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The name "dry eye" can be a little confusing since one of the most common symptoms is excessive watering! It makes more sense, however, when you learn that the eye makes two different types of tears.
The first type, called lubricating tears, is produced slowly and steadily throughout the day. Lubricating tears contain a precise balance of mucous, water, oil, nutrient proteins and antibodies that nourish and protect the front surface of the eye.
The second type of tear, called a reflex tear, does not have much lubricating value. Reflex tears serve as a kind of emergency response to flood the eye when it is suddenly irritated or injured. Reflex tears might occur when you get something in your eye, when you are cutting onions, when you are around smoke or when you accidentally scratch the surface of your eye. The reflex tears gush out in such large quantities that the tear drainage system cannot handle them all and they spill out onto your cheek. Another cause of reflex tearing is irritation of the eye due to lack of lubricating tears. If your eye is not producing enough lubricating tears, you have dry eye.
Your eye doctor can check for dry eye by examining your eyes with magnifying instruments, measuring your rate of tear production and checking the amount of time it takes for tears to evaporate between blinks. The doctor can also check for pinpoint scratches on the front surface of the eye caused by dryness using special, colored eyedrops called fluorescein or Rose Bengal.
The most common treatment is use of artificial teardrops that help make up for the lack of natural lubricating tears. Artificial tear products come in liquid form, longer lasting gel form and long-lasting ointment form which is most often recommended for nighttime use. Many different brands of artificial tears are available over-the-counter. Some of them contain preservatives and some do not. Unpreserved tears may be recommended for people whose eyes are sensitive to preservatives. Artificial tears can generally be used as often as needed, from a few times per day to every few minutes; you should follow the regimen your doctor recommends. Click here for more information on eye drops.
When infection, inflammation of the eyelids or clogged oil glands contribute to dry eye, special lid cleaning techniques or antibiotics may be recommended. It may also help to avoid hot, dry or windy environments or to humidify the air in your home or office.
Research is underway to test the effectiveness of anti-inflammatory medications and nutrients called fatty acids for treating dry eye. This research could lead to new treatment options in the near future.
Punctal occlusion is a medical treatment for dry eye that may enable your eyes to make better and longer use of the few lubricating tears they do produce.
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