Suffering from dry eyes is a common issue for most individuals, especially in our arid climate here in Utah. The wintertime is worse because our forced air furnaces tend to dry the air as they heat it. Staring at a computer or staring at anything for long periods does not help. This condition can cause constant pain, discomfort, and frustration on a daily basis. So let’s talk about why we get dry eyes and how we can improve the issue.
What Causes Dry Eyes?
Dry Eye Disease occurs when the tears in your eyes aren’t producing an adequate amount of lubrication for your eyes. This tear imbalance and deficiency leads to inflammation and damage to the eye’s surface. The inability to produce tears can be caused by aging, certain medications, contact lens use, and medical conditions such as allergies and rheumatoid arthritis, and other autoimmune diseases. Symptoms include burning, irritation, foreign body and scratchy sensation, red eyes, sensitivity to light, and blurred or fluctuating vision.
Dry Eye Treatment
There is currently no cure for dry eyes but there are numerous treatments. These treatments need to be done on an ongoing basis and improvement is measured in months to years and not after a few days. Many people do not feel dryness even when their eyes are severely dry. The nerves become desensitized and dysfunctional. Sometimes as a person treats their dry eyes they can actually feel worse or drier. This happens because the nerves to the eye rebound as healing occurs. A similar process happens when a person freezes their hands. As they warm up their hands sometimes the hands hurt worse and then tingle until the nerves in the hand’s rebound. A similar process occurs with dry eye treatment.
Most people treat their dry eyes incorrectly. They wait until they feel dryness or notice a problem and then put a lubricating drop in their eye. The reason this does not work is that when the eyes dry the surface cells die. These cells will return but only if the surface is made healthy enough for them to do so. If a person waits until they notice a problem then the surface never gets healthy enough for the cells to return. It is best to be proactive and put lubricating eye drops in the eye on a consistent frequent basis even before they feel dry. The frequency of lubrication is best evaluated by an eye doctor with significant experience in treating dry eyes.
The Tear Film and Meibomian Glands
The human tear film covers and protects the eye and keeps it from drying out. When the eye dries the cells on the eye surface can become damaged and even die. When this happens the ocular surface becomes irregular causing the vision to blur and change with blinking causing the vision to fluctuate. This situation makes obtaining an accurate eyeglass or contact lens prescription difficult. When the eye is dry there is more risk of eye infection. Even more serious conditions can occur causing permanent scarring and vision loss.
The tear film is made up of three layers: The outer lipid layer, the middle aqueous layer, and the inner mucous layer. The outer lipid layer is produced by the meibomian glands in the eyelid and is necessary to stabilize and prevent evaporation of the tear film.
The meibomian glands can often become blocked by oils naturally produced on our skin, flaking skin, makeup, and even organisms. When these meibomian glands get blocked they can become infected causing a stye. Over time the meibomian glands can become scarred causing or worsening dry eye. When the glands become scarred they cannot recuperate and we are left with red, painful, dry eyes. This is called Meibomian Gland Disease (MGD) or Blepharitis.
As with dry eyes, there is also no cure for Blepharitis but again there is treatment. Daily lid cleaning (lid scrubs) often with specially designed cleansers can help. Another treatment is Meibomian Gland Expression. Meibomian gland expression uses an instrument to squeeze or milk the meibomian gland and is often preceded by special instruments to heat the lids. The heating helps to melt the oils that are helping block the glands.
Other therapies for dry eyes include reducing screen time and using a humidifier next to your bed or one installed on your furnace.
Davis Vision Center Therapies
At Davis Vision Center, we have noticed meibomian gland dysfunction in a very high percentage of patients and therefore we now offer Meibomian Gland Expression (MGE) treatment in-house. This is like a spa treatment for your eyelids and helps improve the health of your meibomian glands and dry eyes.
If you are interested in MGE or any other treatments or would like an evaluation, please give us a call at 801-253-3080 or visit our website at davisvisionmd.com