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  • Dr. Ashutosh Patil

Dry eye syndrome

Eye discomfort is frequently caused by dry eye syndrome. Anyone can suffer dry eyes, however elderly persons are most frequently affected. Symptoms are often relieved with artificial tears, gels, and soothing ointments.

What is dry eye syndrome?

The condition known as dry eye syndrome, sometimes referred to as keratoconjunctivitis sicca or simply "dry eyes," happens when the tear film that typically maintains the eye lubricated and moist changes. It may happen as a result of different circumstances.

What is the tear film?

Three layers make up your tear film: the thick outside oily layer, the thin inner mucus layer, and the major center watery layer. Tears often refer to the primary center watery layer. A lacrimal gland is located just beneath the eyelid, immediately above and to the side of each eye. These glands produce the watery component of the tear film and discharge it onto the cornea. Your eyelid distributes the fluid over the front of the eye when you blink. Meibomian glands are the name for the many small glands found on your eyelids. These produce the oily liquid that coats the tear film's outer layer. A very small quantity of this oily coating is required, but it keeps the tear surface smooth and slows down the evaporation and drying of the watery tears. The third layer of your tear film is made of a little quantity of mucus-like fluid by the conjunctiva, a transparent layer that covers the bottom of your eyelids and the front of your eye. This mucus enables the watery tears to coat the eye's surface uniformly. The tear film's fluid production never stops. It enters a tear sac after draining out of your eye through tiny canaliculi on the inside side of your eye. From there, it travels into the tear duct, also known as the nasolacrimal duct, and into the nose. The nasolacrimal duct's opening is visible in the lower lid's inner corner of your eye.

Causes of dry eyes :

The causes include: Ageing. As people age, their tears tend to be less frequent. After menopause, women frequently initially detect a change in their dry eyes. Medication. Dry eyes can be an adverse effect of several medications

These consist of:

● 'Water' tablets (diuretics).

● Some antidepressants.

● Antihistamines, often used for hay fever and allergy.

● Some treatments for anxiety and other psychological problems.

● Beta-blockers such as propranolol, atenolol.

● Some treatments for acne, etc.

● Some eye drops used to treat other eye conditions.

● Some cough medicines.

Medical conditions: Some people have dry eyes as a sign of another illness. Rheumatoid arthritis, systemic lupus erythematosus (SLE), and Sjögren's disease are particularly linked to dry eyes. You would typically have additional symptoms in each of these illnesses, such as joint discomfort or skin rashes.

Increased evaporation of tears: Your surroundings have a significant impact on your sight. The eyes can get dry from dry warm air, sun radiation, and wind, which all stimulate evaporation. The following are the main

Environmental triggers of dry eyes:

Low humidity, such as that caused by central heating or cooling systems or by living in a hot, dry area. Low blinking frequency, which is frequently accompanied by wider-than-normal eye openings, causes more tears to evaporate and reduces the effectiveness with which fresh tears are dispersed. Different people blink at different rates. If you stare intently at a computer, TV, or microscope for an extended amount of time, your blinking will decrease. Parkinson's disease patients frequently blink less than usual. Wearing contact lenses. Windy conditions. not entirely shutting the eyelids over the eyes. for instance, as a result of thyroid disease-related eye issues. Ectropion, a disorder that causes the eyelids to roll outward and expose a portion of the eye when sleeping, affects certain older persons. Some people have partially open eyes as they sleep. Damage to the outer part of the eyes, eyelids, etc, from disease, injury or surgery. Skin rashes such as seborrhoeic dermatitis or rosacea. Inflammation of the eyelids (blepharitis), which is often associated with dry eyes. Unknown. Some younger people have no apparent cause. They simply produce less than the normal amount of tears.

Dry eyes symptoms:

Both eyes are usually affected. Symptoms include: Irritation in the eyes. The eyes could feel dry or scalding. The eyes don't become red, though. If they do, there is typically another issue with the eyes or a consequence. Sometimes there may be a very little transient blurring of vision. The seeing portion of the eye is unaffected by dry eyes, and dry eyes often do not permanently impair vision. discomfort when staring at bright lights in your eyes. If you use contacts, you could notice that they start to feel uncomfortable. Although it doesn't always feel dry, the eye frequently feels dry.

What are the possible complications of dry eyes?

Complicacies are rare. They are more probable if you have a medical condition that makes your eyes excessively dry AND you are exposed to a dry environment. It is possible to develop keratitis or conjunctivitis, an inflammation of the cornea in the front of the eye. On the cornea, there may grow tiny ulcers if the condition worsens. The cornea can pierce very seldom (perforate). If your eye turns red or if dry eyes are impairing your vision, you should visit a doctor or an optician. If you have dry eyes and have eye discomfort that seems to be more severe than the typical grittiness or irritation, you should also seek medical care. Pain and blurred vision, which are not typically symptoms of dry eyes, may be signs of another eye problem or a dry eye consequence.

How are dry eyes diagnosed?

Dry eyes may often be identified by your symptoms and an eye exam by a doctor or optician. However, don't be shocked if your doctor asks about a wide range of additional symptoms because dry eyes might be a sign of an underlying illness (such as Sjögren's syndrome). To confirm the diagnosis of dry eyes, a test may occasionally be performed. This test, known as the Schirmer's Tear Test, counts the number of tears you produce. Your lower eyelid is covered with special paper, which is then left there for five minutes. The amount of moisture the filter paper has after five minutes may be used to gauge your tear output. Sometimes, a second examination using a slit lamp is required. This examination is often done by an optician or an ophthalmologist, an expert in eyes. The surface of the eye may develop dry patches or ulcers as a result. Your doctor could suggest seeing an ophthalmologist for guidance and care if your dry eyes are linked to another illness.

What is the treatment for dry eyes?

The majority of dry eye therapies work to rehydrate and lubricate the eye. A few therapies work to change the way your tears are produced. Moreover, you may assist yourself by: Try to protect your surroundings from becoming too dry. This can entail using a humidifier or lowering your heating. going out in a hot, dry area, wearing glasses or shades to protect your eyes from wind and dust. If you've been gazing at a screen or a microscope for extended periods of time, you should give your eyes a break by taking regular pauses. Maintaining healthy eyelids: If your eyelids become puffy or inflamed, they may perform their function of producing the oily portion of your tear film less effectively. Use mild makeup removers if you wear eye makeup, and avoid scratching your eyelids. Regularly switch out your mascara, and if your eyelids start to swell or hurt, think about switching brands.

Artificial tears

These often work well to relieve symptoms and are available as eye drops and gels. They are available over-the-counter at pharmacies. To reduce symptoms at initially, you might need to use them every hour or more. You might then only need to use them three or four times each day after your symptoms start to go better. To prevent symptoms, you might need to use them consistently. Artificial tear drops and gels come in a variety of forms and include various chemicals. Some people occasionally find one type to be irritating. If the initial preparation does not work, switching to a new, preservative-free preparation can be helpful. Consult your optometrist or pharmacist for guidance. Preservatives like benzalkonium hexachloride are present in certain artificial tears. The front of the eye might be harmed by using them often (the cornea). Use a preservative-free brand if you regularly use fake tears more than four times each day

Eye ointment

Additionally, using a lubricating and soothing ointment before bed may be beneficial. Pharmacy chains also sell this. Ointments shouldn't be applied during the day since they might impair your eyesight and reduce the effectiveness of the artificial tears. If you use eye drops for other issues, such as increased eye pressure, do not use eye ointment (glaucoma).

Other treatments

In most instances, artificial tears and soothing creams are effective. If the aforementioned therapies are ineffective for severe situations, a professional may suggest more measures. Examples of other treatment options sometimes used for severe cases include: pills or eye drops that are anti-inflammatory (for example, steroid eye drops or tetracycline tablets). medications to increase the tear gland's production of tears (for example pilocarpine). surgery to prevent the tears from evaporating. Lacrimal ducts are temporarily blocked by plugs to prevent tears from evaporating. Your own blood's liquid component can be used to create unique, organic tear drops. We refer to this as autologous serum tears. In an effort to preserve the moisture in your eyes, special glasses or goggles are employed. Also, some people may need other treatments if they have an underlying cause for their dry eyes.

Dietary changes

Omega-3 fish oil fats in the diet or as supplements appear to help with dry eyes. In order to determine the precise combination and dose, more research is required. However, consuming oily fish once or twice a week may be advantageous. Consult your doctor or pharmacist if you belong to one of the populations that has to be cautious about the amount of fatty fish in their diet or omega-3 supplements (pregnant women, for instance).

Contact lens wearers

Many eye drop kinds should not be used when wearing contact lenses. Consult your physician or pharmacist. The preservative in the drops is frequently what can go wrong. There are certain drops available without preservative that are acceptable for those who wear contact lenses. Wearing contact lenses while applying eye ointment is not advised.

If you think a medication is the source of your dry eyes, let your doctor know.

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