What is Dry Eye?
Dry Eye is a condition in which the tear film that protects your eyes is inadequate for the health and comfort of your eyes. It is a very common condition and effects 15% of the population in the United States, including approximately 5 million people over the age of 50.
What are the symptoms of Dry Eye?
- Fluctuating vision which is often worse first thing in the morning, worsening toward the end of the day
- A stinging, burning or scratchy sensation in your eyes
- mucus in or around your eyes
- Sensitivity to light
- Difficulty wearing contact lenses
- Difficulty with nighttime driving
- Watery eyes
- Blurred vision or eye fatigue
My eyes are always watery, how can they be dry?
When your eyes are dry, they become irritated. When your eye is irritated, your lacrimal gland produces lots and lots of tears to try and soothe or eradicate irritation. The large number of tears that are produced by this reflexive tearing mechanism overwhelms the tear drainage system. This causes your tears to overflow, causing your eyes to water.
Causes of Dry Eye Symptoms and How to Treat Them
- Age: Tears decrease as we get older.
- Contact Lenses: Decrease Contact Lens wearing times, and do NOT SLEEP in your lenses.
- Menopause will dry many mucous membranes
- Lack of Sleep An adequate amount of sleep gives your eye time to rest in the moist environment produced by eyelid closure and gives your tear production system a much-needed rest
- Not drink enough water, most people should drink 2 liters of water or other fluids per day or 8 glasses per day (64 oz). You need to be well hydrated to produce enough tears
- Incomplete Blink or Not Blinking Enough Most people do not blink completely, especially on the computer. Making a conscious effort to blink more often and completely and or take breaks.
- Environment A dry or windy day along with the heater in the winter will also dry eyes out. Wrap around glasses sunglasses: Wearing glasses tends to protect the tear evaporating quickly
- Ceiling Fans-Turn them OFF night!! If needed, try to decrease AC temperature instead
- Smoking will dry make Dry Eyes worse
- Heavy makeup: Through remove your makeup at night before going to sleep
- Prior eye surgery such as LASIK or eyelid surgery
- Autoimmune disease such as Rheumatoid Arthritis, Sjogren’s Syndrome, or Thyroid Disease
- Medication: Antihistamine, Decongestant, Anti-depressant, Anti-anxiety meds, Sleeping pills/Sedatives, Birth control pills, Pain reliever, and Anti-hypertension meds, beta-blockers, alpha-blockers and diuretic
- Use fewer eye drops: Many eyes drop such as anti-allergy drops or “redness reliever” drops have preservative in them that are irritating to the eye. DO NOT USE VISINE and other “GET THE RED OUT” product. They do not address the Dry Eye issue and will make eye worse in some cases
Dry Eye is a chronic condition and will never go away completely
Treating your Dry Eye is like brushing your teeth or washing your face, you have to do it every day in order for it to be effective!
Warm compresses are the most effective means of treating Dry Eye. The key to treatment is that it is done regularly. Warm compresses should be used twice a day for 5 to 10 minutes each time. Warm compresses work because heat result in the opening of the oil glands and the softening of the oils that have become hard and are clogging the glands. Those glands produce the basil, or regular, tears the eyes need to stay hydrated.
Rice in a sock or small plastic bag
- Fill with uncooked rice and microwave for approximately 15 seconds. Warming time may vary depending on your microwave; it should be warm, not scalding hot
Commercial Hot Packs
Lid scrub are helpful because they help get rid of the dirt and debris that collect on the eyelashes and block the oil glands. Lid scrub should be done twice a day daily.
- Put a few drops of Baby Shampoo on the warm washcloth. Rub the washcloth together so it gets foamy. Wrap the washcloth around your fingers and clean along the base of the eyelashes with your eyes closed for approximately 15 seconds on each eye.
Commercial Lid Scrub available at drug stores
- Ocusoft Lid Scrub
- Sterilid by Thera Tears
The use of artificial tears is one of the cornerstones of the treatment of Dry Eye. As we get older, our ability to produce tears decrease. By the age of 65, our tear production is 60% less than what it was at the age 18
How often should I use artificial tears?
One of the most important points about using artificial tears is that if you are using artificial tears when your eyes feel dry, it is already too late. You should use artificial tears 4 to 6 times per day. If your eyes are comfortable at this frequency, you can decrease the frequency to see if your eyes stay comfortable
Which type of artificial tear should I use?
There are many brands of artificial tears and most of them are safe and effective. The brand is not important but if you use artificial tears more than 4 times per day, it is best to use a preservative free variety because the preservative themselves can contribute to eye irritation. Most brands make a preservative- free variety of artificial tears:
Artificial Tears: Refresh TheraTears Systane Blink
Can I overdose or hurt my eyes by using artificial tears too much?
If you are using preservative-free artificial tears, you can never use “too much”. You can use preservative –free artificial tears every hour or more and it will not damage your eyes. The thicker or more viscous tear product are helpful in case of severe dry eye, but they tend to make the vision blurry. Experiment with different product to find what work best for you.
An approach that many patients have found helpful is to use a thick lubricant in the morning and at night and a thinner product during the day.
Thick Lubricants: Refresh Liquigel Refresh PM Celluvisc
What is flaxseed oil?
Flaxseed oil is a polyunsaturated plant to oil that carries vitamins A,D,E and K. It is the most concentrated vegetarian source of Omega 3 fatty acids in nature. Flaxseed oil suppress inflammation and keeps oil glands healthy
1-2 Teaspoon per day is the recommended dose.
What is the best way to take flaxseed oil?
You can buy ground flaxseed or flaxseed oil at the grocery store. It has a nutty flavor and goes well with many dishes. You can stir it into yogurt, sprinkle it on salads, cereal, smoothies or soup. You can also add it to your favorite salad dressing or drizzle it onto stir fry, steamed vegetable, rice or pasta. You should not cook with Flaxseed oil because the high heat can turn this healthy fat into harmful one.
Are there any medication that I may be using that I should discuss with my doctor before I start to use flaxseed oil?
Flaxseed oil can affect the clothing of your blood. You should talk to your doctor if you are using Coumadin, Warfarin, Plavix or other blood thinner prior to starting flaxseed oil. It is fine to use aspirin.