Dry Eye

Under normal conditions, our eyes are constantly making tears to keep the surface of the eye moist. Although tears are typically considered as a simple, homogeneous substance, we have a complex tear film that keeps our eyes healthy and comfortable, which consists of three distinct layers. Every time we blink, the tear film coats the surface of the eye, which helps to keep them clean and clear. If insufficient amounts of the tear film or its composition is off, dry eyes can occur.^[1]

Symptoms of dry eyes include redness or irritation, which is especially evident in the wind, stinging or burning sensation in the eyes, blurred vision, can be especially noticeable when reading, a scratchy or gritty feeling, that feels like sand in the eye, presence of strings of mucus in and around the eyes, pain and discomfort while wearing contact lenses, increased amounts of tears in the eye.

Dry eye is diagnosed by an ophthalmologist, who will start with an eye exam to look at the eyelids and surface of the eye. Ophthalmologists may perform different tests to diagnose dry eyes including the following:

• Examine amount of tears that your eyes make
• Determine how long it takes tears to dry up
• Examine eyelid structure

Artificial tears are one treatment for dry eyes, which are available without a prescription and can be administered multiple times per day.

Prescription eye drop medications may also be recommended to help the eyes make more of their own tears.

Newer treatments are also available (or are being developed) that specifically target the underlying causes of dry eyes.^[2]

Blocking tear ducts is another treatment that may be recommended by an ophthalmologist.

Pycnogenol, a patented formulation of pine bark extract, has shown promise for alleviating dry eyes in patients with Sjogren’s disease, a common autoimmune condition in women that causes dry eyes and dry mouth. The mechanism of action isn’t clear but may be due to the anti-inflammatory effects of pycnogenol.

Fish oil and omega 3 fatty acid supplements have been also have been studied for dry eyes. However, their efficacy across different studies has been inconsistent, with some meta analyses more optimistic on their efficacy for treating dry eye symptoms^[3] than others.^[4] Although one extensively cited cross-sectional study found that higher omega-3 fatty acid consumption was associated with a 17% lower risk of dry eye in a cohort of 32,000 women,^[5] more research is needed to determine their efficacy for the relief of dry eye symptoms of varying etiology in different populations. As with pycnogenol, therapeutic mechanisms of action are not well understood, but likely involve the anti-inflammatory activity of omega-3 fats.

Good nutrition helps to keep the eye healthy overall and may reduce the risk of eye diseases such as dry eye. Overall, getting plenty of leafy green vegetables along with yellow, orange, and other colorful fruits and vegetables will help to keep the eyes healthy.^[6]

Dietary patterns that are good for the heart may also be good for the eyes, since the eyes rely on tiny arteries to deliver oxygen and nutrients. As with the heart, keeping blood vessels healthy will help to keep the eyes healthy.

The most common non-medical treatments for dry eye, such as artificial tears and lubricating eye drops are available over the counter, without a prescription. Although this is a good place to start if you have infrequent issues with dry eyes, it is important to see a doctor if symptoms persist or become worse.

Hormonal changes during aging can be a cause of dry eye. Although both men and women can get dry eye, it tends to be more common in women, especially after menopause. There are many other causes of dry eye, which including autoimmune diseases such as rheumatoid arthritis, Sjogren's syndrome, and lupus, thyroid disease, smoke exposure, wind exposure, or being in a dry climate, prolonged activities that reduce blinking such as working at a computer screen for long periods of time, or reading, wearing contact lenses for an extended period of time, refractive eye surgery such as LASIK.

Additionally, medications that can cause dry eyes include diuretics, beta-blockers, antihistamines, sleeping pills, medications for anxiety or depression, and heartburn medications.^[2]