New research estimates up to six out of 10 adults suffer from dry eyes – a condition thought to have increased through the pandemic while people have been spending more time on screens, which is associated with the syndrome.
“If the problem’s really bad, dry eyes can cause blurry vision, from mucous that’s not washed away by tears,” explains consultant ophthalmic surgeon Mr Badrul Hussain, who works at Moorfields Eye Hospital in London.
Here, Hussain and Marchetti explain what causes dry eyes and how to treat them…
What is dry eye syndrome?
Every time we blink, tiny glands in the eyelids release a thin layer of tears made up of three layers (oily, watery and mucous) to coat the surface of the eye (cornea) and provide it with nutrients. But if insufficient tears are produced, they’re not of good enough quality, or they don’t spread across the eye properly, the eye becomes dry. Those tiny dry patches will feel uncomfortable, and will be irritated each time you blink.
What are the symptoms of dry eye?
Experts say symptoms, which can occur in one or both eyes, can obviously include a dry feeling in the eye, as well as stinging, redness, feeling like you’ve got grit in your eyes, difficulty wearing contact lenses, blurry vision, and even – bizarrely – watery eyes, which is the body’s natural response to the irritation of dry eyes.
“Symptoms of dry eye are a particular problem for contact lens wearers,” says Marchetti, “as three-quarters say they suffer from it.”
What causes dry eye?
Dry eyes are caused by many different things, explains Hussain, including certain medical conditions like rheumatoid arthritis or Sjögren’s syndrome (which affects moisture secreted by the body), surgery or eye trauma, infection or inflammation of any of glands around the eye, or an infection of the eyelash roots (blepharitis).
Ageing also makes you more likely to get dry eyes, as Marchetti says from middle-age, the body produces less hyaluronic acid, which is important for retaining moisture in the eyes. Hormonal changes during the menopause, and regular use of certain drugs including antihistamines, antidepressants and diuretics, can also affect the amount of moisture in the eyes, she says.
Hussain says: “Some people aren’t making enough tears because they have medical conditions that affect the production of watery secretions, such as Sjogren’s Syndrome or other autoimmune conditions. But having dry eye from such medical conditions isn’t as likely as evaporative dry eye, which can happen when the oily layer of the tear film isn’t as good, and is by far the most common reason for dry eyes. This can happen as we get older – as we age, lots of things don’t work as well, and there may not be enough tears.”
How do you treat dry eye?
Hussain says most people don’t have severe dry eye thankfully, and many will be able to make their eye feel comfortable by regularly putting in lubricating drops, which are available over-the-counter at pharmacies.
“It’s about getting the right treatment when you’re experiencing problems,” he says. “Regularly use some type of lubricating tears. To use an analogy, if you water a house plant regularly, it keeps it vibrant and green, It’s the same with your eye – if you put the drops in regularly, it’ll keep it moist and healthier.
“For most people, dry eye is a nuisance, but not something that’s going to have a huge effect on their life – for a lot of people, it’s going to the chemist and getting lubricating drops and putting them in four or five times a day, or more if needed. If you have any worrying symptoms, or changes in symptoms, along with significant pain, you need to see a GP or an optician.”
For severe cases of dry eye, steroid medication may be prescribed, or other eye drops which can help increase tear production. Rarely, autologous serum may be prescribed – these are drops made from a patient’s own blood, which is spun to separate the serum in it from the rest of the blood. The serum is then mixed with saline and returned to the patient as eye drops.
Additionally for severe dry eye, Hussain says tiny plugs, called punctal plugs, made of collagen or plastic, can be inserted into tear ducts on the lower lid to stop tears draining away. “Or there’s surgery to close them permanently,” he says. “But that’s not something we’d do as a first line – surgery and autologous serum are for people with severe dry eye, which isn’t responding to lubricating drops and steroid drops.”