Dry Eyes:Treatment,Oral supplements & Dietary advice

Dry Eye is an eye problem in which there is a deficiency of the tear which ultimately causes eye dryness.

Detailed, Dry eye is a disorder of the tear film due to tear deficiency or excessive tear evaporation which causes damage to the interpalpebral ocular surface (i.e. the exposed surface of the eye) and is closely related to the symptoms of the term called ocular discomfort.

These symptoms include: 

• Heavy eye or eye fatigue.

• Feeling of discomfort in the eye.

• Redness in the eye.

• Continuous itching.

• Dryness.

• An unusual type of Irritation in the eye.

• Crusting of eyelids.

• Scratchiness.

• Excessive tearing in the eye.

• The blur of eye vision.

• Pain and light sensitivity.

• Blinking abnormalities like Eye Twitching.

The exposed surface of the eye becomes unhealthy and rough because of the dryness. This unhealthy surface is the reason for all the dry eye symptoms. Although the underlying problem is dry eyes, you may wonder why then the eyes are tearing so much. The reason why the eye tears, is that eye irritation stimulates 'reflex tearing' from the tear glands.

Although it seems reasonable to diagnose dry eyes based on symptoms alone, it is useful to recall that 'symptoms of ocular discomfort' represent only one aspect of 'dry eyes' as defined by the National Eye Institute workshop on dry eyes.

In the absence of a demonstrable tear deficiency or the possibility of excessive tear evaporation and damage to the exposed surface of the eye, one cannot really satisfy the requirements of a 'dry eye' diagnosis. However, in clinical practice, since 'symptoms of ocular discomfort' respond very well to the dry eye treatment paradigm, it probably is fine to think of these symptoms to be due to dry eyes.

Basic tests that performed on Dry Eye are like-

• Fluorescein staining.

• Tear film break-up time.

• Schirmer test.

 Most other tests are usually performed as part of dry eye research studies.

Dry Eyes

Dry Eye
Image via Good Free Photos

Treatment of Dry Eye

The Problem of dry eye is treated with the use of

• Artificial tears.

• Gels. 

• Ointments. 

These can be used several times a day. In general for mild to moderate dry eye, this is all that is needed, Punctal plugs may also be placed in the lower or upper eyelids. 

In severe dry eyes, other agents like -

• Mild steroid eye drops.

• Cyclosporine eye drops. 

• The use of oral agents (salagen) is also possible.

Replenish the Tears

1. In severe dry eyes tear osmolarity increases. The tear hyperosmolarity has been shown to cause ocular surface disease. Although there are some who disagree, the use of moderately hypotonic artificial tears has been shown by others to promote ocular surface disease healing in severely dry eyes. It is available hypotonic tears include: 

• Thera Tears.

• Hypotears. 

• Akwa Tears. 

2. Bicarbonate containing artificial tears have also been shown to promote healing in severely dry eyes. Available bicarbonate containing tears include:

• Bion Tears.

• Murine Tears. 

• Prolonging the contact time of artificial tears on the cornea also helps.

3. Non-preserved drops are the best. However, if preserved eye drops are to be used, then newer preservatives like GenAqua are preferable to Benzalkonium chloride (BAC).

4. Stop the use of eye drops that are for redness relieving like naphazoline or tetrahydrozoline eye drops such as Clear Eyes, Murine Plus, and Visine and herbals such as witch hazel. 

•  In addition to that also avoid using Vaseline in your eye.

•  Do not aggressively wash your eye with running water or saline.

How to Treat Inflammation in Eye Surface i.e. red irritated eye?

Once the dry eye has developed, inflammation becomes the key mechanism of ocular surface injury, as both the cause and consequence of cell damage. Inflammation may be initiated by 

1. Dryness. 

2. Hypertonicity of tears. 

3. Microtrauma from eyelids during blinking.

4. Proinflammatory substances released by the lacrimal glands or eyelids.

5. A reduced supply of supportive factors from tears and corneal nerves.

 When it is present, inflammation is enhanced by cytokines secreted by damaged surface epithelial cells; and lymphocytes and leukocytes that leak out from dilated conjunctival blood vessels.

Thus patients with severe dry eyes can become trapped in an increasing cycle of inflammation and ocular surface injury. Ocular surface inflammation reduces surface wettability and tears film stability. 

Available anti-inflammatory treatments include 

• Cyclosporin A (Restasis) eyedrops.

• Steroid eye drops (Alrex, Lotemax, FML, or Vexol).

Treat Eye Allergy (itching, mucus strands in the eye)

Eye allergy may be treated with eye drops such as :

• Patanol.

• Alex. 

Do Not Use Systemic antihistamines like Claritin and Benadryl these antihistamines will increase dry eye symptoms. 

Oral supplements & Dietary advice

1. Maintain a good water intake. 

2. Totally Avoid alcohol and caffeine.

3. Oral therapy with polyunsaturated fatty acids reduces ocular surface inflammation and improves dry eye symptoms. 

4. Eating Fish means increase omega-3 fatty acids do not much helpful.

Some Precautions

1. Air currents increase tear evaporation, therefore avoid car air conditioning and heaters.

2. Use a humidifier to increase humidity in your surroundings which in its most basic form consists of a dish containing water on a windowsill or radiator.

3. Avoid dry eye due to computer vision syndrome.

4. Keep your computer monitor at an elevated angle or use a computer shield while looking at a screen.

5. When looking down, the upper eyelid partially covers the eye, thus reducing the exposed area of the eye. 

6. Switching to a laptop may make working in a downgaze easier.

7. Avoid smoke and dust. 

8. Use wraparound sunglasses around your eye and try to cover your eye outside as much as you can.