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Dealing with Dry Eyes
More than one cause, more than one solution
Do your eyes often burn, feel gritty or sandy? Are they dry and scratchy? If so, you may have a dry eye syndrome. Dryness can come from different sources, and ranges in severity. As more than one cause may be involved, a combination of approaches may be needed to provide relief.
Internal issues
If your ophthalmologist says you have poor tear production and significantly dry eyes, the cause may be related to your general health. Your family doctor can test you for certain conditions. It is not uncommon for dry eyes to appear months, even years, before other symptoms of disease.
Some people have less than normal tear production from an early age and also experience dry eye, especially in winter. Often, these people also have problems with dry scalp or skin.
Certain diseases significantly dry the eyes. Other people in the family may have the same conditions.
Abnormal thyroid function can make eyes feel dry. Hyperthyroidism frequently causes other eye symptoms. This includes problems with muscle control of the eyes, such as eyes that do not align (strabismus), bulging eyes (proptosis), eyelid changes, and blurry vision.
If you suffer from any type of arthritis, you may notice dryness in parts of your body that have a mucous lining. This includes the eyes, nose, mouth, throat, sinuses, and bronchial passages in the lungs.
A wide range of hormone disorders can be related to dry eyes, especially in women. Often these changes accompany menopause. Other hormonal causes include some unusual conditions like ovarian cysts or pituitary gland tumours.
Some causes of dry eyes fit into the autoimmune category of diseases. These include lupus erythematosus, bowel disease, unusual types of arthritis, and Graves disease (a thyroid disorder).
Be aware that medications including antihistamines, antidepressants, sedatives, painkillers with codeine, and remedies for heartburn or reflux can all cause dryness. Dryness can affect not only the eyes, but also the skin, mouth, nose, and throat. Talk to your doctor if you notice extreme dryness and are on medication. A less drying alternative drug may be available.
You do not need to worry about developing any kind of dependency on artificial tears. You are simply replacing what your own body is unable to produce.
Certain lifestyle choices make a difference in your tear production. Even drinking four to five glasses of water a day will help your eyes. As well, many of us consume large amounts of products loaded with caffeine, such as coffee, tea, pop and chocolate bars. Since caffeine is a diuretic, it increases the amount of urine you make. It also contributes to osteoporosis and may interfere with sleep patterns and mental function. Certainly you do not want large doses of it in your blood stream.
Lubrication often helps hydrate the eyes. A lack of tears can be replaced with lubricating drops. Add them regularly, at least two to four times a day. Using a gel at bedtime may help. Gel products are thicker than drops and seal the eye during sleep. Several products work very well for dry eyes - Tears Naturale™, Refresh Tears™, Systane™ Lubricant Eye Drops, and GenTeal™ Artificial Tears. Compare different lubricating drops and gels to find the most effective ones for you.
Ophthalmologists are often asked why these lubricating medications are necessary. The answer is that tear film is the first line of defence against infection. If your eyes are well lubricated, there is much less chance of developing a problem such as pink eye (bacterial conjunctivitis), viral keratitis or an ulcer of the cornea. Lubricating medication also helps sight. Tear film adds a bit of extra sharpness to your vision that you will not have if your eyes are really dry. Normally, a smooth tear film increases the sharpness of your sight.
If you are bothered by or allergic to the chemicals or preservatives that keep lubricating drops sterile, preservative-free versions are also available. Refresh™ Celluvisc™ is one option, and may be useful for women who are pregnant. It comes in little plastic vials that provide individual doses of lubricating medications.
Improving the environment
Since your environment can also cause eye dryness, making changes to it may help. You can reduce evaporation of tear film and improve tear production in several easy ways. First, keep a cool mist vaporizer running in your bedroom. Next, avoid having any artificial ventilation blowing on you, such as air from a heater in your vehicle or from an air conditioner in summer. If air often blows at your face, the dryness can become so severe that it irritates the cornea and makes eyes water. (The cornea is the transparent front part of the eye.)
Often, ophthalmologists find that more changes related to dryness appear in one eye. This may happen if air blows at one eye more than the other. When driving, aim vents at your feet and away from your body. As well, wear fit-over or wrap sunglasses and a peaked hat or visor (bigger is better) that comes down to the edge of the frames. Air coming off the windshield will blow right by you without drying the tear film. If walking in the wind, large sunglasses with an aviation-style frame and a ball cap provide a shield.
Working in an area where a heating or air intake vent blows directly on you can make eyes very dry. If this is true for you, ask your employer to place a deflector on the vent or have the vent replaced. Alternatively, move the workstation. A portable heater can be just as drying as building ventilation. Keep heating appliances pointed away from you.
Sometimes you cannot control a dry or dusty environment or the length of time you must spend in a vehicle. In this case, do everything you can to improve humidity where you can control it; in your home. Small, portable, cool mist vaporizers are very useful. Have one in your bedroom and another in a room where you spend the most time. If you have a furnace humidifier, set it at 25 per cent during the winter. Use the furnace humidifier along with the two portable vaporizer units. You do not want so much humidity that you run into trouble with mould, wet windows and problems with frames. However, it is amazing how much difference an extra two to three litres of water per day makes to the comfort of the eyes, nose, throat and mouth.
Common causes |
Remedies |
| Poor tear production Abnormal thyroid Arthritis Hormonal changes Autoimmune diseases Medications Dehydration Artificial ventilation Dry or dusty conditions |
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Whether the source is internal or environmental, lubricating drops and gels can help with dryness. For more severe dryness, use lubricating ointments at bedtime. Punctal plugs may also be placed in the tear ducts, which normally drain into the nose. These plugs held keep the tears from draining out of your eyes. A new product called Restasis™ is now available by prescription in Canada. It is an antibiotic drop that can be used in severely dry eyes.
Having dry eyes is often frustrating because it is chronic. Unfortunately, the body tends to dry out naturally as we age. Canada's prairie provinces have a very dry, desert-like climate in the winter months. You do not need to worry about developing any kind of dependency on artificial tears. You are simply replacing what your own body is unable to produce.
FAMILY HEALTH is written with the assistance of |
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FAMILY HEALTH is written with the assistance of |
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