Dry eyes

Definition of dry eyes

In technical terms, dry eyes are referred to as sicca syndrome or keratoconjunctivitis sicca .

The eyes are moistened with the help of the tear fluid, which is evenly distributed over the cornea by the blink of an eye. As a protective layer over the cornea, the tear fluid has the task of flushing out foreign bodies and fighting off infectious agents. It also smoothes the surface of the eye and allows us to see clearly.

The tear film is made up of three layers.

• The formation of the watery part of the tear fluid takes place in the lacrimal gland on the upper eyelid.
• The mucous part is produced by the conjunctiva.
• The outer fatty part is maintained by the Meibomian gland.

The tear fluid drains from the inner lid via the tear points into the lacrimal sac.

Causes of dry eyes

Dry eyes are often caused by reduced tear production. This can be the case, for example, with damage or dysfunction of the lacrimal gland. A changed composition of the tear fluid can also play a role as a cause of the sicca syndrome. Often the protective layer of fat is too thin, causing the watery layer to evaporate.

• The symptoms can occur, for example, as part of a lid margin inflammation (blepharitis marginalis) . The infection clogs the tear ducts on the outer edge of the eyelid. The symptoms can be caused by hormonal, environmental or infectious triggers.
• Meibomian glands produce the fatty portion of the tear film. Clogged glands can be triggered by mites on the eyelashes, for example.
• The symptoms can also occur as part of various underlying diseases such as diabetes (diabetes mellitus) , thyroid diseases , skin diseases (psoriasis, neurodermatitis, rosacea) and rheumatic diseases.
• Taking medication such as birth control pills, sleeping pills and beta blockers also promotes the development of symptoms. Dry eyes are also observed as a side effect of chemotherapy.
• The term “office eye syndrome” refers to dry eyes that are triggered by rare blinking during concentrated work on a computer screen. Dry heating air and air conditioning often also play a role here.
• Increasing environmental pollution and inhaling dust and cigarette smoke also promote dry eyes.
• The production of tear fluid is subject to daily and hormonal fluctuations. For example, women going through the menopause are particularly affected by dry eyes because estrogens inhibit tear production. Older people also suffer more from Sicca Syndrome, since the formation of the tear film decreases with age.
• Dry eyes can also occur as a result of refractive or cataract surgery.

Symptoms of dry eyes

• Itching and burning in the eyes with reddening of the conjunctiva
• Pain in the surface of the eye
• Bonded Eyes
• blurred vision
• teary eyes

Diagnosis of dry eyes

First, the doctor will have a detailed discussion about your symptoms. Sometimes a trigger for the symptoms can be found through the detailed anamnesis interview. This is followed by a detailed examination of the eye using a slit lamp. This enables the practitioner to inspect the individual layers of the eye. The therapist uses the Schirmer test to measure the amount of tear secretion. He uses a small filter strip that is hung in the outer corner of the eyelid. Determining the break-up time of the tear film provides information about the quality of the tear fluid. This can be followed by other examinations such as a blood test or a swab of the conjunctiva. The reasons for the complaints often remain unclear despite detailed investigations.

You can do this yourself if you have dry eyes

• Make sure to blink regularly.
• Take regular breaks from screen work.
• Replace the filter of your (car) air conditioning system regularly.
• Make sure the room climate is humid. A humidifier can help create a comfortable indoor climate. Turn off air conditioning and fans if possible.
• Air your rooms regularly.
• Protect your eyes from direct sunlight with good quality sunglasses.
• Soft contact lenses are more suitable for patients with dry eyes. Use primarily preservative-free artificial tears.
• Try to cut down or quit smoking altogether.
• Make sure you lead a healthy lifestyle with a balanced diet, enough fluids (about 2 liters per day) and enough sleep.

Therapy for dry eyes

If a clear cause of the symptoms can be determined, it should be treated first.

So-called tear substitutes are available as symptomatic therapy , which are used as eye drops, eye ointment or eye spray to moisten the surface of the eye. When choosing the right product, artificial tears should be chosen that are as preservative-free as possible.

In consultation with the attending ophthalmologist, prescription medication may be tried. A number of immunomodulating drugs are available that have been shown to relieve symptoms.

There is also the possibility of blocking the drainage pathways of the tear fluid. For example, small plugs are used or the tear points are sclerosed with electrocautery.

If the edge of the eyelid is inflamed or the Meibomian glands are clogged, simple eyelid care can be used to try to loosen the fat from the blocked sebaceous glands. For this purpose, warm compresses should be held on the closed eyes for about 15 minutes. Then the edges of the lids are wiped out with cotton swabs in the direction of the eyelashes. Crusts are massaged out of the clogged glands and the drainage is improved.

When to seek medical advice

If the symptoms do not improve despite the use of artificial tears, a doctor should always be contacted. Since dry eyes can damage the cornea in the long term, the right therapy should be started as soon as possible.

If the pain or vision is very severe , you should see a doctor immediately as this could be an emergency situation.

How can Med-Healths help?

You can always contact Med-Healths as soon as you notice dry eyes. You can talk to a doctor about your symptoms via the Med-Healths app. They can help you find out the cause of your dry eyes and refer you to an eye doctor if necessary. In addition, he can give you a prescription for eye drops and explain how to use the medication.