Dry Eye Disease

Dry eye disease affects 6.8% of the US adult populations or about 16.4 million people. It is common especially among the elderly.

What is Dry eye disease?

Dry eye disease is a chronic and often progressive condition that occurs when the eyes do not produce enough tears or when the tears evaporate too quickly. Tears are essential for maintaining healthy eyes, as they provide lubrication, nourishment, and protection against infection. Dry eye disease also affects visual function and quality.

What are the causes of dry eye disease?

Dry eye disease can be caused by a variety of factors, which can be categorized into two main types: decreased tear production and increased tear evaporation.

Factors that can lead to decreased tear production include:

• As people age, tear production tends to decrease, and the composition of tears may change, which can lead to dry eye disease.
• Certain medical conditions, such as Sjogren’s syndrome, rheumatoid arthritis, and lupus, can cause dry eye disease by damaging the tear-producing glands.
• Hormonal changes that occur during menopause, pregnancy, or while taking certain medications, such as birth control pills, can affect tear production.
• Exposure to wind, smoke, and dry air can contribute to dry eye disease.
• Dry eye disease can be caused by some eye surgeries such as Lasik and Photorefractive keratectomy refractive surgeries, cataract surgery, glaucoma surgery, and corneal transplant surgery.

Factors that can lead to increased tear evaporation include:

• Meibomian gland dysfunction: These glands, located along the edge of the eyelids, produce an oily substance that helps to prevent tears from evaporating too quickly. When these glands are not functioning properly, tears may evaporate too quickly, leading to dry eye disease.
• Certain eye conditions, such as blepharitis, conjunctivitis, and corneal ulcers, can cause dry eye disease by interfering with the production or distribution of tears.
• Certain medications, such as antihistamines, decongestants, and antidepressants, can cause dry eye disease by reducing tear production or changing the composition of tears.

It’s important to note that many people with dry eye disease may have a combination of factors that contribute to their condition. A comprehensive eye exam can help to identify the underlying cause(s) of dry eye disease and guide appropriate treatment.

What are the symptoms of dry eye disease?

The symptoms of dry eye disease can vary from person to person but may include:

• The eyes feeling dry, gritty, or scratchy, burning or stinging, and may appear red or bloodshot and light sensitive.
• Blurred vision particularly after prolonged periods of reading or using a computer.
• The eyes may feel tired or achy, particularly after prolonged periods of reading or using a computer.
• Some people with dry eye disease may experience excessive tearing as the eyes try to compensate for the lack of moisture.
• People who wear contact lenses may find that their lenses feel uncomfortable or that they cannot wear them for as long as usual.

What are the treatments for dry eye disease?

The appropriate treatment will depend on the severity and underlying cause of the patient’s dry eye disease. Some common treatments for dry eye disease include:

1. Over-the-counter (OTC) or prescription artificial tears can help to supplement the natural tears and lubricate the eyes. Some people may need to use artificial tears frequently throughout the day, while others may only need to use them occasionally.
2. Prescription eye drops, such as Restasis or Xiidra, can help to reduce inflammation and increase tear production in people with moderate to severe dry eye disease.
3. Punctal plugs are tiny devices that are inserted into the tear ducts to help block the drainage of tears from the eye, thus increasing the amount of tears on the eye surface.
4. Meibomian gland expression is a procedure that can help to unclog the glands in the eyelids that produce oil, which is an important component of tears. It can be performed in the office and at home. Ask your Coastal Skin and Eye Institute ophthalmologist.
5. Certain lifestyle modifications, such as taking regular breaks when reading or using a computer, avoiding dry or windy environments, and staying hydrated, can help to alleviate the symptoms of dry eye disease.
6. Omega-3 fatty acids found in fish oil supplements, or flaxseed oil, may help to improve the quality of tears and reduce inflammation.
7. Prescription medications such as oral antibiotics or anti-inflammatory drugs may be necessary to treat underlying causes of dry eye disease.

Left untreated, dry eye disease can cause a number of uncomfortable symptoms that can negatively impact a person’s quality of life, and can lead to more serious complications, including:

1. Corneal damage: The cornea is the clear outer layer of the eye, and it relies on a healthy tear film to function properly. Chronic dryness can lead to damage to the cornea, which can cause vision problems and even blindness in severe cases.
2. Eye infections: Tears are an important part of the body’s defense against infection, and chronic dryness can leave the eyes more vulnerable to infection.
3. Decreased quality of life: The symptoms of dry eye disease, including dryness, burning, and blurred vision, can significantly impact a person’s daily activities, making it difficult to read, drive, or work.
4. Increased risk of complications during eye surgery: People with dry eye disease may be at increased risk of complications during eye surgeries, including cataract surgery and LASIK.
5. Increased risk of depression and anxiety: Living with chronic pain and discomfort can take a toll on a person’s mental health, and people with dry eye disease are at increased risk of developing depression and anxiety.

It is important to seek treatment for dry eye disease if you are experiencing any symptoms. With proper management, the symptoms of dry eye disease can be eased, and the risk of complications can be reduced. Contact Coastal Skin and Eye Institute to schedule a consultation to learn more about dry eye disease. With offices in Carmel Valley, Encinitas, and La Mesa, we provide expert eye care near you.