An estimated 4.88 million Americans age 50 and older have dry eyes. Of these, over 3 million are women and 1.68 million are men. Dry eye disease is a common condition that occurs in people whose tears aren’t able to provide adequate lubrication for their eyes. In those with dry eyes, tears can be both inadequate and unstable for many reasons. For example, you may not produce enough tears, or you may be producing low-quality tears. Either way, this tear instability leads to inflammation and damage of the eye's surface.
There are a number of symptoms associated with dry eyes, and they usually affect both eyes:
Blurred vision or eye fatigue
If you've experienced some of the above symptoms for a prolonged period of time, including red, irritated, tired or painful eyes it may be time to discuss treatment options with your provider, who can either take steps to determine what's bothering your eyes or refer you to a specialist.
Dry eyes are caused by a variety of reasons, all of which disrupt what is called the tear film. Tears are made up of three layers: the oily layer on the outside, the watery layer in the middle, and the inner, mucus layer. The three layers together are known as the tear film. This combination normally keeps the surface of your eyes lubricated, smooth, and clear. But problems with any of these layers can lead to dry eyes.
There are a number of different factors that can lead to dry eyes, ranging from hormone changes and autoimmune disease to inflamed eyelid glands and allergic eye disease. Two common causes that we will discuss here are decreased tear production and increased tear evaporation.
Decreased tear production occurs when you are unable to produce enough water, or aqueous fluid, in the eye.
Common causes of decreased tear production include:
Corneal nerve desensitivity caused by contact lens use, nerve damage or that caused by laser eye surgery, though this is usually temporary
Increased tear evaporation occurs when the oil film produced by small glands on the edge of your eyelids becomes clogged. This is more common in people with rosacea or other skin disorders.
Common causes of increased tear evaporation include:
Vitamin A deficiency
For most people who experience the symptoms of dry eyes, regular use of over-the-counter eye drops can provide relief. However, if your symptoms are persistent and more serious, there are more aggressive treatment options. Your provider will suggest a treatment modality based upon the cause of your dry eyes.
Treating the underlying cause of dry eyes. In some cases, treatment consists of treating an underlying health issue that is causing the signs and symptoms of dry eyes in a patient. For example, if a medication is causing your dry eyes, your doctor may recommend a different medication that doesn't cause that side effect. Certain eyelid conditions, such as ectropion, where the eyelid is turned outward, require surgery. Your doctor can refer you to an eye surgeon who specializes in this kind of procedure.
Medications. A number of medications can be used to help treat dry eyes. Drugs may be prescribed to reduce eyelid inflammation or to control cornea inflammation. You may also consider eye inserts that work like artificial tears, tear-stimulating drugs, or autologous blood serum drops, which are eyedrops made from your own blood. Other procedures. If medications don’t provide you with dry eye relief, there are a number of other procedures available. Your doctor may suggest closing your tear ducts to reduce tear loss, using special contact lenses, unblocking oil glands, or light therapy and eyelid massage using a technique called intense-pulsed light therapy.
The two most common and successful at-home remedies involve frequent eyelid washing, and use of over-the-counter (OTC) eyedrops to help lubricate the eyes. Talk with your provider about choosing a nonprescription product for your dry eyes, as they can come as eyedrops, gels, or ointments. To wash your eyelids, apply a warm washcloth to your eyes and use mild soap.