Dry eye syndrome: causes and treatments

Every time we blink, tears bathe our eyes to keep them moist. If your eyes are not making enough tears or your tears are evaporating too quickly, your eyes can become dry and irritated. This is known as dry eye syndrome.

Symptoms include redness, irritation and a gritty feeling in your eyes, as well as tired eyes, blurred vision and sensitivity to light. You may find it difficult to wear contact lenses and to read, look at a screen and drive at night.

Your symptoms may be occasional and mild or continuous and severe — you may even find you regularly get eye infections, which can damage the surface of your eyes. Common risk factors for dry eye syndrome include the environment you work in, whether you smoke and if you wear contact lenses for more than the recommended length of time each day.

What causes dry eye syndrome?

Dry eye syndrome is caused by a decrease in tear production or the quality of your tears. Tears are produced by glands at the side of your eyes. They are made of water, oils and mucus and are spread over the front of your eyes, creating a protective film. Tears also contain antibodies that help keep eyes free from infection.

Lots of factors can cause a decrease in tear production or quality, from hormonal changes and vitamin A deficiency to certain medical conditions, including Sjogren’s syndrome, allergic eye disease, rheumatoid arthritis and thyroid disorders. Certain medications can also cause dry eyes, including decongestants and antihistamines. 

Most people suffer from dry eyes occasionally. If you find that it’s happening more often, ask your GP or optometrist for advice. They can advise on treatment to manage your symptoms and may be able to find out what’s causing the problem. If you don’t respond to treatment, they can refer you to an ophthalmologist, a doctor specialising in eye health. Left untreated, dry eye syndrome can lead to other vision problems and further visual discomfort.

Are there effective home remedies?

There are several home remedies for occasional mild cases of dry eye syndrome, but make sure you speak to your GP or optometrist if your symptoms don’t improve or worsen. 

Home remedies you can try include:

• Dampening a clean cloth with warm water and placing it over your eyes for five minutes
• Drinking more water and cutting down on alcohol
• Increasing the amount of omega-3 in your diet — omega-3 is found in oily fish, flaxseeds, chia seeds and walnuts
• Resting your eyes
• Taking a daily supplement of vitamins A, B12 and D

Other dry eye treatments

The most common treatment is artificial tear drops (eye drops) and ointments. Many different types are available over the counter. It is worth trying several to find out which one works best for you.

If you have chronic (long-term) dry eyes, it’s important to use your eye drops regularly, even if your eyes feel fine. If you find that your eyes dry out while you’re asleep, try applying a thicker ointment before bedtime.

If you find that these treatments don’t ease your symptoms see your GP or optometrist. They can prescribe stronger artificial tears or a topical cream to apply to your eyelids.

Another common treatment for more severe cases of dry eye syndrome is a temporary punctal occlusion. The punctum is the duct that drains tears from your eyes into your nose. Your doctor may decide to close the duct with a temporary plug. With the plug in place, you will have more tear fluid in your eyes. The temporary plug will dissolve over time but will indicate to your doctor whether more permanent plugs would be beneficial.

Surgery for dry eye syndrome

If artificial tear drops, ointments and punctual plugs are not effective, your doctor may suggest a minor surgical procedure called cautery. Heat is applied to the punctum to permanently close it. 

You will be given a local anaesthetic to numb your eyelids and surrounding tissue. Then using a special tool, your doctor will cauterise (burn) the punctum. The scar that forms closes the punctum permanently, which means the amount of tear fluid in your eye will increase.

Alternatively, if your doctor suspects that the glands in your eyelids are blocked, a procedure called LipiFlow may be used. The glands are unblocked using a combination of heat and pressure. 

How can you prevent dry eyes?

You can prevent dry eyes by:

• Avoiding air blowing directly into your eyes (eg from fans), cigarette smoke and log fires
• Blinking regularly when you use the computer, read or watch television
• Drinking plenty of water and using a humidifier to increase moisture in the room
• Taking regular screen breaks 
• Using artificial tears regularly through the day
• Wearing sunglasses and protective eyewear when needed

Having dry eyes occasionally through the year is common and especially in the winter months when the air is less humid. If you find that your eyes are red and irritated for a number of days and are not getting better with home remedies, arrange to see your GP or optometrist for advice.