Normally, the eye bathes itself in tears. By producing tears at a slow and steady rate, they eye stays moist and comfortable. Sometimes people do not produce enough or the appropriate quality of tears to keeps their eyes healthy and comfortable. This condition is known as dry eye.
Symptoms of dry eye include:
- Stinging or burning eyes
- Stringy mucus in or around the eyes
- Excessive eye irritation from smoke or wind
- Excess tearing
- Discomfort when wearing contact lenses
Excessive tearing from “dry eye” may sound illogical, but it can be understood as they eye’s response to discomfort. Tear production normally decreases as we age. Although dry eye can occur in both men and women at any age, women are most often affected. This is true especially after menopause.
Dry eye can also be associated with systemic diseases like lupus, sjogren’s syndrome, rheumatoid arthritis or some types of thyroid disease.
Treating Dry Eyes: Lubricate, Lubricate, Lubricate
Welcome to Colorado! Our high desert environment eventually catches up with everyone—regardless of how long or short you’ve been here. Sometimes dryness is the result of other eye or medical conditions, but mostly Colorado is dry. Patients use any of the following words to describe their eyes and their vision: dry, blurred, doubled, ghosted, watery, irritated, gritty, scratchy, red, achy, tired, etc. Some patients have headaches from dry eyes. Ironically, watery eyes are an indication of irritation, and this irritation is usually due to dryness. Tears from a watery eye are not good at lubrication.
Artificial Tears: Blink, Systane, Optive, Refresh, TheraTears
These brands do not contain harsh preservatives that can dry the eye even more. (Store brands are not very good for patients with dry eyes.) Each company thinks theirs is the best, but it really is personal preference that will determine which drop is the “best” drop for you. These brands also come in different thicknesses—thicker tears will last longer, but will be associated with blurring when you use them. Thinner tears will have less blurring, but will not last as long.
Use the drops three to four times a day, especially before engaging in activities that require a lot of concentration—reading, driving, knitting, etc.—or, any other activity that leaves you with symptoms of dryness. As with most conditions, it is harder to treat the symptoms once they appear than it is to prevent them in the first place.
Ointments: Bacitracin, Erythromycin
Please ignore the instructions from the pharmacy if you want this to work! Place a tiny bit on your clean fingertip as you are going to go to bed for the night—half a match-head or half of a grain of rice. Close your eyelid. Place the ointment against the closed lid where the lashes meet, and wipe the ointment from the side by your nose toward the side by your ear. Yes, you apply this to your closed eyelid, right across the lashes. Not on the lid above the lashes and not directly in the eye.
If you open your eyes immediately after applying the ointment and your vision is clear, you’ve applied the right amount. If your vision is clouded, you’ve applied too much. Too much won’t hurt anything, but your vision will be blurry until the ointment goes away.
It may take four to six weeks to see significant benefit, but usually small improvements can be seen quickly. You can use the ointment every night for the rest of your life if that’s what it takes to stay moist, clear or comfortable.
Omega-3’s: Fish Oil, Flax Seed Oil
Any brand will do, and it will take several weeks to a few months to see the benefit. Yes, you take it by mouth, and this is not to be rubbed on the lids.
If you become “belchy” or “burpy” when you take this, and particularly if you taste fish, you are not digesting it, and you probably need to take a better brand. Discuss this with your pharmacist. There is nothing wrong with the cheapest brand, but it won’t work unless you’re absorbing it.
Regardless of the dry eye benefit, omega-3’s may also help with heart disease and macular degeneration.
Warm Compresses/Lid Scrubs:
Debris (“gunk,” “crusties”) on the lashes can cause the eye to be drier. Using water as warm as is comfortably tolerated, wet a clean washcloth, and place it on your eyes for about five minutes to loosen the debris. This is best done before applying the ointment at night. Patients with overnight crusting will benefit from this in the morning as well.
For heavier amounts of debris, commercial lid cleaning pads are available. These contain gentle cleansers, and can remove makeup as well as debris. Avoid baby shampoo—it is an older treatment that may make the eye drier.
If these steps don’t make a difference in your clarity or comfort after six to eight weeks, additional therapies are available. Contact Dr. Dewey’s office at 719-632-3547 to discuss these options.