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Dry Eyes: Symptoms, Causes, Risk Factors, Treatment And Prevention

Dry eyes, also known as dry eye syndrome, is one of the common conditions faced by today's generation. It is a condition in which the eyes are unable to produce enough tears causing chronic lack of lubrication on the eye's surface. The condition results in irritation, inflammation, and scarring of the eyes. In medical terms, it is named as keratitis sicca, keratoconjunctivitis sicca and dysfunctional tear syndrome [1] .

According to the Journal of Global Health, the prevalence of dry eye syndrome in people may range from 5% to 50% depending upon the area across the world. It is a kind of eye defect which can occur at any age (common in people above 65) and also in healthy people. Dry eye is mostly found in people who stay in an area where malnutrition is prevalent causing vitamin A deficiency [2] .

Symptoms Of Dry Eyes

Tear film plays an important role in keeping the eyes moist, preventing dryness, and enabling a clear vision. When the tear film becomes unstable due to the insufficient amount of tears, it breaks down and causes several symptoms of dry eyes syndrome. The symptoms are as follows:

  • Red eyes
  • Dry eyes
  • Itchy eyes [2]
  • Sore eyes
  • Blurred vision
  • Mucus formation around the eyes
  • Photophobia, the discomfort of the eyes due to light
  • Watery eyes [3]

Causes Of Dry Eyes

Tears are a mixture of water, mucus, and fatty oils. They are an important factor to maintain the lubrication of the eyes and keep it healthy. Tears wash away the germs or dust particles that could lead to an eye infection or other eye-related problems.

In some people, dry eye syndrome is caused due to a decrease in tear production while in others, increased tear evaporation and imbalance in the production of tears can be the leading cause of dry eyes.

Decreased tear production: This is a condition defined by the inability of the eyes to produce enough tears. The main causes are ageing, antidepressant drugs, diabetes, vitamin A deficiency, birth control drugs, laser eye surgery, tear gland inflammation, high blood pressure drugs and others [4] .

Increased tear evaporation: This is a condition in which tear produced in the eyes evaporate too quickly, causing dry eyes [5] . The main causes are dry air, smoke, minimal blinking of eyes during working on the computer for long or driving, wind, and other eyelid problems like lagophthalmos.

Imbalance in the production of tears: As aforementioned, tears are a complex mixture of water, mucus, and fatty oils and imbalance in any one of them can result in the dryness of eyes. Some of the causes are clogged meibomian glands [6] (a gland that produces oil), rosacea, and other skin problems.

Risk Factors Of Dry Eyes

The factors that contribute to the risk of getting dry eyes are as follows:

  • Contact lens [7]
  • Indoor environment
  • Frequent travel by flight
  • Being a woman as they experience more hormonal changes [8] .

Complications Related To Dry Eyes

Dry eyes must be treated at an early stage otherwise it may lead to certain complications like

  • eye infection,
  • abrasion on the surface of the cornea [3] ,
  • corneal ulcer [9] ,
  • decreased quality of life due to every day's eye problem and
  • vision problems.

Diagnosis Of Dry Eyes

Dry eyes can be determined by several tests depending on the complication of the problem. The tests are as follows:

  • Comprehensive eye exam to determine the overall eye health of a patient.
  • Schirmer's test to measure tear production [11] .
  • Special dyes in eyedrops to determine the quality of tears [3] .

Also read:

Treatment Of Dry Eyes

The treatment of dry eyes depends on the severity of the condition.

  • Over-the-counter eye drops for mild dry eye symptoms [12] .
  • Antibiotics or eye ointments to reduce inflammation of the eye.
  • Prescribed corticosteroids eye drops for chronic cornea inflammation.
  • Insertion of a tiny eye to work as an artificial tear gland [13] .
  • Tear-stimulating drugs like cholinergic.
  • Autologous blood serum eye drops, a type of eye drops made from the red blood cells of a patient.
  • Using special contact lenses.
  • Device to unblock oil glands like warm compresses.
  • Eyelid surgery [14] .

How To Prevent Dry Eyes

  • Wear sunglasses in dry air season [1] .
  • Close your eyes frequently while travelling in deserted or high altitude areas to minimize tear evaporation.
  • Avoid smoking or staying in a smoking area [10] .
  • Take breaks to relax your eyes if working long on a computer or binge-watching on a smartphone. Also, position the computer screen below eye level.
  • Avoid direct eye contact with car heaters, fans or air conditioner.
  • Keep room temperature moderate.

Foods That Can Help Avoid Dry Eyes

  • Salmon, oysters, sardines, tuna, and halibut
  • Vegetables like spinach, kale, broccoli, and cauliflower
  • Peanut butter
  • Walnuts and oatmeal
  • Flaxseeds and chia seeds
  • Eggs
  • Palm oil
View Article References
  1. [1] Javadi, M. A., & Feizi, S. (2011). Dry eye syndrome. Journal of ophthalmic & vision research, 6(3), 192–198.
  2. [2] Lee, M. H., Sarossy, M. G., & Zamir, E. (2015). Vitamin A Deficiency Presenting with 'Itchy Eyes'. Case reports in ophthalmology, 6(3), 427–434. doi:10.1159/000441969
  3. [3] Messmer E. M. (2015). The pathophysiology, diagnosis, and treatment of dry eye disease. Deutsches Arzteblatt international, 112(5), 71–82. doi:10.3238/arztebl.2015.0071
  4. [4] Golden, M. I., & Fries, P. L. (2018). Dry eye syndrome. In StatPearls [Internet]. StatPearls Publishing.
  5. [5] McCulley, J. P., Uchiyama, E., Aronowicz, J. D., & Butovich, I. A. (2006). Impact of evaporation on aqueous tear loss. Transactions of the American Ophthalmological Society, 104, 121–128.
  6. [6] Chhadva, P., Goldhardt, R., & Galor, A. (2017). Meibomian Gland Disease: The Role of Gland Dysfunction in Dry Eye Disease. Ophthalmology, 124(11S), S20–S26. doi:10.1016/j.ophtha.2017.05.031
  7. [7] Markoulli, M., & Kolanu, S. (2017). Contact lens wear and dry eyes: challenges and solutions. Clinical optometry, 9, 41–48. doi:10.2147/OPTO.S111130
  8. [8] Matossian, C., McDonald, M., Donaldson, K. E., Nichols, K. K., MacIver, S., & Gupta, P. K. (2019). Dry Eye Disease: Consideration for Women's Health. Journal of Women's Health, 28(4), 502-514.
  9. [9] Petroutsos, G., Paschides, C. A., Kitsos, G., Drosos, A. A., & Psilas, K. (1992). Sterile corneal ulcers in dry eye. II. Treatment, complications and course. Journal francais d'ophtalmologie, 15(2), 106-111.
  10. [10] Xu, L., Zhang, W., Zhu, X. Y., Suo, T., Fan, X. Q., & Fu, Y. (2016). Smoking and the risk of dry eye: a Meta-analysis. International journal of ophthalmology, 9(10), 1480–1486. doi:10.18240/ijo.2016.10.19
  11. [11] Senchyna, M., & Wax, M. B. (2008). Quantitative assessment of tear production: A review of methods and utility in dry eye drug discovery. Journal of ocular biology, diseases, and informatics, 1(1), 1–6. doi:10.1007/s12177-008-9006-2
  12. [12] Pucker, A. D., Ng, S. M., & Nichols, J. J. (2016). Over the counter (OTC) artificial tear drops for dry eye syndrome. Cochrane Database of Systematic Reviews, (2).
  13. [13] Pucker, A. D., Ng, S. M., & Nichols, J. J. (2016). Over the counter (OTC) artificial tear drops for dry eye syndrome. The Cochrane database of systematic reviews, 2, CD009729. doi:10.1002/14651858.CD009729.pub2
  14. [14] Hamawy, A. H., Farkas, J. P., Fagien, S., & Rohrich, R. J. (2009). Preventing and managing dry eyes after periorbital surgery: a retrospective review. Plastic and reconstructive surgery, 123(1), 353-359.
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