Dry Eyes

DRY EYES

Lubricating dry eyes

Dry eyes are a very common condition.  In fact, about half of the patients in my practice complains of it, especially with this era in which the use of 3C gadget  (computer, ipad, handphone or cellphone) has become so prevalent.  Dry eyes can be manifested as uncomfortable, sore, foreign body sensation , gritty and scratchy feeling and even itchy eyes.  Many has been misdiagnosed as allergic conjunctivitis.  Reduced vision or fluctuating vision is also described.

There is also daily variation of symptoms e.g some worse on waking whilst other worse towards end of day.   All these will need to be addressed by attending to ophthalmologist.

CAUSE

The cause of dry eyes are multifactorial.  It can due to hyposecretion which occur in patient with Sjögren syndrome primary or secondarily to Rheumatoid arthritis or SLE or other connective disease.  I have seen someone with Mikulicz syndrome with severe dry eyes.

The other cause are unstable tear film.  Despite having adequate amount of tears, their tears are not stable and hence can't stay in the eyes for a long time.   It can be due to disruption of the three layer of tear. Our tear film is consisted of three layer, lipid lalee imal gland and the mucin layer secreted by goblet cell in conjunctiva.  Any disruption in this three layers can cause tear film to be unstable and subsequently causing dry eyes.

TREATMENT

As there are multiple causes of dry eyes, all these factors needed to be addressed adequately.  The most common cause of treating dry eyes is using eye drops.  There are many in the market, ranging from carboxymethycellulose, polyvinyl alcohol, glycerol and hyaluronate of various percentages.   New technologies such as those catinonic has been developed to increase attraction of drops to eye surface .

It is important to see ophthalmologist to ascertain degree of dry eyes and use artificial tears according to severity and cause of dry eye.  Self medication with buying artificial tears in pharmacy without  being examined by ophthalmologists may lead to inadequate treatment.

With recent attention to meibomitis as cause of evaporative dry eye, warm compress has been proposed with a varying degree of success.

As inflammation is related with development of dry eyes, steroid and cyclosporin have been used successfully to treat dry eyes.  However,  it needs doctors' supervision.

People with dry eyes best use drops without preservatives.

Environment modification is also found to be useful in treating dry eyes.

Please kindly make appointment with ophthalmologist to have eyes examined and to get the most appropriate and latest treatment for dry eye syndrome.

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