How Should I Cope with Dry Eye?

What Does “Dry Eye” Mean?

Dry eye comes in two basic types, aqueous deficiency and evaporative. “Aqueous deficiency” means the body simply can’t produce enough tears. “Evaporative” means the body makes a dysfunctional tear film that evaporates too easily off the eye’s surface. Sometimes the two combine in the same patient, making it even more difficult to cope with dry eye.

Contributing factors include medical conditions, reactions to medications, hormonal changes, age, environmental conditions and overuse of digital devices. In most cases, multiple factors unite to cause dry eye symptoms. Those include burning, stinging, scratchiness, the sensation that grit or a foreign body has entered the eye, excessive tearing and blurred or fluctuating vision. Redness and sensitivity to light can also be indicators.

Pinning Down the Problem

Doctors begin by getting your complete medical history and a list of your medications, then giving you a comprehensive eye exam. They’ll evaluate your eyelid structure and your blink response to stimuli. They may do extra testing to view the structure of the meibomian glands, the eyelid glands that add oil to tears, and assess tear consistency and break-up time.

They’ll want to return your ocular surface to a healthy baseline and reduce symptoms. You may need to try a treatment for weeks or even months before knowing how well it addresses your condition.

Common Treatment Options

The simplest way to fix the problem is to supplement natural tears with artificial tear drops, gels and/or ointments. Prescription drops such as Restasis, Xiidra and Cequa may also increase production by the tear gland.

Tyrvaya, a prescription nasal spray that stimulates cranial nerve 5, produces a complete tear that includes oil from the eyelid’s glands. The biologic drop RegenerEyes reduces inflammation at the ocular surface.

You’ll also want to treat systemic conditions that contribute to dry eye symptoms, possibly altering your behavior or environment, and take Omega 3 supplements to support healthy oil production in the glands.

Medical options can be added when drops and ointments don’t completely do the job. Procedures such as LipiFlow and intense pulsed light (IPL) stimulate oil production in the meibomian glands. Amniotic membranes help heal disrupted corneal surfaces in severe cases.
Ophthalmologists can block the puncta, the places where tears flow off the eyes, by installing dissolvable and semi-permanent plugs. If the problem persists, they can use cautery to more permanently occlude the puncta.

Preventing Dry Eye

Simple changes in your habits may keep dry eye from affecting you. Stay hydrated by drinking plenty of water, eat a diet rich in omega 3s and/or take an omega 3 supplement.

Blink and take breaks when using digital devices, according to this rule of thumb: Every 20 minutes, look 20 feet away for 20 seconds. Use humidifiers during dry times of the year to put moisture into the air at home or work.

Wear sunglasses when you’re outside, not just to block ultraviolet rays but to reduce loss of tear film from wind. When driving, direct air condition/heating vents away from your face. Consider turning off the ceiling fan while you sleep.

And if you’re in a dry environment likely to cause discomfort, supplement your own tears with artificial drops. Those can’t solve every problem, but they’re a good first line of defense.

To schedule a dry eye consultation at Horizon Eye Care, call 704-365-0555 Monday-Thursday, 8 a.m. to 5 p.m., or Friday, 8 a.m. to 3 p.m. The optical department closes on Fridays at 2:30 p.m.