Patient Information

Dry Eye

What are the symptoms of Dry Eye?

  • Gritty, scratchy, burning or irritated eyes.
  • sometimes painful in extreme cases
  • Blurry vision (intermittent)

What is the cause of Dry Eye?

There are 2 main reasons for Dry Eye. 

  1. Your eyes do not produce enough tears, or 
  2. Your tears are not remaining long enough on the surface of the eyes to keep your eyes moist.

You can have one type of dry eye, or have both at the same time.

When your eyes do not produce enough tears

A gland in the corner of your eye called your lacrimal gland makes your tears. Normally, this gland makes enough moisture to keep your eye healthy. The tears wash away dust and anything else that may fall in your eye. They also protect your eyes from germs and infection.

When your lacrimal gland doesn’t make enough tears, it causes a dry eye.  Another name for this type is keratoconjunctivitis sicca. You might have it because your eyes have aged and aren’t able to make tears the way they used to.

You might also have it because of a medical condition, like: Diabetes, Rheumatoid Arthritis, Scleroderma, Lupus, Thyroid disorders, Sjogren's Syndrome, Vitamin A deficiency.

You may also get this as a side effect of certain medicines, like: Decongestants, Antihistamines, Hormone replacement therapy, Anti-depressants, Acne medicine, Blood pressure medication, Birth Control, Parkinson's Disease medications.

Lacrimal glands can also have trouble making enough tears after laser vision correction (LASIK) surgery. This usually goes away after a few months. 

You can also get this type of dry eye if inflammation or radiation damages your lacrimal glands.

When your tears do not remain long enough on the ocular surface

When your tears evaporate too quickly it affects the lubrication of the ocular surface,  it may be because of a problem with the makeup of your tears. Other times, it comes from changes to your eye, or the environment.

Tears have three layers: an oily outer layer, a watery middle layer and an inner mucus layer. The oily outer layer helps keep the watery middle layer from evaporating too quickly. The mucus one spreads tears evenly over the surface of your eye. A problem with any of these can cause dry eye.

Glands within your eyelids called Meibomian glands make the oil in your tears. Sometimes they get clogged. When that happens, your tears don’t get enough oil. The watery layer of your tears loses its protection and your tears evaporate faster.

This is common in people who have a condition called Blepharitis (inflammation of the eyelid)

What are other causes of Dry eye?

  • Environmental factors like wind, smoke, or dry air
  • Not blinking enough, for example: while you’re staring at a screen or reading for a prolonged period.
  • Eyelid problems like ectropion (your eyelids turn outward) or entropion (your eyelids turn inward). Sometimes, the eyes can't close completely after cosmetic eyelid surgery or in patients with Bells palsy.
  • If the exposed surface of your eye gets bigger, your tears may have a hard time covering it. This can happen if you have thyroid issues that make your eyes bulge, or if you have eye surgery that opens your eye too far.

How is Dry Eye Diagnosed?

At Hills Eye Surgery the surface of your eyes will be carefully examined using a slit-lamp and specialised tests conducted as needed where any signs of Dry Eye can be detected. 

How is Dry Eye treated?

There are many eye lubricating drops on the market, which can be used to treat dry eye. Often it is a matter of finding which lubricating eye drop works best for you.

Preservative-free lubricating eyedrops are usually the better option, as some patients can be sensitive to the preservative in the lubricant eye drops dispensed in a bottle. You may use lubricating eye drops as often as needed  (there is no such thing as 'over dosing' on lubricants, since it is not a medication, but purely moisture for the eye).

At Hills Eye Surgery, other suggestions for dry eye may be suggested if lubricants alone do not help, these may include:

  • A lubricating gel/ ointment to use at bedtime before sleeping
  • Punctal plugs: Usually the dissolving type which are inserted into your tear duct to help preserve the moisture in your eye & prevent moisture from escaping down the tear duct.
  • Introducing supplements like: Flaxseed oil to your diet, which has been known to help with moisture to not only the eyes, but generally for ones body. 
  • using special eyedrops or ointment containing Vitamin A or a drug called Cyclosporine