Dry eye or Dry Eye Syndrome is a disorder of the tear film due either to tear deficiency or excessive evaporation, which causes damage to the surface of the eye and is associated with symptoms of discomfort and visual disturbance. Until recently most dry eye treatments assumed that insufficient tears were the root cause, this is not however the case and the most common cause of dry eye is now known to be poor tear quality leading to increased or excessive evaporation. At Newsome Opticians we run a specialist Dry Eye Clinic to ascertain the cause of your dry eye and advise on the best course of treatment, see below under Dry Eye Diagnosis.
What are the Symptoms of Dry Eyes?
• Stinging or burning eyes
• Grittiness or scratchiness
• Stringy mucus in or around the eyes
• Discomfort when wearing contact lenses
• Blurred or fluctuating vision which improves on blinking
• Light sensitivity
• A feeling of a foreign body in the eye
• Excess watering
• Redness of the eye
• Increased irritation from smoke or wind
• Decreased tolerance of reading, computer work and other visually intensive tasks
Tears are just water .. aren’t they?
Well the short answer is no, but to give you a little bit more insight, they are effectively split into 3 main parts as follows:-
The oily layer, produced by the meibomian glands in the eyelids, forms the outermost surface of the tear film. Its main purpose is to smooth the tear surface and reduce evaporation of tears.
The middle watery layer makes up most of what we ordinarily think of as tears. This layer, produced by the lacrimal glands in the eyelids, cleanses the eye and washes away foreign particles or irritants.
The inner layer consists of mucus produced by the conjunctiva. Mucus allows the watery layer to spread evenly over the surface of the eye and helps the eye remain moist. Without mucus, tears would not stick to the eye.
Functions of the Tear Film
• Keeping the surface of the eye moist
• Transferring oxygen from the air to the cornea
• Acting as a first line of defence against infection
• Maintaining the health of the cornea and conjunctiva
Causes of Dry Eye Syndrome
Environment and Activities
Environmental factors can have a drying effect on your eyes, causing your tears to evaporate more quickly. These include:-
• dry climate
• air conditioning and central heating
Certain activities can also contribute to dry eye syndrome, such as:-
• working with a computer / tablet / mobile phone
People blink less frequently during activities that require visual concentration, particularly when working on a tablet or computer, this means that the tear film evaporates or drains away more quickly than it is replenished.
Hormones play an important part in tear production they stimulate the production of tears, changes in hormone levels, particularly in women, can increase the risk of dry eye syndrome.
Medical Conditions and Medication
There are a number of medical conditions that increase your risk of developing dry eye syndrome.
Many people with dry eye syndrome also have blepharitis or meibomian gland dysfunction (MGD). This is where the eyelid margins become inflamed, which can block the glands that produce the oily part of the tear film.
Other conditions that can contribute to dry eyes include:-
• Rheumatoid Arthritis
• Sjogren’s Syndrome
• Thyroid problems
Some common prescription and over-the counter medications can cause dry eye as a side effect in some people, these include:-
• Beta Blockers
Age - dry eye is a part of the natural aging process. The majority of people over 40 experience some symptoms of dry eyes due to reduced tear production.
Low Omega 3 Fatty Acid Intake – Can lead to a decreased lipid layer with faster tear evaporation and secondary dry eye issues.
Dry Eye Diagnosis
At Newsome Opticians our full Dry Eye Assessment takes approximately 1 hour and involves comprehensive eye examination and specialised testing.
External Examination of the Eye including lid structure and blink dynamics.
Evaluation of the Eyelids and Cornea
Measurement of the Quantity and Quality of Tears for any abnormalities. Special dyes are instilled in the eyes to observe tear flow and to highlight any changes to the outer surface of the eye caused by insufficient tears.
You will receive your dry eye treatment plan with full instructions on how to move forward and review your progress at a follow up appointment.