Dry eyes – a medical affliction

Today we are going to chat about an ailment that may affect a lot of you without your knowing that it is actually a medical affliction. It is called dry eye.

Dry eye is a collection of symptoms secondary to an insignificant production of tears that is necessary to maintain a humid and comfortable eye. It is generally accompanied by hyposecretion of the salival glands and is more frequently found in females, in patients over 45 years of age and in the post menopausal period.{{more}}

There are two types of tears – those that are produced constantly and those that are produced in response to irritation (foreign bodies) or emotion (crying).

Our tears usually flow when we cry or when our eyes are irritated, but their daily function is even more important and that is to maintain an optimally smooth and clear ocular surface for blinking (tear film) without which a good vision would not be possible.

The tear film consists of three layers: an oily layer, a teary layer and a layer of mucus with a delicate equilibrium in the production of the same, so that there may be an adequate tear quality.

Why does the patient come to see us? There are usually complaints of sandiness or sensation of foreign bodies in the eye, stinging or burning, sensitivity to light, eye irritation or difficulty in eye movements, all of which can get much worse on exposure to cigarette smoke or dry climates. In some cases, the patient may refer to previous ocular or periocular trauma, physical or chemical burns, prolonged use of some medications, eyelid abnormalities, ptergyum etc.

What are the most common findings on examining the patient? The general physical examination may reveal painful joints (rheumatoid arthritis), salival, bronchial and/or vaginal dryness, whilst upon examining the eye there may be eyelid swelling, redness, loss of the normal corneal shine, corneal inflammation when tinted with a diagnostic drop (fluorescein) and little or no tears confirmed with filter-paper test (Schirmer test).

How do we go about treating dry eye? There are new explorations with medications and alternatives to try and increase tear production in those patients that suffer from dry eye, but up to date there is no sure way to produce more tears and even more so the quality of the same. The only solution is to make an attempt at replacing our real tears with artificial ones in the form of eye-drops, which can be used once or twice a day, or as indicated by your ophthalmologist.

It is also of vital importance to use sunglasses, to avoid dry and air conditioned environments, and to protect your eyes from dust and cigarette smoke.

l What do you know about conjunctivitis? Next week.