Dry Eye

Dry eye occurs when there is a decrease in the quantity or a deterioration in the quality of tear production. This condition can be caused by several factors including reduced tear secretion, excessive tear evaporation, abnormalities in the mucin or lipid components of the tear film, degeneration of the lacrimal glands, or underlying health conditions such as Sjogren’s Syndrome, neurotrophic keratitis (reduced corneal sensitivity), allergic-conjunctivitis, vitamin A deficiency, thyroid disease, or certain medications. Dry eye can affect both men and women. While typically not severe, untreated dry eye can lead to corneal damage.

Prevention

• Avoid staying in dry and hot environments for long periods. Use a humidifier to reduce air dryness.

• Take regular breaks from activities requiring visual focus, such as reading or computer use.

• Adjust the computer monitor position to be lower or level with the eyes to reduce eye strain.

• Blink frequently, especially while reading, watching TV, or using computers, to remove foreign matter and evenly spread tears.

• Avoid direct exposure to hair dryers, heaters, and air conditioners.

• Refrain from wearing contact lenses during dry eye symptoms to prevent irritation, infections, and injury.

• Quit smoking and avoid cigarette smoke, which can worsen dry eye symptoms.

• Wear glasses or eye shields when outdoors or during winter to protect the eyes.

Self-care and Management

• Drink 8–10 glasses of water daily to stay hydrated and support normal tear production.

• Especially during hot weather or windy conditions, fruit juices may help reduce dehydration.

• Use artificial tears frequently throughout the day to lubricate the eyes.

• Apply warm compresses to the eyes to relieve dry eye symptoms.

When to See a Doctor

• Symptoms worsen despite initial management.

• Red eyes while wearing contact lenses accompanied by eye pain.

• Presence of thick eye discharge.

• Severe headaches.

• Abnormal vision.

• Eye injuries.

Treatment Options

1. Artificial Tears (Ophthalmic Lubricants)

Artificial tears are a first-line treatment for relieving dry eye symptoms by providing lubrication and reducing irritation. These eye drops mimic natural tears and help restore moisture to the eyes.

Common active ingredients in artificial tears include:

• Dextran, hydroxypropyl methylcellulose, glycerin, polyethylene glycol 400, propylene glycol, sodium chloride, potassium chloride and calcium chloride.

Some formulations may also contain preservatives such as:

• Benzalkonium chloride, EDTA(ethylenediaminetetraacetic acid), purite, chlorobutanol, sodium perborate and sorbic acid.

Cellulose derivatives, such as carboxymethylcellulose, hydroxyethyl cellulose, hydroxypropyl cellulose, methylcellulose, hydroxypropyl methylcellulose, and hydroxypropyl guar, guar help coat the surface of the eye, retain moisture, and protect against environmental irritants.

Povidone is another lubricant agent that enhances tear film stability and soothes eye discomfort.

Sodium hyaluronate, a naturally occurring polymer, not only moisturizes but also promotes corneal wound healing, making it beneficial for more severe dry eye cases.

Diquafosol, a P2Y2 receptor agonist, is used to stimulate natural tear and mucin secretion, especially in patients with kerato-conjunctival epithelium disorders caused by lacrimal gland dysfunction.

2. Antibiotic Eye Drops or Ointments (Eye Anti-infectives & Antiseptics)

Dry eye caused by meibomitis (inflammation of meibomian glands) can be treated with tetracycline or doxycycline eye drops, which have anti-inflammatory properties.

3. Immunosuppressive, Anesthetic, or Anti-inflammatory Eye Drops

Cyclosporine eye drops may relieve inflammation-induced dry eye, although full efficacy can take up to 6 weeks.

4. Other Eye Preparations

Eye ointments containing yellow/white soft paraffin, liquid paraffin, and lanolin can complement artificial tear therapy for mild to moderate dry eye.

Eye washes with sodium chloride may also help relieve dry eye symptoms.

5. Other Treatment Options

Punctal plugs, made of dissolvable collagen or silicone, can block tear drainage to help retain moisture on the eye surface.

In severe cases, moisture chamber spectacles (specialized goggles) can help alleviate dry eye symptoms.