Dry Eye Syndrome Treatment in London

Dry eye symptoms, treatments and more

It is condition that is common and affects many people. Dry eye syndrome is where a person does not have enough quality teary to nourish and lubricate the eye. The tears are essential for providing clear vision and maintaining the health of the cornea which is the front surface of the eye.

It becomes more common as we get older and can be persistent and require long term treatment. Dryness affecting the conjunctival layer of the eye is known as Keratoconjunctivitis sicca. The tears spread across the cornea, which is the front surface of the eye, as we blink. The tears help to lubricate the eye as the eyelid blinks, help to wash away any particles that enter the eye, keep the corneal surface smooth to provide clear vision and help to reduce the risk of eye infections.

 

Why is my dry eye watery?

 

People with dryness tend to produce tears that are not of high enough quality to help maintain the front surface of the eye. As a result they then produce more poor quality tears which results in the over production of the watery layer. This overproduction leads to a watery eye. It typically is worse when outdoors, in air conditioned environments or when reading or using a computer (evaporative dry eye).

What symptoms are associated with it?

 

People may experience a range of symptoms associated with the condition. They may experience an irritated sensation through to feeling gritty, a foreign body sensation, scratching, watery eyes or burning eyes. The vision may become blurred. The eyes can appear red and there may be sensitivity to light.

What are the causes?

 

Those who suffer from symptoms either have tears that are not of high enough quality or do not produce enough tears.

Poor quality tears

Tears are not just made of water but consist of three layers; oil, water and mucin. The oil layer is the top layer is the oil layer prevents the water layer from evaporating. It is produced by the meibomian glands in the eyelids. The mucin layer helps spread the tears evening over the cornea. If the tears evaporate too quickly due to a deficiency in the oil layer (meibomian gland dysfunction) or do not spread across the eye evenly due to a deficiency in the mucin layer dry eye symptoms can develop.

Too few tears​- A number of glands around the eyelids produce tears the most significant of which is the lacrimal gland. As we age tear production tends to decrease. Other medical conditions can also affect tear production such as Sjögren's syndrome, thyroid eye disease, rheumatoid arthritis and diabetes. When there are too few tears on the eye, dry eye syndrome develop.

It can be associated with a number of issues including:

  • Age. As we age we tend to produce fewer tears and many people over the age of 65 experience symptoms associated with dry eye syndrome.

  • Gender. Pregnancy, the use of oral contraceptives, hormone replacement therapy and menopause are all associated with the condition making women more likely to suffer from this.

  • Blepharitis. Inflammation of the eyelid margin and congestion of the glands that create the oil layer of the tears can lead to a deficiency of the oil layer in the tear film and cause dryness through dysfunctional tear syndrome.

  • Medications. Certain medicines, including antihistamines, decongestants, blood pressure medications, and antidepressants, can lead to dryness and people on these prescription medicines may need to take dry eye drops or other treatments.

  • Medical conditions. People with diabetes, , blepharitis and diabetes can have symptoms of dryness associated with their condition.

  • Autoimmune conditions such as thyroid eye disease, rheumatoid arthritis and Sjögren syndrome can cause reduced tear production from the tear glands as well as the salivary glands giving a chronic dry eye and mouth. These patients are more likely to experience corneal ulcers if the dryness is severe. Corneal ulceration is rare and may require a surgical procedure if severe.

  • Reading or computer use. Concentrating for prolonged periods of time results in a reduced frequency of blinking and can contribute to the symptoms and dryness to the eye's surface.

  • Air. Wind, dry climates and smoke exposure can increase the evaporation of the tears and contribute to dry eye symptoms. 

  • Contact lenses. The prolonged use of contact lenses over a long period of time can lead to dryness.

  • Refractive surgery such as LASIK can also reduce the blink frequency following the surgery and cause dryness.

How is it diagnosed?

 

It can be diagnosed after having an assessment of the eyes with an evaluation not the quality of tears and the quantity of tears produced in the dry eye clinic. This will include taking a history to determine the nature of how you are affected, when it develops and if you have any other health problems, medications and any environmental factors that could be making your eye problem worse. Assessment of the eye include looking at the eyelid structure and assessing your blink. The front of the eye and the cornea will also be assessed using light and microscopic magnification. The measurement and quality of tears and the rate of tear evaporation may be assessed by your eye doctor. Dyes my be used to assess the tear flow and assess any changes to the ocular surface that can change in if the symptoms persist.

With this information Mr Ahmad Aziz from his London clinic can then assess the eyes syndrome and what treatment is likely to be effective.

How do you treat dry eye?

 

Treatment options aim to minimise the dryness and any discomfort as well as to maintain the eye health. In many people dry eye disease is a long term condition. Simple self help remedies include:

Conserving tears

  • Applying warm compresses or using a heat eye mask daily can help encourage the oil layer of the tear film to be released onto the eye. This will help prevent the tears from evaporating and keep the tears you currently produce on the eye for longer. If there are very few tears produced then small silicone punctal plugs can be placed into the punctum which is the opening of the tear duct of the lower eyelid. This will reduce the amount of tears that are naturally drained away allowing the tears to stay around the eye for longer.

Increasing tear production

  • In some cases of where few tears are produced such as in Sjogren’s syndrome, medication can be used that can encourage tear production. It is seldom used however unless the case is severe as the medication tends to increase the production of in the sweat glands of the body as well. This may not be acceptable to many people. Taking a simple supplement such as Omega 3 to increase your Omega 3 to Omega 6 ratio in your body may be a more simple way of trying to increase your natural tear production although there is conflicting clinical research data on this.

Treating inflammation

  • hot flannels or a heat eye mask can also help with treating any blephritis or inflammation to the eyelids. In severe cases there can be inflammation on the front surface of the eye. 

Anti inflammatory drops

  • may be used and a more recent treatment that is just once a day can be used to help with this and give relief to the symptoms. 

Adding tears

  • Mild cases can be treated with over the counter eye drops or artificial tears. Sometime when one brand does not work another brand is more effective. Preservative-free eye drops are recommended as they contain fewer additives which can themselves irritate the eye. Using artificial tears is a good self help way of trying to address mild dryness prior to seeking medical help as in many cases drops alone will help their symptoms.

 

How can I prevent the symptoms from developing?

 

Dry eyes symptoms can be managed in many cases by taking the following lifestyle changes:

  • Regular blinking when using a computer screen for prolonged periods or reading.

  • Increasing the humidity of the air at work or at home and avoiding air conditioning where possible as this increases the evaporation of your natural tears.

  • Wearing sunglasses with wraparound frames when outdoors to shield the eyes from the wind and the sun.

  • Omega-3 fatty acid supplements may help some people. 

  • Drinking plenty of water throughout the day with a recommended 2 litres throughout the day to prevent dehydration.

  • Directing car heaters away from your face when driving to prevent your tears from evaporating too quickly.

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