What you can do about dry eyes

Created date

August 28th, 2017
Cartoon image of a dry eye.

Cartoon image of a dry eye.

According to the National Eye Institute (NEI), about five million seniors in this country have dry eyes. 

Having dry eyes can significantly affect your quality of life by interfering with watching television, using your computer, playing games, reading, or seeing a movie. Having dry eyes may go beyond discomfort and result in light sensitivity, pain, vision changes, or eye infections.

Why eyes become dry

Aging may affect tear glands in different ways. “Your tears may not be the proper consistency or evaporate too quickly,” says Raina Patel, M.D., a physician at Eagle’s Trace, an Erickson Living community in Houston, Tex.

Many other factors come into play. “Certain medications, including antihistamines, decongestants, hormone replacement therapy, antidepressants, diuretics for high blood pressure, and sleeping pills can make your eyes dry,” says Kam Silani, O.D., chief clinical director at Beverly Hills Optometry in Beverly Hills, Calif. “Systemic health conditions, including Parkinson’s disease, Sjogren’s syndrome, arthritis, thyroid disease, irritable bowel disease, rosacea, and blepharitis [eyelid inflammation] can cause or exacerbate dry eyes.”

Medications and health conditions affect different eye structures and the makeup of tears. “Tears are made of a mucin [lubricant] layer, a water layer, and an oil layer. Any health condition that alters any of these components can result in dry eye,” says James Heltzer, clinical correspondent for the American Academy of Ophthalmology. 

You may also develop dry eyes if you have had refractive eye surgery or have worn contact lenses for a long time.

Feeling better

“Underlying causes should be investigated and treated before other options are considered,” Patel says. “If dry eye results from taking a medication, your doctor may recommend changing to a medication that does not cause the dry eye side effect.” 

Medications to treat dry eye include cyclosporine (Restasis), an anti-inflammatory medication. It decreases corneal damage and increases tear production. It may, however, take three to six months of twice-a-day dosages for it to work. “Some studies show positive results from taking flaxseed oil or fish oil supplements,” Heltzer says. “Because most supplements are available over the counter, talk to your doctor before trying them in order to reduce the risk of drug interactions,” Patel advises. 

“Some oral medications such as doxycycline may be able to help reduce blepharitis,” Silani adds.  

Eyecare professionals offer other options for people with more severe cases. “Some key in-office treatment options include punctal plugs and placement of amniotic membranes to promote healing and reduce inflammation,” Silani says. “Most recently, the use of in-office thermal pulsation of the eyelids has proven as an effective holistic approach in providing patients with long-term relief.”

People who do not respond to medications or other treatments have more options. “Specialty contact lenses can be customized to help patients who do not find relief from conventional dry eye treatments,” Silani says. “Another alternative that is quite effective for patients is called autologous serum drops. This unique approach uses the patient’s own blood to create eye drops, which have beneficial properties to promote proper cellular health.” 

What to do at home

Most people use over-the-counter artificial tears, gels, and ointments. “They all work differently, so if one doesn’t work, try another,” Heltzer says. “But avoid excessive use of anti-redness drops or artificial tears with preservatives because they can make symptoms worse.” 

To slow the evaporation of tears, wear glasses or sunglasses that fit close to the face (wraparound shades) or have side shields. Indoors, an air cleaner to filter dust and other particles may help. A humidifier may also provide some relief. Allow your eyes to rest when performing activities that require you to use your eyes for long periods of time. 

“You can also use warm compresses, such as a Bruder Moist Heat Eye Compress, for periodic relief,” Silani says. 

Future treatment options

The scientific research community is investigating a number of new ways to treat dry eyes. For example, a synthetic form of a protein called lactin is in clinical trials. Lactin stimulates tear production. Researchers are also studying stem cell therapy to repair tear glands. 

Omega-3 fatty acid supplements are also the subject of a large NEI study. Previous studies have produced mixed results and most are small studies. The current NEI study is a large, multisite study that will provide more insight into how omega-3 fatty acids work.

If you have dry eyes, early detection and treatment are essential. “You should see an eyecare specialist regularly whether or not you have dry eye syndrome,” Heltzer says. “Exams in which your pupils are dilated are especially important, because sometimes small changes in the eye can signal the presence of a disease like high blood pressure or diabetes even before you have any other symptoms.”

Fast fact

Tears contain about 1,500 proteins.

Source: Gordon Laurie, Ph.D., University of Virginia School of Medicine