Dry Eye (XEROPHTHALMIA)

DRY EYE (XEROPHTHALMIA)

Dry eye is a disease that occurs in eyes that are not sufficiently moisturized. In order to understand this disease ( also called dry eye), we first need to learn the tear layer. Tears maintain the overall health of the eyes and keep them moisturized. The tear film allows the eyelids to move smoothly and provides comfort. It also prevents external factors from damaging the eyes. It protects the eye from foreign objects, bacteria and germs. Structural differences that may occur in tears cause a feeling of dryness in the eye and disrupt the moisture balance. High frequency of blinks has a positive effect on the quality of tears.

If left untreated, dry eye can negatively affect eye health. Many factors play a role in the development of the disease. Eye inflammation and infections, contact lens use, eyelid problems, rheumatic disorders and previous eye surgeries are examples of these factors. The most common cause of dry eye is a decrease in tear production with advancing age. Eye health is of great importance in terms of maintaining quality of life. Although it is perceived as an insignificant disease in the society, it creates serious problems when left untreated.

WHAT IS THE STRUCTURE OF THE TEAR FILM LAYER?

The tear film layer consists of 3 different layers. These are named as Aqueous layer, Lipid layer and Mucus layer. These layers have different functions. Tears improve the quality of vision by providing a smooth and transparent environment. Before these details, the functions of tears should be known. Tears remove foreign bodies from the eyes:

• Provide quality vision
• Contribute glucose and oxygen to the corneal epithelium
• Lubricate the eyelids and make blinking easier
• Protect the eye from infections
• Remove foreign bodies from the eye

The three layers that make up the tear film and their functions are as follows:

Mucus Layer: It is the inner layer. It covers the surface of the eye while allowing the tears to adhere to the surface of the eye. Thanks to this, tears are more evenly distributed and easily adhere to the surface of the eye. The function of the mucus layer produced by goblet cells is therefore of great importance.

Aqueous Layer: The aqueous layer is the middle layer. Most of the tears are produced in this layer. It is also secreted by the lacrimal glands, also known as tear glands. It cleans and nourishes the surface of the eye as well as keeping it moist.

Lipid Layer: The lipid layer is the outer layer. It prevents the evaporation of tears. It consists of fatty substances. These oils completely cover the tear surface and reduce evaporation. In this way, tears are kept on the surface.

Mucus, Lipid and Aqueous layers come together to form the tear film. Thanks to these layers, the eyes continue to function in a healthier way. The tear film helps prevent different eye disorders, especially dry eye.

CAUSES OF DRY EYE

Dry eye can develop due to many different causes. Environmental factors, eye disorders, rheumatic diseases, certain medications and age factors are among the causes of dry eyes. On the other hand, the winter season can also have a negative impact on eye health. In winter, dry eye can become severe with cold and dry air. Wind and staying indoors can also trigger dry eye. This is due to the low humidity in indoor environments. Hormonal disorders and air pollution are also among the causes of dry eye.

Air Pollution: Air pollution, which causes not only dry eyes but also burning eyes, negatively affects eye health. Waste gases, industrial wastes and construction particles are known to cause dry eye.

Rheumatic Diseases: Some rheumatic diseases can cause dry eye. These are SLE, Rheumatoid Arthritis and Sjögren’s Syndrome.

Medications Used: Some medications such as antidepressants, decongestants and antihistamines can cause dry eye.

Age: Tear production may decrease with advancing age. Dry eye may be more common in older men and women after menopause.

Eye Diseases: Eye diseases such as eye inflammation, eyelid inflammation, conjunctiva and cornea inflammation can cause dry eye.

Eye Surgery: Temporary dry eye may be observed after certain types of eye surgeries (LASIK).

In addition to these, the following factors can also cause dry eye disease:

• Vitamin A deficiency
• Excessive blinking
• Hormonal changes such as menopause and pregnancy
• Laser eye surgeries
• Allergic reactions to eye ointments or drops
• Indoor heating systems
• Constant exposure to sun, wind or smoke
• Blood pressure medicines
• Alcohol and cigarette consumption
• Prolonged exposure to harmful light

Technological developments have also changed today’s working conditions. For this reason, eye health is affected in individuals who spend prolonged time in front of a cell phone or computer. These devices prevent the eye from staying moist as they reduce blinking time.

WHAT ARE THE SYMPTOMS OF DRY EYE?

The most common symptoms of dry can be listed as:

• Eyelids sticking together
• Burning sensation in the eyes
• Stinging sensation in the eyes
• Eye redness
• Pain in the eyes
• Eye strain
• Pain and burning sensation when wearing contact lenses
• Strain in the eyes while driving
• Vision loss
• Eye blurring

Fibrous mucus around the eyes, constant itching of the eyes and eye fatigue during reading are dry eye symptoms. Strain in the eyes while driving at night, difficulty opening the eyes in the morning and sensitivity due to smoke and wind can also be listed as dry eye symptoms.

Dry eye is more common in people over the age of 50. Omega-3 and vitamin A deficiency triggers the disease. Individuals who observe one or more of the symptoms listed above should have an eye check-up immediately.

WHAT ARE THE PROGRESSIVE SYMPTOMS OF DRY EYE?

The progressive symptoms of dry eye are:

• Permanent damage to the eyes
• Severe eye pain
• Significantly increased light sensitivity
• Noticeable decrease in visual acuity
• Frequent irritation of the eyes

HOW IS DRY EYE DIAGNOSED?

To diagnose dry eye, a number of symptoms need to develop. Eye tests facilitate diagnosis. The Schirmer test can be used to measure the moisture content in the eye. The quality of tear should be determined. Tear protein analysis and tear breakage test are perfomed for this. Also the refraction time is tested together with the evaporation time of the tear.

In addition to these tests, the health of the conjunctiva and cornea is examined with the use of special dyes. Density measurement is also among the new methods used today.

HOW TO TREAT DRY EYE

Multiple methods are used for the treatment of dry eye disease. The main purpose of the treatment is to ensure that the eyes are protected, moisturized and relieved. Treatment methods vary, depending on the causes of the disease, its severity and the intensity of the symptoms seen. The most commonly used methods today are listed as follows:

Punctum Plugs: Silicone plugs are inserted into the tear ducts in the lower eyelid. In this way, tears stay in the eye area longer and symptoms are reduced.

Special Lens Applications: They are developed with special formulas. These lenses provide comfort and reduce dry eye symptoms.

Hot Compress: When hot compress is applied to the eyelids, the secretions of the eyelid glands can be thinned. This application improves tear quality and can be used to treat dry eye.

Anti-Inflammatory Treatments: In some cases, anti-inflammatory drugs are used to reduce inflammation in the eyelids and to alleviate dry eye symptoms.

Eyelid Massage: Massaging the eyelids can increase tear flow. This can relieve dry eye symptoms. In addition, applying light massage to the eyelid margins helps the lid glands to function in a quality manner.

Ambient Humidifiers: Humidifiers used in living spaces increase the humidity level of the environment. The increased humidity level allows the eyes to rest. This method is often preferred by individuals who use heating in the winter season.

Eyelid Hygiene: Eyelid inflammations are among the causes of dry eye. Frequent cleaning of the eyelids eliminates oil deposits. Special wipes or cleaning solutions should be preferred for eyelid hygiene.

Artificial Drops And Gels: These drops or gels moisturize the eye surface and provide significant relief to the eyes.

NEW TECHNOLOGICAL METHODS USED IN DRY EYE TREATMENT

In addition to the treatment methods above, there are alternative procedures that stand out today.  We can list these procedures as follows:

Eyelid Devices: These devices remove the deposits around the eyelid and provide detailed hygiene.

Hot Compress Devices: New technology hot compress devices can be used to stimulate the eyelid glands.

Meibomian Gland Obstruction Treatment: Microwave and thermal applications can be used to prevent blockages that may occur in the Meibomian glands. These new methods are preferred to reduce dry eye symptoms.

Light Modulation Mask: In a light modulation mask, a special light is applied to the eyelid. This method is used to stimulate the glands in the eyelids and increase tear production.

IPL Treatment: It is mostly preferred for blockages that may occur in the eyelid glands. It is a light treatment and is applied to increase the quantity-quality of tears.

What is Good for Dry Eye?

There are some issues that individuals with dry eye complaints should pay attention to in their daily lives. Cleaning the eyelids every day is one of these issues. Methods such as hot compresses, tear drops and frequent resting of the eyes are also useful. The following points about dry eye should be especially taken into consideration.

Adequate Water Consumption: Proper hydration is crucial for protecting eye health. For your body to function properly, you must replenish its water supply by consuming at least 2 liters a day.

Avoiding Cigarette Smoke: Smoking causes serious damage to the body and can cause dryness in the eyes. Therefore, it is essential to prevent exposure to cigarette smoke.

Sleep Pattern: A number of studies have shown that sleep patterns have a positive effect on eye health. Therefore, those who want to take precautions for dry eyes should pay attention to both sleep pattern and sleep time.

Diet: A nutritious diet is strongly recommended for preventing an inflammation. Some people should follow a special diet. A gluten-free nutrition program for gluten intolerance is a good example for a special diet.

Sunglasses: Constant exposure to environmental factors such as UV rays and wind can cause dry eyes. Therefore, it is recommended to use sunglasses to prevent dry eyes.

Omega-3 Supplements: Core findings of scientific studies claim that Omega-3 is good for dry eye. Omega-3 contributes to tear production and it is beneficial for eye health in every sense. Omega-3 is found in flaxseed and vegetable oils as well as fish.

Humidity Level Of The Environment: The humidity level of living spaces is important for eye health. Dry environments invite dry eyes. The most classic method for humidifying the work and home environment is the use of wet towels on radiators. You can also moisturize your living spaces by using a cold steam apparatus.

Looking At The Screen For a Long Time: Looking at the screen for a long time is among the causes of dry eyes. For this reason, it is recommended to rest your eyes periodically.

Blinking Frequently: Looking at a single point for a long time can cause dry eyes. To keep your eyes moisturized, you can keep your eyes closed at certain intervals and blink frequently.

Eyelash Cleaning: Keeping the eyelashes clean prevents irritation and inflammation in the eyes. This activity contributes to the prevention of dry eye.

ARE THERE ANY SPORTS AND ACTIVITY LIMITATIONS FOR DRY EYE?

Individuals with dry eye may need to avoid some activities. Intense physical practices are an example to such activities. We can list the points to be considered as follows:

• Contact lens users should remove their lenses during sports activities.
• Sports should not be practiced in environments with allergens or dust. Allergic reactions can cause dry eye.
• Care should be taken when using swimming pools. Because the chemicals in the pool water (especially chlorine) can cause eye irritation.
• Sports should not be practiced in environments with air flow devices such as heaters and air conditioners. Because dry and hot air can directly invite dry eyes.

Sports should not be practiced outdoors in windy weather. Because the wind allows the tears to evaporate very quickly. This increases the possibility of dry eye.

FREQUENTLY ASKED QUESTIONS ABOUT DRY EYE

Question: What are the natural methods of treating dry eye?

Answer: It is important for patients to apply eye massage, consume Omega-3 fatty acids and benefit from some herbal solutions. These applications should be performed under the supervision of a doctor.

Question: What are the practical methods that I can apply at home to prevent dry eye syndrome?

Answer: We can list the practical methods that can be applied at home in dry eye syndrome as follows:

• Ambient humidity should be increased
• Rosemary, thyme, turmeric and green tea should be consumed with doctor’s approval
• Tear production should be increased by gently massaging the eyes
• Regular eye exercises should be done to strengthen the eye muscles
• Eyes should be rested after reading a book or using a computer
• Eyes should be closed every 20 minutes while doing these activities

Question: Are there any early symptoms of dry eye syndrome?

Answer: Yes, there are some early symptoms of this disease. We can list them as follows:

• Stinging and burning sensation in the eyes
• Foreign body sensation in the eyes
• Sensitivity to light
• Blurred vision after blinking
• Pain in the eyes
• Feeling of fatigue in the eyes

Question: Are there any early diagnosis methods for dry eye?

Answer: In the early diagnosis of this disease, a number of tests are performed to measure tear production. The treatment depends on the cause of dry eye.

Question: What are the most preferred treatment methods for dry eye?

Answer: In the treatment of dry eye, light therapy around the eyes, eyelid treatments and artificial tear drops are most commonly used.

The content of our website has been created for informational purposes.  It does not constitute a diagnosis or treatment recommendation. An ophthalmologist should be consulted for definitive diagnosis and treatment.