Dry Eye - FAQ

Question 1: What is Dry Eye?

Answer: Dry eye is a broad term describes abnormalities in the tear film.  Other common terms for dry eye syndrome include chronic dry eye, dry eye syndrome, dry eye disease and keratoconjunctivitis sicca.

Dry eye doesn’t necessarily mean that your eyes are dry. In fact, many people find that they suffer from dry eyes yet experience watery eyes. Dry eye actually means that there is something wrong with your tear film. The tear film is a complex combination of different layers, which include water, oil and mucus. Each of the three layers in typical tear films come from different sources, therefore disruption to any of these sources can affect lubrication and lead to dry eye.

Question 2: What Causes Dry Eye?

Answer: Dry eye can occur for two different reasons. It can happen if glands in your eyelids don’t produce enough oil to keep your tears from evaporating, or it can occur if you do not produce enough water for healthy tears. No matter what is causing dry eye, it is important to have it diagnosed and treated in order to protect your vision and ensure good eye health and comfort.

Question 3: What Are the Symptoms of Dry Eye?

Answer: Dry eye causes a wide range of symptoms, including dryness, irritation and the feeling that there is grit or debris in the eye. This condition can also cause your eyes to become more sensitive to light or even water. You might also have a burning sensation or blurred vision. Your eyes might feel tired as well, or you might have discharge – especially in the mornings upon waking.

Question 4: How Are Dry Eyes Diagnosed?

Answer: A variety of tests are used to diagnose dry eyes.  Due to the complexity of dry eye diagnosis, regular eye examinations are useful to screen for dry eye but you may be asked to attend for a specialist dry eye assessment.  Assessment involves measuring tear volume by looking at the tears along the lower eyelid, or using a Schirmer strip of Red Thread test which evaluates the amount of tears absorbed into a thin paper or thread.  The tear break-up time test can also help to determine tear film stability. More specialised tests at our practice look at the thickness of the oil layer, tear sampling to measure inflammatory biomarkers in the tear film, meibography (to look at the oil producing glands) and a variety of ocular staining tests using a number of temporary dyes that show up damaged cells on the eye.

Symptoms play a vital role in diagnosis, we will also conduct a dry eye questionnaire.  If you have symptoms of dry eye, do not assume it is normal or that you have to put up with it.  Dry eye can now be treated.

Question 5: How Are Watery Eyes Related to Dry Eye?

Answer: When you have dry eye, you might have watery eyes as one of the symptoms. While this might seem unusual, it is a common sign of dry eye. This condition can cause your eyes to produce too many tears in order to make up for tears that evaporate too quickly due to a problem with your eyelid glands. You might also have watery eyes if you have a full or partial blockage of your teat ducts (tiny openings in the corner of your eyes which drain tears out of the eye).

Question 6:  Can Dry Eye Be Cured?

Answer: There is no cure for dry eye. However, IPL (Intense Pulse Light) and other treatment methods can help manage this condition for long-term relief so that you are far less dependent on drops and your symptoms are significantly reduced.

Question 7: Why Does It Feel Like I Have Something in My Eye?

Answer: The sensation of grittiness or sandiness in the eye is very common in dry eye suffers. Clinicians often refer to it as a foreign body sensation and it can either be very localized or occur throughout the entire eye. Dry spots or small injuries on the cornea can cause a gritty or painful sensation that feels as though there is something in the eye.  Remember, tears primarily lubricate the eye, if you have reduced tears, then as you blink the eyelids no longer smoothly glide over the eye, instead the friction makes blinking feel uncomfortable.

Question 8: What’s the Role of Gels, Ointments, and Artificial Tears?

Answer: The health of the eye relates directly to the ability of the surface to remain lubricated. A dry ocular surface can result in severe injuries, abrasions, and erosions, which can even lead to ulcers that sometimes reduce vision. Nearly all patients with dry eye disease need to use lubricants, drops, and ointments to help protect their eyes and reduce discomfort.  However, the problem with drops is compliance and cost.  Patients generally only use drops when their eyes are already uncomfortable.  In fact, drop should be used regularly throughout the day and more frequently with activities like driving and use of computers.  Remember, drops, gels and ointments are to lubricate and relive symptoms, they don’t address the root problem.

Question 9: What’s the Difference Between Gels, Ointments, and Artificial Tears?

Answer: Drops, Gels and Ointments all lubricate the eye but are of varying consistency so that they are retained in the eye for shorter and longer periods.  Drops are not retained in the eye as long as gels which in turn don’t last as long as ointments.  However, the downside to have long lasting lubricants is that they cause smearing to vision.  That’s why ointments are almost always advisable before going to bed.

Question 10: What Treatments Are Available for Dry Eye?

Answer: The type of treatment you receive for dry eyes should be tailored to the type of primary cause of dry eye. That said, multiple causes are often present in dry eye suffers and in more severe cases it is usually necessary to use multiple treatments in order to break free of the cycle of inflammation caused by dry eye. Some of the treatments for dry eye include:

• Intense Pulse Light
• Lipiflow
• Punctal plugs
• Various lubricants
• Oil drop supplementation
• Lid hygiene
• Steroids drops
• Low does immunosuppressives
• Low dose antibiotic tablets over a 2-3 months
• Warm compresses
• Protective eyewear
• Specialised scleral lenses

Question 11: What Should I Do if I Have Gritty, Tired Eyes?

Answer: Contact us for a specialist dry eye assessment.  We will then clearly explain what the cause is, the severity and how best to manage the problem.  You should not put up with dry eye as the condition will worsen and it will become more difficult to treat.  If you are a health professional you can refer to us through the referral form.