The sensation of dryness of the eyes is common. If it is present on a daily basis for more than 3 months, it should be evaluated by an ophthalmologist or optometrist. There are many potential causes, including the drying effect of medications, inflammatory conditions affecting the surface of the eye, thyroid eye disease, blockage of oil glands in the eyelids (meibominitis), a poor blink reflex, and Sjögren’s disease. The symptoms of dry eyes vary. Some patients report a feeling of grit or sand in their eyes. Others will report repeated blinking, difficulty wearing contact lenses, blurred vision, or even excessive tearing. The symptoms of dry eye correlate poorly with the severity of the condition as assessed by an ophthalmologist or optometrist. Thus some people with Sjögren’s can have minimal symptoms yet have quite severe dryness of the eye surface.
An ophthalmologist or optometrist can diagnose dry eyes with simple tests. The Schirmer’s test measures the amount of tears produced in a period of 5 minutes, using a strip of filter paper placed inside the lower eyelid. With special non-toxic dyes, the ophthalmologist or optometrist can look for abnormal staining in portions of the eye surface that have been devitalized as a result of excessive drying. The integrity of the tear film can also be assessed with these dyes.
The treatment of dry eyes involves the application of artificial tears, medicated drops, and tear gels at bedtime. A specific medicated nasal spray can be prescribed to improve tear flow. Your ophthalmologist or optometrist can block the tear ducts with removable plugs or with a simple surgical procedure. This prevents the flow of tears out of your eyes and can relieve their dryness. Daily eyelid hygiene assures that the meibomian glands can secrete oils that coat the tear film and slow down its rate of evaporation. Fish oil supplements may also improve the health of these glands. Advanced techniques include the formulation of eyedrops using one’s own serum, physical treatments to unblock the meibomian glands, and the use of scleral lenses.
