Dry Eyes

Dry eye syndrome, or dry eye disease, is a common condition that occurs when the eyes don’t make enough tears, or the tears evaporate too quickly. This leads to the eyes drying out and becoming red,
swollen and irritated.

Dry eye syndrome can occur when the complex tear production process is disrupted in some way. There are many different reasons why this can happen, although a single identifiable cause often can’t be found.

Common causes include:

• being in a hot or windy climate
• wearing contact lenses
• certain underlying medical conditions, such as blepharitis (inflammation of the eyelids)
•  side effects of certain medications – including antihistamines, antidepressants, beta-blockers and
  diuretics
• hormonal changes in women – such as during the menopause, pregnancy, or while using the contraceptive pill

Although the condition may affect people of any age, your chances of developing dry eye syndrome increase as you grow older. It’s estimated up to one in every three people over the age of 65 experiences problems with dry eyes

Managing your condition

Dry eye syndrome isn’t usually a serious condition. As well as medical treatments, there are some things you can do yourself to help prevent dry eye syndrome or reduce the symptoms. These include:

• keeping your eyes and eyelids clean and protecting them from dusty, smoky, windy
  and dry environments
• using your computer or laptop correctly to avoid eye strain
• using a humidifier to moisten the air
• eating a healthy diet that includes omega-3 and omega-7 fats
• removing contact lenses and wearing glasses to rest your eyes
• not smoking or drinking too much alcohol

How can I avoid triggers/ suggested lifestyle changes

Keep your eyes clean

Good hygiene will help improve dry eye syndrome, particularly if you have blepharitis. There are three main ways you can maintain eyelid hygiene. These should be performed once or twice a
day:

• Warm compress – Use a warm compress to make the oil produced by the glands around your eyes
  more runny
  • • boil water and leave it to cool to a warm temperature
    • soak a clean flannel or eye pad in the warm water and gently place this over the eyes for around 10 minutes
    • reheat the compress periodically by soaking it in warm water, ensuring the flannel doesn’t become cold

  You can also buy a special microwaveable compress for your eyes to use instead of a flannel.

• Eyelid Massage – gently massage your eyelids to push the oils out of the glands
  • gently massage your closed eyes by rolling your little finger in a circular motion
  • take a cotton wool bud and, with your eyes shut, gently roll it downwards on the upper eyelid
    towards the lashes and edges of the eyelids – this helps to push the melted oil out of the glands, although you won’t see anything come out
  • repeat this process along the whole width of the upper and lower eyelids
  • This process may cause your eyes to become slightly irritated at first, a bit like getting soap in
    your eyes, but this is normal and should get better with time
• Lid margin hygiene – clean your eyelids to wipe away any excess oil and remove any crusts, bacteria, dust or grime that might have accumulated. Various eyelid-cleaning solutions and eyelid wipes are available commercially, or you can try making one at home.
  For a homemade solution, fill a bowl with one pint of boiled water and allow it to cool to a warm temperature. Then add a teaspoon of bicarbonate of soda. Once you’ve made a cleaning solution:

• soak some clean cotton wool in the solution and remove crustiness from around the eyelids, paying special attention to the eyelashes
• repeat this process if necessary using a clean piece of cotton wool
• dip a clean cotton bud into the solution and gently clean the edges of the eyelids by wiping the
  cotton bud along the bases and lengths of the lashes

How do I treat?

Sometimes the tips above for good eyelid hygiene aren’t enough to keep symptoms under control. There are many dry eye treatments available over the counter to help relieve the symptoms, which include:

• Eye drops to lubricate the eyes
• Medications to reduce any inflammation

Speak to your pharmacist – for advice if you’re not sure which type of medicine is best for you and your symptoms.

When should I seek advice?

Although dry eye syndrome may be uncomfortable, it doesn’t usually cause any serious problems. The two main complications associated with dry eye syndrome are:

• Conjunctivitis – inflammation of the conjunctiva, the transparent layer of cells that covers the white part of the eyeball and the inner surfaces of the eyelids; most cases are mild and don’t need specific treatment. Visit your Pharmacy if you suspect you have this for further treatment advice.
• Inflammation of the cornea – in rare cases, severe untreated dry eye syndrome can damage the surface of the cornea (keratitis); this damage can make the cornea vulnerable to ulceration and infection, which could potentially threaten your sight.

Contact your optometrist or GP, or visit your nearest accident and emergency (A&E) department immediately if you have any of the following symptoms, as they could be a sign of a more serious condition:

• you have a red eye and wear contact lenses as this could be a sign of an eye infection
• extreme sensitivity to light (photophobia)
• very painful or red eyes, severe headache and you feel sick
• a deterioration in your vision
• your eyes are very dark red
• you have injured or pierced your eye, or something is stuck in your eye (like a piece of glass)

Where can I get more information?

• NHS Choices
• Your local community pharmacy