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Dry Eye Syndrome

Chronic dry eyes is known as dry eye syndrome (DES), or keratoconjunctivitis sicca. Affecting 1 in 20, it is the most common eye disease in the world, and is particularly common among post-menopausal women and the elderly.

A general feeling of discomfort is the primary symptom of DES. Patients describe itching, burning, scratchiness, stinging, and dryness, of course. When the eye becomes irritated they also become very red. Less common symptoms include a feeling of pain or pressure. There also may be a feeling that a foreign object is stuck in your eye.

Oddly, dry eye symptom is also associated with excessive tear production. Unfortunately, these tears will not lubricate the eyes. The liquid produced because of DES is the same type produced when you cry or have something stuck in your eye. These do not contain the proper chemicals that keep the eyes lubricated. The excessive tear production is a reflex response to protect your eyes from damage by flushing out anything that may be trapped in your eye; your body mistakes the dryness for a foreign object. Those with DES may notice more “sleep” in their eyes every morning. It is often described as “stringy.”

DES is normally chronic, with symptoms worsening or lessening depending on conditions. Activities that involve prolonged eye use such as driving, reading, or looking at a screen worsen the symptoms. Your eyes’ blink rate decreases when actively using your eyes, and this causes your eyes to be lubricated less. Other conditions include times when there is low humidity (due to weather, A/C, or heating), high pollution, or high altitudes. Humidity and showering lessens the symptoms.

Despite the fluctuating symptoms, most cases of DES are very mild. Patients can have DES their whole life without any serious side effects. If DES is severe enough, dry eyes can wear out the cornea, causing impaired vision. Those with severe DES may need corrective eyewear to counteract the damage done.  In extreme and untreated cases, permanent vision loss can occur.

There are a few causes for DES. Tears are extremely vital for eye health. They keep the eye lubricated, which allows the parts of the eye to be malleable and allow light through. They also contain chemicals that prevent the tears themselves from evaporating. They also contain proteins to prevent infection. DES occurs when one of these functions is not carried out correctly. The most common cause is the decrease in production of lubricating tears. In other cases, glands responsible for producing the chemicals that are in the tears malfunction. This causes the oils that keep the tears from evaporating to not be produced. This causes excessive watery tears and leaves the eyes dry.

Aging and menopause are the most common cause of malfunctioning tear production. The body eventually stops producing hormones that tell the body to create lubricating oils in tears. Autoimmune diseases are known to wear down the glands that produce tears. Diabetes is also a known cause. Some medications can also halt tear production.

Blinking and closing your eyes during sleep allows the tears to clean the eyes and keep them hydrated. Any disease that makes your eyes unable to close completely could also lead to DES.

Dry eyes are a side effect of many laser eye surgeries throughout the healing process. As the eye attempts to heal itself, it may produce excess tears without sufficient chemicals in them. During this period you may be more prone to corneal infections. Most symptoms disappear after a few months. Those with DES symptoms beforehand may experience them worsening. In most cases, the symptoms are kept under control by using post-surgery prescribed medicine.

Wearing contact lenses is also a common cause for dry eyes, as they may prevent tears from reaching all the areas of the eye.

Eye drops are the easiest fix for DES. They can help reduce inflammation of secretion glands and provide artificial lubrication. If you wear contacts, wetting & rewetting drops should be used to keep lenses moist. Surgery can be performed to clear any blockage in glands. Omega-3 fatty acids from fish and flaxseed oil have also been shown to keep DES symptoms in check. They contain nutrients that help the eyes produce proper lubrication.