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Definition
A condition known as dry eye occurs when
tear film abnormalities prevent the eyes from being comfortable.
Although dry eye can occur in both men and women at any age, women are
most often affected.
Tear production normally decreases as we age. Dry eye can also be
associated with arthritis, and occasionally with a dry mouth.
Medications sometimes cause dry eye by reducing tear secretion. Since
these medications are often necessary, the dry eye condition may have
to be tolerated or treated with "artificial tears." A wide variety of
common medications that can cause dry eye include diuretics;
betablockers; antihistamines; sleeping pills; medications for
"nerves"; pain relievers; or alcohol. Be sure to tell your
ophthalmologist the names of all the medications you are taking.
People with dry eye are often more prone to the toxic side-effects of
eye medications, including artificial tears.
There are two kinds of tears: those that constantly lubricate the eye
and those that are produced as a response to irritation or emotion.
The healthy eye constantly produces tears that lubricate. When a
foreign body irritates the eye or when a person cries, more tears are
produced. Excess tearing from dry eye may sound like a contradiction,
but your tears must have the right balance of oil, water, and mucus to
be able to protect your eyes. Without this balance, your eyes become
dry and irritated and produce too many tears.
Symptoms
Stinging or burning
Eye irritation or scratchiness
Excess tearing, especially when reading, driving, or watching
television
Stringy mucus in or around the eyes
Difficulty wearing contact lenses
The symptoms described above may not necessarily mean that you have
dry eye. However, if you experience one or more of these symptoms,
contact your eye doctor for a complete exam.
Treatment
Your ophthalmologist is often able to diagnose dry eye by simply
examining the eyes. Sometimes tests that measure tear production may
be necessary. Such tests may involve placing filter-paper strips under
the lower eyelids to measure the rate of tear production under various
conditions
Dry eye is sometimes treated using eye drops called "artificial
tears." Artificial tears are available without a prescription. You may
want to try several brands to find the one that you like best.
Preservative-free eye drops are available if you are sensitive to the
preservatives in artificial tears. If you need to use artificial tears
more than every two hours, preservative-free brands may be better for
you. Solid lid inserts that gradually release lubricants during the
day may also be beneficial for some people.
Some patients with mild dryness may benefit from blinking more
frequently, especially when reading, driving, or watching television.
Conserving the tears in your own eyes is another approach to keeping
the eyes moist. Tears drain out of the eye through a small canal into
the nose (that is why your nose runs when you cry). Your
ophthalmologist may close these canals either temporarily or
permanently. This closure conserves your own tears and makes
artificial tears last longer.
Other methods may include steps to prevent the evaporation of tears.
In winter, when indoor heat is on, a humidifier or a pan of water on
the radiator will add moisture to dry air. Wrap-around glasses
(illegal to wear while driving in some states) may reduce the drying
effect of the wind. Anything that adds to dryness such as an overly
warm room, hair dryers, or wind should be avoided by a person with dry
eye. Smoking is especially bothersome. Some people with dry eye
complain of "scratchy eyes" upon awakening. This symptom can be
treated by using an ointment at bedtime. Use the smallest amount of
ointment necessary for comfort, since the ointment can cause your
vision to blur temporarily.
Dry eye caused by a lack of vitamin A in the diet is rare in the
United States, but is more common in poorer countries. Ointments
containing vitamin A can help dry eye caused by this unusual
condition. Vitamin A does not seem to help people with ordinary dry
eye.
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