Dry Eyes

Some people do not produce enough tears or the appropriate quality of tears to keep the eye healthy and comfortable.  This is known as dry eye.  Tears are produced by two different methods.  One method produces tears at a slow, steady rate and is responsible for normal eye lubrication.  The other method produces large quantities of tears in response to eye irritation or emotions.  Tears that lubricate are constantly produced by a healthy eye.  Excessive tearing occurs when the eye is irritated by a foreign body, dryness, or when a person cries.

Excess tearing from “dry eye” sounds illogical, but if the tears responsible for maintenance lubrication do not keep the eye wet enough, the eye becomes irritated.  When the eye is irritated, the lacrimal gland produces a large volume of tears that overwhelm the tear drainage system.  These excess tears then overflow from your eye.

Tear production normally decreases as we age.  Although dry eye can occur in men and women at any age, women are most often affected.  This is especially true after menopause.  Dry eye can also be associated with other problems.  A wide variety of common medication prescriptions and over the counter drugs can cause dry eye by reducing the tear secretion.  Be sure to tell your doctor the name of all the medications you are taking, especially if you’re using diuretics, beta-blockers, antihistamines, sleeping pills, medications, or “nerves” or pain relievers.  Since these medications are often necessary, the dry eye condition may have to be tolerated or treated with “artificial tears”.  People with dry eye are often more prone to the toxic side effects of eye medications, including artificial tears.  For example, the preservatives in certain eye drops and artificial tear preparations can irritate the eye.  Special, preservative-free tears may be required.

Your eye doctor is usually able to diagnose dry eyes by examining the eyes.  Sometimes tests that measure the tear production may be necessary.  One test- the Schirmer tear test involves placing a strip of special paper under the lower lid to measure the rate of tear production.

Eye drops called artificial tears are similar to your own tears.  They lubricate the eyes and help maintain moisture.  Artificial tears are available over-the-counter without a prescription.  There are many brands to choose from so you may want to try a few brands to find one that works the best.  You can use these artificial tears several times a day or several times an hour. 

Tears drain through a small channel in your nose.  Your eye doctor may close these channels either temporarily or permanently.  The closure conserves your own tears and makes artificial tears last longer.  You can take steps to avoid evaporation of your natural tears.  Avoid overly warm rooms, hair dryers, and wind.  Smoking can also be bothersome.

Dry eye can be a very annoying condition, but with the help of your eye doctors you may find that you can be made relatively comfortable.