Dry eye and Ocular Surface Disease (OSD)
Read the article below to learn more about the causes, prevention and treatment options for the condition known as Dry Eye. You can book with one of our friendly team members to find a treatment option that is best suited to your needs.
Dry Eye occurs when the tear film that coats our eyes is insufficient to keep them adequately lubricated.
This could be due to reduced tear production (aqueous deficient dry eye)
Aqueous insufficiency occurs when the lachrymal gland fails to produce enough of the watery component of the tears. This results in loss of tear homeostasis, which means the tear salts and proteins become highly concentrated. In turn these high concentrations irritate the front surface of the eye, causing it to become inflamed.
Or excessive tear evaporation (evaporative dry eye)
Evaporative dry eye accounts for around 80% of dry eye disease. This dry eye subtype is most often caused by meibomian gland dysfunction (MGD) in which the oil (lipid) secretion required to control evaporation and maintain a normal tear film is poorly functioning or blocked.
In the early stages of the condition these can present with the same symptoms and can also be a combination of both types.
Contributing causes include:
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Age
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Medications (eye drops and Oral medicine)
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Hormonal Changes (eg. pregnancy, menopause)
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Sex (Females)
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Allergies
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Eye Surgeries (eg. LASIK)
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Digital device use
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Environmental (eg. airconditioning, climate)
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Medical conditions (eg. Srogjrens Syndrome, thyroid eye disease)
SYMPTOMS
The lack of moisture can lead to a range of symptoms, including:
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irritation of the eye
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dryness
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stinging
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scratchy or gritty feeling
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tired eyes
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fluctuating or blurry vision
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excessive watering.
DIAGNOSIS
Dry eyes can be diagnosed in a comprehensive eye examination. Testing with emphasis on the evaluation of the quantity and quality of tears produced by the eyes may include:
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Patient history (comprehensive Questionnaire) to determine the patient's symptoms and to note any general health problems, medications or environmental factors that may be contributing to the dry eye problem
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External examination of the eye, including lid structure and blink pattern
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Evaluation of the eyelids conjunctiva and cornea using a Slit lamp providing bright illumination and magnification
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Measurement of the quantity and quality of tears for any abnormalities. Special dyes may be put in the eyes to better observe tear flow and to highlight any changes to the outer surface of the eye caused by insufficient tears.
With the information obtained from testing, an Optometrist can determine if you have dry eyes and advise you on treatment options.
TREATMENTS
Although dry eyes cannot be cured, the tear film can be supplemented in an attempt to improve the comfort that normally produced tears provide.
Nutrition for Dry Eye
Eating healthily helps ensure your eyes get the vitamins and minerals they need. To protect your vision, improve overall eye health and relieve your dry eyes symptoms, you may want to start adding vital nutrients to your diet.
1. Water – it’s easy to say but keeping your hydration levels up can help improve the comfort of your eyes.
2. Omega-3 fatty acids – omega-three is an anti-inflammatory and building block for Meibomian Gland Oil. Fish, leafy vegetables, nuts, and seeds are good sources of omega-3s. Supplementing may also help.
3. Vitamin A – helps protect the surface of the eye. Vitamin A deficiency can increase dry eyes. Add food rich in Vitamin A to your diet, like carrots, fortified skim milk and other orange and yellow fruits and vegetables. Eye drops with vitamin A can also be an effective treatment for dry eyes.
4. Zinc – also plays a significant role in keeping the eye healthy. It’s the mineral responsible for getting vitamin A from your liver to your retina and producing melanin, a pigment that protects your eyes. Oysters, dairy, whole grains, nuts, legumes and meat are excellent sources of zinc.
5. Lutein and zeaxanthin – are antioxidants that help keep cells healthy and functioning correctly. They help prevent many chronic eye diseases like dry eyes. Foods rich in these antioxidants include leafy greens like spinach, kale, lettuce and silver beet. Supplements with lutein and zeaxanthin can also be an option.
Medication/ Drops for Dry eye
There are several over the counter and prescription eye drops that can help with dry eyes. Remedies for dry eyes may include the following:
1. Manuka Honey Eye Drops – these have a triple benefit by lubricating the eye as well as acting as a natural antibiotic and anti-inflammatory. Despite an initial sting, the drops feel soothing within minutes of putting them in.
2. Eyelid wash – can reduce eyelid inflammation by targeting bacteria and mites that live on eyelids and near your lashes. These puts toxins into the eye and the eye tissues become inflamed. This is also known as Blepharitis. Hypochlorous acid wash or tea tree foams help to reduce the quantity of bacteria and debris from mites. The best time to use the wash/foams is at night.
3. Artificial tear drops – are probably the most commonly used option for dry eyes. They help lubricate and treat irritation, dryness, and inflammation, giving some relief. For some of the common symptoms it is recommended to use preservative-free drops.
4. Prescription eye drops – topical corticosteroids are usually used in short term doses to settle inflammation quickly. These medications require a prescription.
5. Eye ointments – sometimes you can have a small gap between your eyelids as you sleep which can lead to exposure and dryness. Eye ointments are thicker in consistency and act as a barrier and treatment for your eyes overnight.
Self-care options
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Blink more often and fully (training support with your Optometrist)
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Wear eye masks overnight
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Remove contact lenses and maintain day wear only
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Remove all makeup
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Do not put excessive skin creams directly on the eyelids
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Consider a humidifier
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Reconsider the fit of your CPAP mask for Sleep Apnoea, or cover the eyes with a sleep mask or goggles.
Artificial tears in drop or ointment form are frequently effective in treating dry eyes – targeting the meibomian gland function and inflammation via in-office procedure.
Patients can benefit from the use of humidifiers in their home or office in some cases – temporary or permanent closure of the tear drains helps preserve the natural moisture layer of the eye.