Millions of Americans suffer from chronic dry eyes; many don’t even know they have it. They chalk up their discomfort to allergies, weather conditions or advancing age.  Symptoms of dry eye disease include red eyes, burning, itching, sandy/gritty feeling, light sensitivity, watery/tearing eyes, contact lens discomfort, eye soreness and/or blurry/fluctuating vision.

Your eyes need healthy tears = a complex mixture of oil, proteins, mucous, and other components that are essential for ocular health and comfort. The tear film section does more than lubricate the ocular surface. The tear film also consists of its own immune system. So, a healthy tear film is able to protect the eye from potential ocular infections

Underlying changes to the health of the tear-producing glands can result in a change in the quantity and quality of tears you make.  Even if you are able to make tears, they may not be healthy tears.  Unhealthy tears can no longer provide enough nourishment or protection to the surface of the eye. Unhealthy tears can lead to damage to the eye’s surface.

Why can tearing be a symptom of dry eye disease?

When the eye is irritated from dryness, the lacrimal gland produces a large volume of tears that can overwhelm the tear drainage system and overflow from your eye.  

Tearing and dry eye...Oxymoron?  Not really! 

Many people complain of tearing, and they are subsequently diagnosed with dry eye.  Why is this?

Think about this analogy: when debris, trash, an eyelash gets inside your eye or any other foreign body gets inside your eye, your eye starts to tear because your eye is trying to flush out whatever is in it.  Well, when your eye is dry, a foreign body sensation is created, and a signal is sent to your eye to flush away whatever it thinks is in there.  

Many times, people are unaware of their dry eye status; however, the eye itself is fully aware of the irritation.  In order to alleviate the discomfort, the eye will start to tear.  Unfortunately, after the eye finishes tearing, the eye is left more dry than it was.  So, when artificial tear supplementation is recommended by your eye doctor, the advice should be followed!

What causes dry eye disease?

 Some causes of Dry Eye Disease are age, autoimmune disorders, eyelid problems, eye surgery, and/or environmental stresses.  Prescription and over-the-counter medications may be the culprit, as well; such as high blood pressure medications, diuretics, beta-blockers, allergy medications, antihistamines, sleeping pills, anxiety medications or antidepressants, pain relievers, and preservatives in eye drops – OTC or Prescription i.e., glaucoma drops. 

Tear production normally decreases as we age.  Although dry eye can occur in both men and women at any age, women are most often affected, especially during and after after menopause.  Other factors such as wind, air pollution, low humidity, air conditioning / heating, lack of sleep, too much caffeine/poor diet, use of computer terminals, prolonged reading, decreased blink rate and contact lens wear.

Surgery induced dry eye

LASIK and other refractive surgeries can lead to ocular surface disease, aka dry eye syndrome.  In essence, the refractive procedures disturb the corneal nerves.  As a result, the innervation to the lacrimal gland is interrupted, so the signal needed for the gland to produce tears isn't there.  Consequently, the patient suffers from dry eyes temporarily and sometimes permanently.  On average, it takes 6 months for functionality to return.  

Current Therapies for Dry Eye Syndrome

OTC Lubricating Drops

Punctal Occlusion/Punctal Cauterization

Lateral Tarsorraphy (reduces the surface area that requires lubrication)

Prescription meds such as: anti-inflammatories, Restasis

Liposome Spray-effective in  patients with eyelid infections/dry eye simultaneously

Lacrimal Inserts

As of now, dry eye disease and symptoms can not be permanently eliminated, however, the symptoms can be alleviated with the aforementioned therapies, as well increasing water intake and modifying environmental factors.