Dry eye is a common condition, which in some instances, can lead to significant difficulties with vision and with eye comfort. Dry eye results from the destabilization of the tear film, the thin layer of oil, water, and mucous that covers the surface of the eye. If any one of the three components of the tear film is deficient, one or more of the following symptoms may occur:
The tear film is very important to the health of the eye, and in advanced cases of tear film deficiency, infections or other serious problems may develop.
There are many causes and risk factors of dry eye, and some are easier to control than others.
Dryness is a chronic condition in most cases, but there are several available treatments. Staying hydrated and taking fish oil supplements and/or flaxseed (if safe to take from a medical standpoint) can be helpful. Artificial tear drops and/or artificial tear ointments are used as a first-line treatment to add additional lubrication to the eye surface. Prescription drops can be used if topical lubrication is not adequately addressing symptoms; these drops help to diminish inflammation in the glands that produce tears, leading to increased production of natural tears. If there is eyelid inflammation, resulting dryness is often due to the inability of the oil glands in the eyelid margin to properly secrete oils into the tear film. In this situation, daily warm compresses, gentle eyelid scrubs, and artificial tears containing oils can be helpful. More significant eyelid inflammation can be treated with anti-inflammatory drops and ointments, and even oral antibiotics can be helpful in some instances.
Surgical options are available when medical treatment is not adequate. Small plugs called punctal plugs can be placed in the tear ducts, the small passageways in the inner corner of each lid that carry tears away from the eye and into the nose. Plugging the tear ducts keeps the tears, which are coating the eye surface, from draining into the nose as quickly as they normally would. Some patients who respond well to punctal plugs can actually have their tear ducts cauterized so that the ducts are closed permanently. If there are other problems with the eyelids (becoming too lax, lower lids turning out, etc.), repair of these lid conditions can help to make the eye surface healthier.
Less common and less readily available treatments are reserved for patients with severe dry eye, including the Boston scleral lens and autologous serum drops.