What is Dry Eye?

by Jan 3, 2022

An ever-increasing problem in today’s world is dry eye. What is it and what can we do to help it?


What Causes Dry Eyes?

The eyes are protected from the outside world by an outer coating called the tear film. The tear film is made up of water, oils, mucins, and anti-microbial properties to not only keep the eye lubricated and comfortable, but also to help protect it against dirt, dust, bacteria, allergens, etc. free floating in the air.

When the tear film is of proper quality and quantity, the eyes feel great! However, when the tears’ quality is poor, or quantity is subpar, individuals may experience symptoms of dry eye.

Dry eye symptoms include dryness, grittiness, sandy or gravel-like sensations, the feeling of something being stuck in the eye (foreign body sensation), burning, excessive watering, redness, and intermittent blurry vision.

Some of those symptoms may sound counter-intuitive, so we’ll dig in deeper to some of these findings.

Those suffering from dry eye may experience excessively watery eyes. This is because the eyes feel dry and send a signal to the brain to produce more tears.

The brain complies, but the tears produced are of poor quality. They are very watery, lacking the oily component that keeps the tears stable. As a result, the eyes water and these poor-quality, excessively watery tears drip down onto the cheeks.

Since the eyes are still lacking proper lubrication, they continue to send signals to the brain for an increase in tear production, and the cycle continues—which can be quite frustrating!

Intermittently blurry vision is another confusing, yet common finding associated with dry eyes. Intermittent blurry vision is defined as vision that is clear sometimes, and then other times is quite blurry, possibly interfering with activities of daily life. Intermittent blurry vision points towards a problem with the tear film and cannot be corrected with an updated glasses prescription.

This can be differentiated from constantly blurry vision in which vision never improves and is habitually blurry day-to-day. Those with constantly blurry vision may benefit from an updated glasses prescription.

In dry eye, the tear film is unstable. Normally, when we blink the eyelids smooth out the tear film and should result in clear vision for 10 or more seconds before an additional blink is necessary.

In many patients with dry eye, the tears evaporate too quickly meaning a blink may temporarily smooth out the tears, but then within a second or two the tears evaporate and degrade into small patches.

You can think about this like driving on a misty day. When your windshield wipers wipe, it smooths out the windshield and you can see well. But within a few seconds the mist fills the windshield in a patchy manner, making it difficult to see clearly.

Intermittent blurry vision is exasperated by tasks that require a lot of focus—driving, computer work, reading, writing, playing video games, watching tv, etc. as focusing on these tasks has been shown to decrease blink rate (to as little as less than once a minute!), therefore resulting in an increase in dryness and a non-uniform tear film.


What are the Treatments for Dry Eye

If you think you may be suffering from dry eye—you are not alone! Many individuals suffer from dry eye—some may have intermittent dry eye that only occurs on occasion, whereas others may notice symptoms every day.

Regardless, there are several different things that can be done to help manage dry eye.


Treating Dry Eye Disease with Eye Drops

The first and most popular way to treat dry eye is with eye drops—artificial tears that supplement your natural tears to help better lubricate the eyes.

There are many great brands of artificial tears. While they may be expensive, it is always recommended to purchase name brand artificial tears such as Systane, Refresh, and Soothe, as generic brands tend to have higher amounts of preservatives and the formulary can vary slightly bottle to bottle resulting in more eye irritation down the road.

When it comes to purchasing artificial tears, it is also important to buy drops labeled “artificial tears” and not drops targeted to remove or reduce redness of the eyes.

Regular artificial tears can be used 4-6 times a day. Preservative free artificial tears that come in individual vials can be used as frequently as you would like, as long as the individual vial is disposed of after 24 hours.

In those with moderate to severe dry eye, using artificial tears regularly is important. Applying tears to the eyes once or twice a day is likely not enough to make a difference, and it make take weeks of applying tears 3-4 times per day to really start noticing a decrease in symptoms.


Warm Compresses, Eyelid Massage and More

Another great treatment for dry eye is warm compresses and digital massaging of the eyelids each evening. This can be accomplished using a warm washcloth, or the preferred method of using a special eye mask called a Bruder mask.

Bruder masks contain small beads that heat up to the optimal temperature for your eyelids and stay warmer longer than traditional warm washcloths.

Warm compresses can help with dry eye as the eyelids contain specialized glands called Meibomian Glands. Meibomian glands are responsible for producing and secreting the oil component of the tears.

When the oils become stagnant in the glands, they can harden and even die off. Too little oils in the tears is a major contributor to the tears evaporating too quickly from the eyes—resulting in chronic dry eye.

Regular warm compresses help to heat the oils within the glands, making it easier to express the oils from the glands and into the tear film, thus improving the quality of the tears.

If these treatments do not work, there are many other options including dry eye treatments with specialized equipment, prescription strength dry eye drops, and even little plugs that can be put into the tear drainage ducts (puncta) to help keep the tears on the eyes longer before draining out.

Ultimately, if you are suffering from dry eye, be sure to talk to your doctor about it! It is not something you need to suffer with in silence. It may take some time to find the right treatment for you, but dry eye is manageable!


Our eye doctors at Wilmington Family Eye Care in Wilmington, DE excel in prescription of glasses, contact lenses and the diagnosis of a variety of eye diseases. Call our optometrists at 302-299-1286 or schedule an eye exam appointment online if you would like to learn more about dry eye and dry eye treatments. Our eye doctors, Drs. Daniel Baruffi, Joseph Goldberg, Karen Darrell and Patricia Jones provide the highest quality optometry services and eye exams in Wilmington, Delaware and its surrounding areas.

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