Dry eyes are preventable and treatable but unfortunately, not completely curable. There are two approaches to dealing with dry eyes. One approach is identifying the underlying condition that is causing dry eyes and then treating the condition. The second approach is increasing the production of tears, preventing the early draining of tears, or improving the quality of tears.
Treating the cause:
In some cases, there is an underlying reason that causes dry eyes which can be addressed. If dryness of eyes is occurring as an adverse reaction to medication, the medication causing the problem can be changed so that it doesn’t cause dry eyes. If a systemic disorder like rheumatoid arthritis is suspected, expert consultation might be required. If dry eyes are caused due to the outward turning of the eyelids, called ectropion, surgical correction of the lids may be advised.
Increasing tear secretion:
Cholinergic drugs increase the basal rate of tear production by stimulating the formation of tears. Drugs like pilocarpine may be used for this purpose. These may be taken as an oral medication, applied in a gel form or used as eye drops. It is a prescription medicine.
These are over-the-counter medications with different constitution and viscosity. There are two broad categories of artificial tears. One is the low-viscosity, watery type which needsto be applied at frequent intervals but iscomfortable and doesnot cause blurred vision. The other type of artificial tears has a high viscosity and may cause discomfort and blurring of vision but provides longer lasting lubrication.
A slow release form of a lubricant like hydroxy propyl cellulose is inserted under the lower eyelid. It is placedat the junction of the eyeballand the lower lid conjunctiva. Lacrimal inserts are recommended for people with severe eye symptoms. It relieves dryness, burning, or irritation. If used improperly, inserts can cause damage to the cornea and other symptoms like redness and sensitivity to light.
Improving the quality of tears:
Anti-inflammatory drugs improve the function of the meibomian glands along the lid margin that maybe blockeddue to inflammation. It helps produce more natural tears that don’t evaporate quickly and keep the eyes moist, healthy, and comfortable.
Steroid eye drops:
Steroids are better at managing the underlying inflammation that other anti-inflammatory drops. They have a risk of developing high ocular pressure and cataracts if used for a prolonged period.
Autologous blood serum drops:
In severe forms of dry eye, where not even the steroid drops can provide much relief, serum drops are used. They are produced from a person's blood by separating red blood cells and adding a salt solution.
Meibomian gland expression:
Meibomian glands are oil-secreting glands present along the margin of eyelids – these open near the base of eyelashes. Openings of the meibomian glands can get clogged and obstruct their secretions which mostly comprises the oil that keeps the tear film from evaporating too quickly. Lack of this oil can lead to early evaporation of teal film and dry eyes. Expression of meibomian glands is a procedure to remove the debris, hardened meibum, or other substances blocking its opening. Expression will help you retain your tear film.
Warm compression is another wayto deal with the blocked meibomian glands. It will soften the meibum that is obstructing the openings and relieve dry eyes if used at a temperature of 108 degrees Fahrenheit for ten minutes twice daily.
Thermal pulsation therapy:
The principle of pulsation therapy is the sameas meibomian gland expression. Here, a specialized device is used to deliver intermittent pulses of high temperature to soften the meibum and pressure to express the contents of the clogged meibomian glands. This procedure restores oil balance in the eyes and relieves symptoms of dry eyes.
Intense pulsed light therapy:
The Food and Drug Administration (FDA) has approved the use of "Intense Pulsed Light Therapy" for treatment of rosacea on the skin and eyelids. Rosacea is a condition where blood vessels are dilated near the eyelid margin and may cause the blockage of the lid's oil-secreting glands. Intensepulsed light therapy uses specific wavelengths of light to reverse the effects of rosacea. This procedure has shown improvement in many patients with dry eyes.
Preventing Drainage of Tears:
These are small implantable devices used to block the tear ducts in the eyes. A portion of tears secreted throughout the day evaporates from the surface of the eyeballand the rest of the secretion, along with any excess is drained along two small puncta present in the upper and lower eyelidat the inner corner of the eye. Blocking of these puncta prevents drainage of tears and maintains the tear film for a longer duration.
It is done as a last resort to retain some of the tear secretionsin the eye. Surgery is done to partially or completely block the tear ducts. Thermal cautery may also be used for this purpose.
Deficiency of vitamin D can make you prone to develop dry eyes. Supplementing vitamin D has been proven useful in many cases of dry eyes by improving tear secretion, promoting tear stability, and decreasing inflammation.
Deficiency of vitamin A may cause dry eyes, sensitivity to light, loss of vision or even blindness. Vitamin A is foundin green leafy vegetables, fruits, and eggs. It can provide relief from symptoms in vitamin A deficient dry eyes.
Omega-3 fatty acids:
These have shown considerable improvement with eye symptoms. These fatty acids are available in flaxseed oil, palm oil, soybean oil, fish such as salmon, tuna, and sardines, and also walnuts. All of these foods are recommended in people dealing with dry eyes.
Measures to make your tear film last longer:
Blink regularly, especially if your work involves focusing on a near object like a computer desktop or any electronic device. Take short breaks in between and focus on any object that is at a distance of 20 feet from you for at least 20 minutes. Blinking causes a renewalof the tear film, keeping the eyes moisturized and healthy.
Eyelidhygiene: It is advisable to clean your eyes regularly and prevent the formation of crusts. Cleaning the eye with clean,warm compresses also help.
Humidification of air: Use an air humidifier or at least place a bowl of water around the room or near your radiator or at anair entry point.
Minimize air conditioners or heaters: Appliances like fans and hair dryers may cause the tear film to evaporate too quickly and cause irritation and dryness in the eyes. Stay away from cigarette smoke.
Special contact lenses: These trap a layer of moisture on the surface of eyes. These are called scleral lenses or bandage lenses.
Wraparound sunglasses: Wheneveryou are in a windy area, use a pair of wraparound sunglasses. They prevent wind fromblowing directly into your eyes and the resulting dryness.