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What Is Chronic Dry Eye? - Still Experiencing Symptoms?

Paula Aridai
July 29, 2021

Overview

Dry eye disease is a common condition that occurs when your tears aren’t able to provide adequate lubrication for your eyes. Tears can be inadequate and unstable for many reasons. For example, dry eyes may occur if you don’t produce enough tears or if you produce poor-quality tears. This tear instability leads to inflammation and damage of the eye’s surface.

Dry eyes feel uncomfortable. If you have dry eyes, your eyes may sting or burn. You may experience dry eyes in certain situations, such as on an airplane, in an air-conditioned room, while riding a bike or after looking at a computer screen for a few hours.

Treatments for dry eyes may make you more comfortable. These treatments can include lifestyle changes and eyedrops. You’ll likely need to take these measures indefinitely to control the symptoms of dry eyes.

Causes

Dry eyes are caused by a variety of reasons that disrupt the healthy tear film. Your tear film has three layers: fatty oils, aqueous fluid and mucus. This combination normally keeps the surface of your eyes lubricated, smooth and clear. Problems with any of these layers can cause dry eyes.

Reasons for tear film dysfunction are many, including hormone changes, autoimmune disease, inflamed eyelid glands or allergic eye disease. For some people, the cause of dry eyes is decreased tear production or increased tear evaporation.

Increased tear evaporation

The oil film produced by small glands on the edge of your eyelids (meibomian glands) might become clogged. Blocked meibomian glands are more common in people with rosacea or other skin disorders.

Common causes of increased tear evaporation include:

  • Posterior blepharitis (meibomian gland dysfunction)
  • Blinking less often, which tends to occur with certain conditions, such as Parkinson’s disease; or when you’re concentrating during certain activities, such as while reading, driving or working at a computer
  • Eyelid problems, such as the lids turning outward (ectropion) and the lids turning inward (entropion)
  • Eye allergies
  • Preservatives in topical eyedrops
  • Wind, smoke or dry air
  • Vitamin A deficiency

Complications

People who have dry eyes may experience these complications:

  • Eye infections. Your tears protect the surface of your eyes from infection. Without adequate tears, you may have an increased risk of eye infection.
  • Damage to the surface of your eyes. If left untreated, severe dry eyes may lead to eye inflammation, abrasion of the corneal surface, corneal ulcers and vision loss.
  • Decreased quality of life. Dry eyes can make it difficult to perform everyday activities, such as reading.

Prevention

If you experience dry eyes, pay attention to the situations that are most likely to cause your symptoms. Then find ways to avoid those situations in order to prevent your dry eyes symptoms. For instance:

  • Avoid air blowing in your eyes. Don’t direct hair dryers, car heaters, air conditioners or fans toward your eyes.
  • Add moisture to the air. In winter, a humidifier can add moisture to dry indoor air.
  • Consider wearing wraparound sunglasses or other protective eyewear. Safety shields can be added to the tops and sides of eyeglasses to block wind and dry air. Ask about shields where you buy your eyeglasses.
  • Take eye breaks during long tasks. If you’re reading or doing another task that requires visual concentration, take periodic eye breaks. Close your eyes for a few minutes. Or blink repeatedly for a few seconds to help spread your tears evenly over your eyes.
  • Be aware of your environment. The air at high altitudes, in desert areas and in airplanes can be extremely dry. When spending time in such an environment, it may be helpful to frequently close your eyes for a few minutes at a time to minimize evaporation of your tears.
  • Position your computer screen below eye level. If your computer screen is above eye level, you’ll open your eyes wider to view the screen. Position your computer screen below eye level so that you won’t open your eyes as wide. This may help slow the evaporation of your tears between eye blinks.
  • Stop smoking and avoid smoke. If you smoke, ask your doctor for help devising a quit-smoking strategy that’s most likely to work for you. If you don’t smoke, stay away from people who do. Smoke can worsen dry eyes symptoms.
  • Use artificial tears regularly. If you have chronic dry eyes, use eyedrops even when your eyes feel fine to keep them well lubricated.

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