Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Dry Eye Syndrome

Conditions & Treatments

Dry Eye Syndrome

Many people experience occasional dry eyes, which can be related to the weather, allergies, contact lenses, or other factors. However, some people develop chronic dry eye disease. This is referred to as dry eye syndrome, dysfunctional tear syndrome, or keratoconjunctivitis sicca (KCS). Dry eye syndrome refers to a group of disorders of the tear film. This is usually due to reduced tear production, poor quality tears, or excessive tear evaporation. Dry eye syndrome can cause eye discomfort and poor vision, as well as lead to other diseases of the eye surface.

The Tear Film

The term ‘tear film’ refers to the thin layer of tears that covers the surface of the eye. It is formed from a combination of aqueous (watery) secretions from the tear glands, oils from the eyelid glands, mucin from the goblet cells, and electrolytes and other components that work to protect the eye. The tear film is important not only to keep the eye moist but also to help keep vision clear and to fight infection. The tear film is continuously replaced by the eye and spread evenly over the surface of the eye due to blinking.

Symptoms of Dry Eye Disease

Common symptoms of dry eye disease include grittiness, burning, foreign body sensation (the feeling that something is in your eye), watery eyes, red eyes, blurred vision, eye fatigue, and contact lens discomfort. These symptoms can be worsened under certain conditions, such as prolonged staring (such as with reading, watching TV, or driving), windy environments, and indoor heating or drafts from nearby air conditioning vents.

Causes of Dry Eye Disease

There are several causes of dry eye disease. Most common is when the tear glands do not produce enough tears, but there can also be deficiencies with oil secretion from the Meibomian glands as well as with mucin secretion from the goblet cells. Furthermore, the quality of tears can be poor in chronically dry eyes, containing more inflammatory chemicals and salts that can actually further irritate the eye and worsen the dryness. Having had any eye surgery, including LASIK and cataract surgery, can make the eye more dry. Situational dryness can occur under certain circumstances, as with long periods of computer work or reading, sitting or sleeping under a ceiling fan, and windy environments.

Risk Factors for Dry Eye Disease

Many conditions can increase a person’s risk for dry eye disease. Common risk factors include increased age, female gender, post menopause, Sjogren’s Syndrome, autoimmune conditions (e.g. rheumatoid arthritis), chronic use of certain medicines (e.g., antihistamines, antidepressants, diuretics), blepharitis, and rosacea.

Diagnosis

An eye exam is necessary to determine the factors behind an individual’s dry eye problems. Tests can be done using a patient’s tears to determine how quickly the tear film breaks apart between blinks, and to measure how much tears are produced. Our physicians can tell you more about diagnosing dry eye disease. Sometimes a full medical exam is recommended with your general doctor to help discover any other conditions that may be affecting the health of your eyes.

Treatment Options

In many cases, dry eye disease can be progressive and worsen if not treated adequately. In addition to trying to prevent dry eye symptoms from developing, such as avoiding drafts and windy environments, taking frequent breaks from long periods of computer use or reading, and increasing room humidity, there are several medical options for treating dry eye disease:

  1. Artificial tears: available over-the-counter, these products can include liquids, gels, and ointments placed on the eye to alleviate discomfort and provide more moisture.
  2. Omega-3 supplements: for certain types of dry eye disease, such as those associated with blepharitis, taking omega-3 fatty acid supplements (such as flaxseed oil or fish oil) may help.
  3. Prescription medicines: eye drops and other medications can be used to control the inflammation (and associated discomfort) on the surface of the eye and help increase the production of one’s own tears.
  4. Punctal plugs: these are small, inert inserts that are placed into the punctum (the opening of the tear drainage system) or in the canaliculus (the tear drainage duct) of the lower or upper eyelid. Plugs cause a back-up of tears in your eyes, similar to the buildup of water in a bath tub when the drain is closed shut, therefore making the eye moist and comfortable.
  5. Surgical: various procedures may be of benefit by permanently closing the eyelid puncta or by correcting eyelid problems, thereby preventing the loss of tears. A procedure called Meibomian gland probing can also be of benefit to patients suffering from dry eye. Download a brochure on this procedure.