Dry eye is one of several common eye problems
Sore, irritated, inflamed or red eyes can have different causes. Allergies can lead to red, watering, itching eyes in some people. In others, problems with tear production cause grittiness and irritation known as 'dry eye'. Allergic eye (allergic conjunctivitis) and dry eye are two common eye problems. It is important to let your doctor check the exact cause of your eye problem as the correct treatments vary considerably.
Also see our topic on allergic eye.
Dry eye
Normally, tears form a protective film over the surface of the eye, lubricating movement and washing away debris and any toxins. Tears are made up of three separate secretions: a sticky base layer, a watery mid layer and an oily top layer (which slows tear evaporation).
Dry eye is a sore, gritty sensation caused by too little tear production or poor quality tears that form an inadequate film. Dry eye can be painful and cause sensitivity to bright light or open air and wind. Despite the name, the irritation of dry eye may trigger excessive tears.
Dry eye may also redden the eyes, but it requires different treatment from allergic conjunctivitis and 'red eye'. People with dry eye should not use drops available directly from the pharmacy without advice. Some 'red eye' or 'allergic eye' drops can make dry eyes worse after a while, and drops containing preservatives can also create problems if you are sensitive to the preservative.
Common causes of dry eye
- age - it affects 75% of people over 65 years of age
- being female - hormonal changes (eg, pregnancy, menopause, oral contraceptive)
- eyelid (meibomian) gland inflammation - see below - you may have red eyelid margins and scaly eyelashes (blepharitis)
- medications - eg, decongestants, antihistamines, oral contraceptives, antidepressants, isotretinoin for acne, blood pressure tablets and 'red eye' drops
- diseases - eg, rheumatoid arthritis, diabetes, asthma, thyroid disease, other immune diseases
- computer use - users tend to blink less
- wearing contact lenses.
If there is an obvious cause, your doctor will try to find a way to ease the problem, though there may not be one simple remedy. Otherwise, 'artificial tears' or ointment can alleviate the symptoms.
How to apply drops and ointment
To apply drops:
- always wash your hands first
- open the container, and pull the lower eyelid gently down with your forefinger to form a pocket
- tilt your head slightly back and look up; and
- holding the bottle between the thumb and forefinger, gently squeeze the recommended number of drops in the lower eyelid pocket.
To apply ointment:
- hold the tube between the thumb and forefinger
- rest your hand against your nose to position the tip of the ointment tube
- apply a small strip of ointment into the lower eyelid pocket.
Do not touch the eye with the dropper or tube tip. You should also discard all drops, solutions and ointments one month after opening to avoid bacterial contamination. Single dose lubricant eye drops remain sterile until opened, if used before the expiry date.
What else can you do to help?
You can help prevent dry eye symptoms by:
- protecting your eyes from sun and wind by wearing wrap-around sunglasses
- avoiding irritants such as smoke, dust, cosmetics and chlorine
- avoiding air conditioners that dry the air
- avoiding hair dryers
- using a humidifier at home, and
- using artificial tears or lubricant regularly.
Tear gland inflammation and scaly eyelashes
Often, oily tear (meibomian) glands in the eyelids become blocked, stagnant, inflamed and produce irritant secretions that worsen dry eye symptoms. This gland inflammation is common and difficult to cure, but the following daily routine can help.
- Carefully warm the eyelids for two minutes using a wheat bag or hot shower.
- Using firm finger pressure, press on the upper and lower lids. This will squeeze the secretions out of the glands. The secretions are not visible.
Scaly eyelashes (blepharitis) sometimes occur as well. If the scales fall into the eye, they causes grittiness and irritation. To help with this - after the massage - use a moist cotton pad to gently rub away scales from the base of the eyelashes.
These problems develop over years, so controlling them may mean months of this routine, but they will improve.
When should you seek medical advice?
You should seek medical advice if:
- the eye is painful
- eyesight is deteriorating
- vision is blurred
- the eye is red
- the eye has a coloured discharge
- the eyelids are stuck together on waking
- you have glaucoma
- you have rheumatoid arthritis
- you have diabetes, or
- the dry eye persists for seven to 10 days, despite treatment.
Original content provided by everybody, reviewed November 2008.
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