Dry Eyes are on the Rise. Why?

Restored from the Empower Network archive (2011–2017), lightly edited to meet our current advertising standards. Views are the original author’s.

What’s to Blame for your Dry Eyes?

A growing number of people are showing up in their doctor’s office complaining of gritty, irritated and burning eyes.

No, it’s allergies or an eye infection. Most of these patients are suffering from dry eyes, a condition that affects as many as 25 million Americans, according to eye-care industry estimates. Eye doctors say dry-eye syndrome is especially prevalent among women and older people and is the second most common complaint after vision problems.

Behind the growing number of dry eye cases: Mucus membranes that produce a key component of tears naturally dry up as people age. Spending a lot of time in low-humidity environments, such as air-conditioned office buildings or airplane cabins, also can promote dry eyes, as a recent study published in the journal Cornea found. And staring at a computer or smartphone screen for long periods also can contribute to dry eyes, as people forget to blink.

“I have patients who have jobs that require them to stare at a computer all day,” said Dr. Marioneaux, an ophthalmologist in Chesapeake, Va. . “I have them put a sticker on their computer that says, ‘Blink!’ ” Ideally, a person should blink 12 to 15 times a minute, she said.

Other reasons behind dry eyes can include certain autoimmune diseases, and medications like antihistamines and antidepressants. Some eye surgeries, such as Lasik, can cause temporary dryness. Dry and windy climates can contribute to dry eyes, as can contact lens intolerance and eye makeup.

There are two main types of dry eyes. One occurs when your eyes aren’t producing enough tears. For a long time, doctors believed this was the main culprit. But in recent years there has been recognition that poor tear quality, often referred to as evaporative dry eyes, is far more prevalent, accounting for the majority cases. Many people have both problems.

Coating the surface of the eye is a protective tear film that consists of three main components—an outer, oily layer that prevents evaporation and a watery layer mixed with bits of a gel-like substance called mucin that holds the tear film to the eye. Evaporative dry eyes occur when the so-called meibomian glands, located in the upper and lower eye lids, don’t produce enough oil, or the oil isn’t of high quality. This causes the watery layer of the tears to evaporate more quickly.

Every time you blink and your top lid touches the bottom lid, the meibomian glands squirt oil that stabilizes the tear film, said Dr. Marioneaux. “If you’re not blinking completely, which actually a lot of people do, you’re not getting the release of this oil. So oil backs up in the lid and begins to get thicker and starts to clog up the oil gland,” she said.

Most patients with dry eyes have relatively mild symptoms, which can include a gritty feeling, burning or itching and sometimes blurry vision. Excessive tearing can occur when the body responds to the dryness by producing more tears as a protective mechanism. More severe cases can result in a stabbing pain caused by exposed nerves on the dried surface of the eye that become irritated from the formation of microscopic erosions.

Brad Feldman, a cornea, cataract and refractive surgeon at Wills Eye Institute in Philadelphia, said contact-lens wearers with dry eyes can be more prone to infection and irritation, such as getting a scratch on the eye.

Are Lubricating Drops Best for Dry Eyes?

Finding the right treatment to reduce dry-eye symptoms can involve trying different products and approaches. Most people start with over-the-counter drops to replenish moisture and tears. Some of the newer products also try to address evaporative dry eyes by replenishing the tear film’s oil layer. For patients who use drops more than three or four times a day, doctors recommend getting products without preservatives, which can cause some discomfort. Preservatives are sometimes added to drops to prolong their shelf life while keeping bacteria at bay.

Gel drops and ointment can help in cases of severe dry eyes. These treatments may cause blurred vision so are usually recommended for nighttime use. They are also recommended if patients have a condition in which the eye doesn’t fully close at night when sleeping.

Some patients also benefit from the use of an anti-inflammatory such as steroids or omega-3 fatty acids to reduce inflammation of the glands, or antibiotics, taken orally or topically. Allergan’s Restasis, an anti-inflammatory eye drop, is the main prescription drug used, primarily for individuals who don’t produce enough tears.

Another procedure to treat dry eyes is called punctal plugs. The puncta—the hole in the corner of the eyelid where tears drain to the back of the nose and down the throat—is plugged so tears stay in the eye longer.

For evaporative dry eyes, experts recommend warm compresses or eye massage to unclog the glands. Patients should use compresses two times a day for five to ten minutes each time.

Sometimes dry eyes can be brought on by other conditions. Anne Slattery, a patient at Wills Eye Institute, has suffered from dry eyes since 2008, when she was also diagnosed with corneal disease and ocular rosacea, an inflammatory condition. The 60-year-old said she believes another cause of the dry eyes was her age, as she was going through menopause at the time.

Ms. Slattery, who continues to be treated for her eyes, also has sought to alleviate symptoms of dry eyes. Her doctors initially recommended hot compresses four times a day, eye drops every hour and an antibiotic ointment at night. She stopped wearing makeup. Staring at a computer made it worse. “I eventually quit my [administrative-assistant] job because I couldn’t do it anymore.”
SOURCE: WSJOnline

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