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Dry Eye Syndrome: Causes, Symptoms And Treatments

Dry eye syndrome is probably the most common issue among all the eye problems.

A recent Harris Poll indicated that at least 33 million adults in United States are affected with dry eyes.

What distinct dry eyes from other eye problems is the lack of adequate amount of lubrication and moisture on the surface of the eye.

Dry eyes also are described by the medical term, keratitis sicca, which generally means decreased quality or quantity of tears. 

It may not feel so but our tears are very important for the well-being of our eyes. 

Tears are made up of oil, water, and mucins (heavily glycosylated proteins) and they serve a protective function. 

Like the water on the windshield, they keep the eyes clear and wash away debris that gathers on the surface of the eye.

This includes bacteria, foreign objects and irritating chemicals that can damage the cornea.

Moreover, tears contain antibodies to prevent infection.

They also contain enzymes that neutralize the microorganisms that colonize the eye.

The result of having not enough tears in your eyes is an uncomfortable feeling of constant irritation and feeling of sting or itchy around your eyes. 

Dry eye syndrome is not a considered a disease but a group of symptoms that develop as a result of another condition.

For example, it can be due to allergy or environmental factors such as low humidity.

Layers Of Tear Film

In order to understand the dry eyes, we must first understand the function and components of the tear film.

The tear film is made up of three layers. 

Outer oily layer (lipid layer) - This layer is produced by meibomian glands. Its primarily purpose is to reduce tear evaporation

Middle watery layer (aqueous layer) - The thickest layer which is made up of very dilute saltwater solution.

This layer is produced by the lacrimal glands in the eyelids and it’s function is to keep the eye moist and washes away foreign particles or irritants.

Defects of the aqueous layer are the most common cause of dry eye syndrome, also referred to as keratoconjunctivitis sicca (KCS) 

Inner layer - The thinnest layer which is made up of mucin (or mucus) produced by the conjunctiva. The mucus helps the watery layer to spread evenly over and stick to the surface of the eye.

Dry eye syndrome can affect any of these layers.

Symptoms Of Dry Eye Syndrome

If you are experiencing any of the following, you may be experiencing DES.

• Pain in eyes
• Light sensitivity
• Excessive tearing 
• Burning sensation
• Redness of the eyes
• Feeling of foreign body
• Blurry or fluctuating vision
• Gritty, sandy feeling of the eyes
• Discomfort when wearing contact lens

It may sound contradictory, but excessive tearing may happens as dryness on the surface of your eyes will sometimes over-stimulate production of tears as a protective mechanism.

Causes Of Dry Eye Syndrome

If you have dry eyes, it means that your tear film isn't functioning properly.

It can be due to one of the followings:

Insufficient Tear Production

• Due to age progression and hormonal changes (women especially during menopause)

• Conditions which affect lacrimal gland or its ducts, including autoimmune diseases, such as primary Sjogren syndrome, rheumatoid arthritis, or lupus. 

• A wide variety of medications can decrease tear production, such as diuretics, beta-blockers, Parkinson's medications, birth control pills, antihistamines, antidepressants and oral contraceptives.

Excessive Tear Evaporation

• Low blink rate. When you participate in activities that requires your constant attention such as reading, using computer or watching TV,  you unconsciously blink much less than usual.

• Certain conditions, such as stroke, thyroid eye disease and Bell's palsy, make it difficult for you to close your eyes. As a result, your eyes may become dry from tear evaporation.

• Air conditioning or dry heating system at your home or office can dry out your eyes.

• Contact lens is like a sponge in which it soaks up the moisture around it in order to maintain its own saturation. Dry eye syndrome is the most often complaint of contact lens users

Abnormality In The Production Of Mucus

• Decreased mucus production can be caused by chemical (alkali) burns to the eye or autoimmune diseases, such as Stevens-Johnson syndrome and cicatricial pemphigoid.

• Insufficient mucus leads to poor spreading of the tears over the surface of the eye which causes the surface of the eye to dry out and even become damaged.

Insufficient Lipid Layer

• Meibomian gland dysfunction, due to rosacea or as a result of taking oral isotretinoin medication.

• Can also be caused by an eyelid infection called blepharitis. Insufficient oil may happen if the bacteria break them down, therefore resulting in not enough oil to cover the watery tear layer to prevent tears evaporation. 

Risks Factor For Dry Eye Syndrome 

• Gender - More common among women (especially those who are going through menopause).
• Occupational and environmental factors  - Low humidity, high room temperature, exposure to wind, smoke and quality of air.
• Smoking increases your risk of getting dry eye.
• Long term user of contact lens.
• Had refractive surgery before particularly LASIK.
• Dietary habit - Low on Omega-3 or a diet with a relatively high amount of omega-6 fatty acids relative to omega-3 fatty acids.
• People who uses computer for long hours.

Dry Eye Complications

Dry eyes can be pain in the ass which may requires you to dutifully apply eye drops every hour.

Other than the inconveniences caused, if left untreated, the lack of tears can lead to several complications such as:

• More frequent eye infections such as conjunctivitis
• Scarring of the cornea which may lead to corneal ulcer
• Blurred vision due to irregularity of the cornea

Types Of Conventional Treatment Available

Currently, there are no cure for dry eye as dry eye isn’t a disease itself. Instead several treatments are available for the symptoms. 

• Adding tears (such as applying eye drops and lubricating gel)
• Medication treatment (such as taking steroids and apply antibodies to the eye)
• Surgery (such as silicon plugs and Lateral tarsorrhaphy)
• Wearing special contact lenses

For more information, check out my article on the types of dry eye treatment available.

Natural Remedies For Dry Eye

It is important to know that the conventional methods act mainly to alleviate the symptoms. They can’t cure your dry eye symptom most of the time.

Moreover, some of them are expensive and creates recurring costs.

They are just not natural.

Many symptoms of the dry eyes can be relieve by just making simple changes to your lifestyle. 

In my article on Remedies for dry eyes, I had shared 17 safe and effective ways which you can provide instant relief and possibly stops the symptoms from coming back once and for all.

Always use medical approaches as your last resort. 

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