How dry are your eyes? If they are only mildly dry, you may think they don’t require any treatment. But is that really the case?
What we are now starting to understand is that dry eyes are much easier to treat when the disease is mild (or moderate), compared to waiting until there are signs and symptoms of severe disease.
This post looks at what signs and symptoms you should be looking out for and when to seek treatment from a professional.
The downward spiral
Dry eye disease is one of the most common eye problems we see every day in clinical practice. Underlying causes are very varied: hormones, skin problems, autoimmune disorders and medications can all contribute to the disease.
But the picture can be simplified by dividing the cause of dry eye into either a lack of water or a lack of oil.
Oil or water?
Tears are made of a thicker aqueous (watery) layer and a thinner lipid (oily) layer. Problems in either of these layers results in dry eye.
Over 70% of dry eyes are caused by problems with the oily tears; if there’s no oil, there’s nothing to stop the aqueous tears from evaporating.
The oily layer is crucial to a healthy tear film. If it’s not working properly, your watery layer will also be affected and the cycle of inflammation will continue.
The reverse is also true; if the watery layer is not working properly, that will impact on the oily layer and lead to inflammation and other symptoms of dry eyes.
Do the symptoms vary, depending on the cause?
The interesting thing – which has been shown in the recently published Dry Eye Work Shop 2 report, is that it doesn’t matter what the underlying cause of your dry eye; ultimately the outcome will be the same – red, sore eyes with a poor tear film.
What does this mean?
Dry eye disease leads to a cycle of inflammation and breaking that cycle is key to successful management. It is MUCH EASIER to break the cycle before things get out of hand.
Signs versus symptoms
Some people have symptoms of dry eye (such as gritty, irritated, sore or sticky eyes), but no clinical signs – such as blocked glands, inflammation or a reduced volume of watery tears. Other have NO symptoms or MILD symptoms, but clear clinical signs of dry eye disease. This is the group that can proactively manage their eye condition BEFORE it starts to hurt.
Take it seriously!
Even mild dry eye symptoms and signs should be taken seriously! This can lead to a serious reduction in quality of life and constant distress. People suffering from severe dry eye often end up with chronic and debilitating pain. If it gets to this stage, we’re managing a chronic pain syndrome, and not just dry eyes.
What you need to know
Be aware of the SYMPTOMS of mild dry eye disease:
- Sore, gritty, dry, irritated eyes
- A feeling like you have something in your eye constantly
- Waking up with sticky, sore, gritty eyes
- Inconsistent blurred vision, especially in air-conditioning, such as driving or office work
If you experience these symptoms, DON’T IGNORE them!
See your optometrist who will look for SIGNS of dry eye:
- Red eyes
- Crusting around base of eyelashes
- Blocked oil glands in eyelids
- Reduced volume of aqueous (watery) tears
If picked up early, mild dry eye disease can often be nipped in the bud by appropriate therapy. This may include use of prescription anti-inflammatory eye drops, the use of an eye mask during sleep, blinking exercises or the use of artificial tears.
Aren’t eye drops all I need?
Lubricant eye drops provide symptomatic relief from dry eye, and can prevent worsening symptoms, but do little in terms of treating the underlying cause of the condition. Constant use of these drops is a bit like continually basting the turkey to stop it from burning when the real solution is to turn off the oven. Finding the underlying cause and managing it is the key to long term successful management of your dry eye disease.