Dry Eye Syndrome

What is dry eye syndrome?

Dry eye syndrome is a condition in which your eyes do not produce enough tears or the tears do not have the normal chemical makeup. Another name for dry eye syndrome is keratoconjunctivitis sicca.

How does it occur?

Normally, your body produces two types of tears:

• Lubricating tears, which are produced while you are awake. They help keep your eyes moist and clean and help fight infection. The tear film that forms contains layers of water, mucus, and oil. Dry eye can occur when any one of these layers is not normal. Most often, the watery layer is too thin.
• Reflex tears, which are produced in response to injury, irritation (such as smoke or toxic chemicals), or emotion. They may even be produced in response to dry eye, when your eyes lack lubricating tears, so your eyes may be more watery than normal.

Dry eye may be caused by:

• aging, because your lubricating tears may not contain enough water
• your environment, which may cause your eyes to dry out
• some medications that may decrease your body's ability to produce lubricating tears, such as antihistamines, birth control pills, diuretics, and beta blockers
• lack of vitamin A, which reduces tear production
• diseases that reduce tear production, such as arthritis, Sjogren's syndrome, systemic lupus erythematosus (SLE), leukemia, and Stevens-Johnson syndrome
• an enlarged drain (called the punctum) between your eyes and your nasal sinuses, which allows too much fluid to flow from your eyes toward your nose
• a change in the function of the eyelid so your eye does not close properly
• chemical or thermal (heat) burns, which change the composition of your lubricating tears.

Sometimes dry eye occurs for no apparent reason.

What are the symptoms?

Symptoms may include:

• a scratchy, gritty, burning feeling in your eyes (like when you have something in your eye)
• excessive watering
• stringy mucus in your eyes.

How is it diagnosed?

Your health care provider will examine your eyes and ask about:

• your symptoms
• your environment
• your overall health
• medicines you are taking.

The answers to these questions will help your provider determine if you need other tests, such as:

• Schirmer test (a strip of filtered paper placed in your eye at the edge of your eyelid to test the rate of tear production)
• fluorescein or rose bengal staining (special eyedrops that help your provider see problems with the surface of your eyes).

How is it treated?

There is no cure for dry eye. However, several treatment options are available that can reduce your discomfort and protect your eyes. Usually, your health care provider will recommend that you use eyedrops called artificial tears during the day and sometimes similar ointments at night.

If these products do not help, your provider may recommend other treatments, such as:

• artificial tear inserts that dissolve slowly when you place them under your eyelids
• temporary or permanent plugs that block the punctum (tear drain) so the eye can make full use of the lubricating tears it does produce
• laser treatment or minor surgery to close off the punctum.

How can I take care of myself?

• See your health care provider if you have any symptoms of dry eye.
• Follow your health care provider's instructions for controlling your dry eyes.
• Have your eyes checked regularly (at least every 2 or 3 years).