Tips for Dry Eyes

In South Africa almost 50% of the population suffer from dry eyes! Fortunately, it can easily be managed. But it is important to identify the cause of your specific Dry Eyes and manage it accordingly.

A red eye condition (conjunctivitis) is not always due to dry eyes – although the symptoms and appearance may be synonymous. Therefore we can classify these conditions together in order to distinguish them.

The following article will help you understand the following better:

What is Dry Eyes Syndrome
Understanding your type Dry Eyes (or Red Eye condition)
Tips to treat your Dry Eyes

What is Dry Eye Syndrome

Dry Eye Syndrome is a condition where the eyes do not get enough lubrication or moisture from the tears. Generally this is because the eyes do not produce enough tears or produces poor quality tears.

Poor tear stability can lead to inflammation and damage of the eye’s surfaces (i.e. dry eyes).

It is important to firstly understand the structure of the tear film in order to understand why the eyes get dry.

Your tears are not just water! The tear film consists of 3 distinctive and important layers:

Tear film layers

Outer Oily layer – secreted by the Meibomian glands in the eyelids. This layer provides lubrication and ensures that the tears do not evaporate too quickly.
Middle Watery layer – secreted by the Lacrimal gland. This layer is moisture component to tears as well as provide nourishment to the ocular surface.
Inner Mucus layer – secreted from Goblet cells in the Conjunctive. This layer ensures the coherence of tears and assists with the spread and stability over the eye.

If there is an abnormality in any of these tear layers, the function of the tear film is compromised. This leads to inflammation and damage of the eye surface. Once the eye’s surface is damaged, dry eye symptoms are experienced (such as redness, irritation etc.). It is important to determine the cause of the dry eyes (i.e. which layer of the tear film is affected) in order to treat the problem more accurately.

There are several basic causes of dry eyes (or related conditions):

Oil deficiency (meibomian gland disfunction) – the tears evaporate too quickly and leaves the eye dry.
Aqueous deficiency – the lacrimal glands of the eyes do not produce enough tears to keep the eye moist.
- Computer Vision syndrome is the most common form of aqueous deficiency by which excess computer/device use results in dry eyes.
Mixed – A combination of oil and aqueous deficiency.
Allergy (mucus) – an allergic reaction results in excess an poor quality mucus in the tear film. In this case it is not necessarily a dry eye, but you experience the same dry eye symptoms due to inflammation and swelling.
Infection – This is not a form of dry eyes. But have similar symptoms of red, irritated, inflamed eye.

The table below summarises symptoms experienced by each form of Red eye:

Symptoms experienced

	Oil deficiency	Aqueous deficiency	Allergy	Infection
Red eyes	Mild to moderate	Mild to moderate	Mild	Moderate to severe
Gritty feeling	Yes	Yes	No	Yes
Sensitivity to light	Moderate	Moderate	Mild	Severe
Burning / stinging	Moderate	Moderate	Mild	Severe
Blurred vision	Fluctuating	Mild	–	Mild to severe
Watery eyes (epiphora)*	Yes	Yes	Yes	Yes
*Watery eyes may seem confusing, but this is very common. Because the eyes are dry, the lacrimal gland is stimulated to secret tears in order to compensate. However, the underlying problem still persists, which is the cause of the dry eyes.
Discharge	Dry, crusty, sandy	–	Sticky, clear (mucus)	Bacteria: Yellow Puss Virus: Clear watery
Itchiness	–	–	Severe	–

Factors that promote Dry Eyes

Smoking
Increased age: generally above 50 the tear system produces poorer quality tears
Gender: Women are more likely to experience Dry Eyes
Weather: dry climate etc.
Contact lens wear
Computer / digital work or prolonged working times
Decreased sleep
Allergies
Medications: The majority of medications can cause dry eyes. Such as medication for, Depression; Oral Contraceptives; Blood Pressure; Allergies; Glaucoma; Menopause; Pain etc.
Medical conditions: Especially Autoimmune or Endocrine conditions such as, Rheumatoid Arthritis; Lupus; hyperthyroidism; hypothyroidism etc.
Surgeries: LASIK; Cataract surgery; Corneal surgery
Environment: Aircon; fans; heaters etc.
Sun exposure; dust etc.

Treatment and Tips

It is important to have a Optometrist look at your Red eyes to determine the exact cause and treat accordingly. Below are a few tips to help treat dry eyes:

1). Hot Compress massages (opens the tear ducts, reduces Redness, Dryness and Swelling)

Use a face cloth and soak in hot water (not too hot) or use a special Gel eye mask in hot water for a few seconds.
Place the warm cloth or eye mask over the eyes and cover for 5-10min.
- This will moisture lock the eyes and soften the tear ducts.
Remove the cloth or mask after 5-10min.
With the finger tips: press and massage the eyelids from out to in (towards the eyelid margin) in order to expel the blocked ducts. See the diagram

Repeat 1 x mornings and 1 x evenings for 3 months or until the eyes feel better.

2). Wash & Scrub eyelids(cleans sand, crust, or pus that forms on the eyelids)

Use Johnsons & Johnsons Yellow Baby Shampoo

or make your own mixture using 1 tbl salt + 1 tbl bicarb soda + 1 litre water

Put a few drops of J&J Baby Shampoo in a small cap of clean hot water
Using the mixture, with a cotton pad or face cloth – lightly scrub and wash the eyelids.
- Be sure to also scrub the eyelid margin.

Repat 1 x mornings and 1 x evenings for 3 months or until resolved.

Tagged Eye Health, Vision