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What Is Dry Eyes?

Introduction To Dry Eyes.

Dry eyes, or dry eye syndrome, is a common eye condition characterised by a lack of sufficient lubrication and moisture on the surface of the eyes. This can occur due to an imbalance in the tear film, which consists of three layers: the oily (lipid) layer, the watery (aqueous) layer, and the mucin layer. The two primary types of dry eye syndrome are:

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Aqueous tear deficient dry eye: This type of dry eye occurs when the lacrimal glands do not produce enough watery (aqueous) components to maintain a healthy tear film. As a result, the eyes become dry and irritated. Aqueous tear deficient dry eye can be further classified into two subtypes:

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A) Sjögren's Syndrome-related dry eye: An autoimmune disorder affecting the lacrimal and salivary glands, leading to a decrease in tear and saliva production.

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B) Non-Sjögren's Syndrome-related dry eye: A deficiency in tear production unrelated to Sjögren's Syndrome, which can be caused by various factors such as ageing, hormonal changes, or certain medications.

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Evaporative dry eye: This type of dry eye is caused by excessive evaporation of the tear film due to an insufficient oily (lipid) layer. The primary cause of evaporative dry eye is meibomian gland dysfunction, which results in inadequate lipid secretion to stabilise the tear film. Other factors contributing to evaporative dry eye include:

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  • Blinking abnormalities

  • Environmental factors, such as dry or windy conditions

  • Prolonged screen time, which can reduce blink rate

  • Contact lens wear

  • Eyelid inflammation or disorders, such as blepharitis or ectropion

 

It is important to consult an eye care professional, such as an ophthalmologist or optometrist, for an accurate diagnosis and appropriate treatment plan if you experience symptoms of dry eye syndrome. Treatment options can include artificial tears, prescription eye drops, punctal plugs, warm compresses, or eyelid hygiene measures, depending on the specific cause and severity of the condition.

Dry Eye Symptoms

Dry eye syndrome can manifest through various symptoms, which may vary in severity and frequency. Common symptoms of dry eyes include:

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  • Dryness or a gritty sensation in the eyes

  • Stinging or burning sensations

  • Itchiness or irritation

  • Redness of the eyes

  • Sensitivity to light (photophobia)

  • Blurred or fluctuating vision

  • A feeling of having a foreign body in the eye

  • Excessive tearing (reflex tearing in response to eye irritation)

  • Eye fatigue or discomfort after prolonged visual tasks, such as reading or using a computer

  • Difficulty wearing contact lenses

  • Mucus or stringy discharge around the eyes

 

In some cases, people with dry eye syndrome may experience paradoxical excessive tearing as a response to the irritation and dryness. The tears produced in this situation are often of poor quality and do not effectively lubricate the eye's surface.

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If you experience any of these symptoms or suspect you may have dry eyes, it is essential to consult an eye care professional, such as an ophthalmologist or optometrist, for a thorough evaluation and appropriate treatment.

What Causes Dry Eyes?

Dry eyes, or dry eye syndrome, can be caused by various factors that disrupt the balance of the tear film, which consists of three layers: the oily (lipid) layer, the watery (aqueous) layer, and the mucin layer. Common causes of dry eyes include:

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  • Ageing: Tear production tends to decrease with age, making older adults more susceptible to dry eye syndrome.

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  • Hormonal changes: Hormonal fluctuations, particularly in women during pregnancy, menopause, or while using oral contraceptives, can affect tear production and contribute to dry eyes.

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  • Medications: Certain medications can cause dry eyes as a side effect, including antihistamines, decongestants, antidepressants, blood pressure medications, hormone replacement therapy, and acne medications (isotretinoin).

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  • Medical conditions: Some medical conditions, such as Sjögren's syndrome, rheumatoid arthritis, lupus, diabetes, thyroid disorders, and vitamin A deficiency, can cause or exacerbate dry eyes.

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  • Meibomian gland dysfunction: Inadequate lipid secretion by the meibomian glands can lead to an unstable tear film and increased tear evaporation, causing evaporative dry eye.

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  • Environmental factors: Dry, windy, or smoky conditions, as well as low humidity, can contribute to dry eyes by increasing tear evaporation.

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  • Prolonged screen time: Spending extended periods looking at computer screens, smartphones, or other digital devices can reduce blink rate, leading to dry eyes.

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  • Contact lens wear: Long-term use of contact lenses can cause irritation and increase the risk of dry eyes.

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  • Eye surgeries: Procedures like LASIK or cataract surgery can temporarily or permanently affect tear production or the corneal nerves, leading to dry eyes.

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  • Eyelid disorders: Conditions such as blepharitis, ectropion, or entropion can disrupt tear film distribution or cause inflammation, contributing to dry eyes.

 

Incomplete blinking or infrequent blinking: This can lead to poor tear distribution and increased tear evaporation, resulting in dry eyes.

If you suspect you have dry eyes or experience symptoms, it is essential to consult an eye care professional, such as an ophthalmologist or optometrist, for a thorough evaluation and appropriate treatment.

Can Dry Eyes Cause Headaches?

While dry eyes themselves do not directly cause headaches, the two conditions can be related in some cases. Dry eyes can lead to eye strain, discomfort, and fatigue, especially during prolonged visual tasks such as reading, working on a computer, or watching television. This eye strain can potentially trigger headaches or exacerbate existing headache symptoms. Moreover, certain factors can contribute to both dry eyes and headaches, such as:

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  • Prolonged screen time: Spending extended periods looking at computer screens or other digital devices can reduce blink rate and cause eye strain, which may lead to both dry eyes and headaches.

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  • Environmental factors: Dry, windy, or air-conditioned environments can contribute to dry eyes and eye strain, potentially resulting in headaches.

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  • Dehydration: Insufficient fluid intake can lead to dehydration, which may cause both dry eyes and headaches.

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  • Medications: Some medications can cause dry eyes and headaches as side effects.

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  • Underlying medical conditions: Certain medical conditions, such as Sjögren's syndrome or autoimmune disorders, can cause both dry eyes and headaches.

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If you are experiencing dry eyes along with headaches, it is essential to consult an eye care professional, such as an ophthalmologist or optometrist, for a thorough evaluation. 

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They can help identify the underlying cause and recommend appropriate treatments to manage your symptoms. Additionally, you may need to consult your primary care physician or a headache specialist to address the headaches specifically.

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Looking For Dry Eyes Treatment?

Dry Eye Treatment

Treatment for dry eye syndrome aims to alleviate symptoms, restore the tear film balance, and address any underlying causes. Here are some common treatment options for dry eye, including the latest treatments for dry eye syndrome and those known as the best dry eye treatment UK.

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Artificial tears: Over-the-counter artificial tear solutions can help lubricate the eyes and provide temporary relief for mild to moderate dry eye symptoms.

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  • Lubricating eye ointments or gels: These are thicker than artificial tears and provide longer-lasting relief, especially for night-time use.

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  • Prescription eye drops: Cyclosporine (Restasis) and lifitegrast (Xiidra) are two prescription eye drops that can help reduce inflammation and increase tear production in patients with dry eye syndrome.

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  • Punctal plugs: Small silicone or collagen plugs can be inserted into the tear drainage ducts (puncta) to reduce tear drainage and keep more moisture on the eye surface.

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  • Meibomian gland expression: Manual expression or devices like LipiFlow can help clear blocked meibomian glands and improve lipid secretion, addressing evaporative dry eye.

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  • Warm compresses and lid hygiene: Regular use of warm compresses and gentle eyelid cleaning can help improve meibomian gland function and reduce inflammation associated with conditions like blepharitis.

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  • Nutritional supplements: Omega-3 fatty acid supplements may help improve dry eye symptoms by enhancing the lipid component of the tear film and reducing inflammation.

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  • Intense pulsed light (IPL therapy): This treatment uses pulses of light to reduce inflammation and improve meibomian gland function, primarily for evaporative dry eye.

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  • Autologous serum eye drops: Eye drops made from a patient's blood serum can help provide essential nutrients and growth factors, promoting ocular surface healing in severe dry eye cases.

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  • Scleral contact lenses: These large, gas-permeable contact lenses create a reservoir of fluid that continually bathes the eye surface, providing relief for patients with severe dry eye symptoms.

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While these treatments are commonly used globally, including the UK, it is essential to consult an eye care professional, such as an ophthalmologist or optometrist, for a proper evaluation and treatment plan tailored to your specific needs and circumstances.

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