoke in the air? Or, are you suffering from dry eyes?

The glands around your eyes create a normal tear. It consists of water for moisture, oils for lubrication, mucus for even spreading, and antibodies and unique proteins to keep infections away. WebMD describes dry eyes as when your “tear system is out of whack.”

If your tears aren’t providing enough moisture, you could suffer the above symptoms. Additional symptoms may include stinging, burning, or scratchy sensation in your eyes; stringy mucus in or around your eyes; difficulty with nighttime driving; watery eyes; blurred vision or eye fatigue. Either one or both of your eyes may be affected.

“Sometimes, dry eyes create too many tears,” WebMD says. “This confusing condition is called reflex tearing. It happens because of the lack of moisture irritates your eye. It sends a distress signal through your nervous system for more lubrication. Your body sends a flood of tears to try to make up for the dryness.”

Dry eyes are very common. The American Optometric Association says that it’s a part of the natural aging process. “The majority of people over age 65 experience some symptoms of dry eyes. Women are more likely to develop dry eyes due to hormonal changes caused by pregnancy, the use of oral contraceptives, and menopause.”

Other causes are the medications you take. Antihistamines, decongestants, blood pressure medications, and antidepressants can reduce tear production. People with some medical conditions such as rheumatoid arthritis, diabetes, and thyroid issues often get dry eyes.

“Also, problems with inflammation of the eyelids (blepharitis), inflammation of the surfaces of the eye, or the inward or outward turning of eyelids can cause dry eyes to develop,” AOA says.

And then, there are environmental conditions that can contribute to dry eyes. Smoke, wind, and our dry climate can increase the evaporation of tears. Looking at your computer screen for long periods without blinking can also contribute to dry eyes. Long-term use of contact lenses and refractive eye surgeries (such as LASIK) can also decrease tear production.

A comprehensive eye exam will diagnose the problem. Testing will evaluate the quantity and quality of tears. The eye specialist will take into consideration your health history, medications, or factors that may be contributing to the condition. They’ll do an external examination of the eye, including lid structure and blink dynamics.

The examination will include “evaluation of the eyelids and cornea using bright light and magnification and measurement of the quantity and quality of tears for any abnormalities,” AOA says. “Special dyes may be put in the eyes to observe better tear flow and to highlight any changes to the outer surface of the eye caused by insufficient tears.”

The medico will then recommend treatment, which might be as simple as using over-the-counter artificial tears. “Preservative-free artificial tear solutions are recommended because they contain fewer additives, which can further irritate the eyes.”

If you don’t respond to that treatment, the clinician may recommend a conserving tear method that involves blocking the tear ducts with tiny silicone or gel-like plugs that can be removed if needed. There’s also a surgical procedure that can permanently close the tear ducts.

Prescribed medications are on the market to increase tear production, or your doctor may recommend taking an omega-3 fatty acid nutritional supplement. If you have a contributing eyelid or ocular surface inflammation, you may be prescribed eye drops or ointments, warm compresses and lid massage, or eyelid cleaners to help decrease the inflammation.

What you should do to prevent getting dry eyes is to remember to blink regularly, particularly when you’re reading or looking at your computer, tablet, or phone. Increase the humidity in your home or office, wear sunglasses whenever you’re outdoors, avoid getting dehydrated by drinking your requisite eight glasses of water each day, and don’t let the car air-conditioner or heater blow in your face.

Bonner General Health’s Ophthalmology Clinic is now accepting new patients. Call 208-265-1011 for an appointment.

Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com.

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Kathy Hubbard