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Grittiness, burning, itching, and tearing: these are eye symptoms we are all too familiar with. In fact, about 10 million Americans suffer from these symptoms, which are related to dry eyes. In a recent survey, about 50% of all adults said they felt they had dry eyes. Dry eye is a condition when the eyes either cannot produce enough or the proper quality of tears to lubricate and nourish the ocular surface. The worst part about dry eyes is if it goes untreated, your vision can become temporarily impaired.

Causes of dry eyes

Increases with age

• With age, eyes will become naturally drier as your body produces 60% less oil when you turn 65, compared to when you were 18 years old.
• Less oil in the tear layer causes faster evaporation of tears off the ocular surface and can dry the cornea.
• Females are more prone to symptoms secondary to hormonal changes.
• Pregnancy and menopause causes a drastic change in hormone levels, specifically testosterone, which is a hormone that is actually protective in dry eyes. In general, women have very low testosterone levels, but during times of life when hormones change, testosterone is at its lowest thereby causing an increase in dry eye symptoms.

Health conditions: arthritis, diabetes, thyroid imbalance, autoimmune disorders

• Most of these conditions cause inflammation of the eyelids, which decreases oils in your tears and increases ocular dryness.
• Systemic medications: antihistamines, decongestions, antidepressants, oral contraception
• Environment: dry climates, exposure to wind/smoke, prolonged computer use

Treatment

Change your habits to lessen the symptoms

• Blink more frequently while reading or on computer
• Studies show decreased blink rate during these activities
• Increase humidity in office/home
• Avoid being directly under a blowing air vent or fan
• Wear sunglasses with adequate wrap to protect the eyes from exposure

Proper diet with balance nutrition

• Drink adequate water to avoid dehydration
• It is recommended to drink at least ½ your body weight in ounces
• Eat fish and/or take fish oil supplements that contains omega-3 fatty acids

Artificial tears

• Not all artificial tears are equal, so it is important to follow the advice of your optometrist on the brand and dosage appropriate for your type of dry eyes
• Most over-the-counter tears work to help mask the symptoms, yet they lack the ability to cure the cause of the symptoms
• Restasis
• Prescription eye drop that increases tear production/ decreases eye inflammation

Punctal Plugs

• A gel-like plug placed in your tear duct to keep natural tears on the eye longer

The news about omega-3 fatty acids

Recently, there has been a lot of research concerning omega-3 and dry eyes, since it decreases the amount of inflammation in the body. A new study showed those who consumed omega-3 from cold water fish had a 17% lower risk of suffering from dry eyes. In addition, those who had at least 5-6 servings per week, compared to those with only one serving per week, had a 68% lower prevalence of dry eye syndrome.

It is important to understand that not all fish will provide you with the appropriate type of omega-3. The cold water fish like tuna, salmon, mackerel, and herring provide your body with the long chain fatty acids called DHA and EPA, which is essential to our diet. In addition, not all omega-3 fatty acids are the same. The short chain omega 3 fatty acids found in nuts and flaxseed oil are not as effective for controlling dry eyes alone, so it is recommended to combine the two types of omega-3 in order to benefit the most.

Supplementation is essential in order for the body to get the amount of omega 3 it needs. In order to treat dry eye, it is recommended that you take about 1200mg-1500mg of the DHA/EPA fatty acids a day. You want to achieve that dose in about two pills; otherwise you will be getting unnecessary fillers in your supplements, so it is important to read the serving sizes. Make sure you are not supplementing omega-6 as these are readily found in the American diet (margarine, corn oil, and carbohydrates are rich with omega-6). Too much omega-6 increases inflammation in the body and eyes, and will cause adverse dry eye symptoms.

The most common type of dry eye

Most Americans suffer from dry eyes that are related to poor quality of tears. Glands in our upper and lower lid, called meibomian glands, are responsible for producing the oils in our tears. When these glands become clogged or stop working properly, our tears will begin to evaporate very quickly off the surface of the eye causing irritation, redness, burning, and reflex tearing. The best way to stimulate the meibomian glands to start working better is applying heat to the lids. Warm compresses that allow 10 minutes of continuous heat (like a facial heating pad) is the most therapeutic. In addition, specific brands of artificial tears help replenish the oil layer of the tears. If this type of dry eye is diagnosed early, typically the above treatment regimen is all that is needed. If left untreated, we have to resort to more invasive regimens like oral antibiotics, chronic prescription eye drops, and sometimes probing of the glands to improve their function.

The optometrists at Southwest Vision will recommend the correct dry eye treatment to keep your eyes comfortable and healthy. We spend the time necessary with our patients to determine the cause of the dry eyes and prescribe a treatment regimen appropriate to you. We will discuss eye drops, environmental changes, and importantly nutrition changes that can help improve the comfort of your eyes. Please call us at 512-327-3130 to make your appointment today.

References:

Bloomstein, M. How to manage the ocular surface. Optometric Management. 2012 May; 24-26, 72.

Rosenzweig, T. The new face of dry eye management. Optometric Management. 2012 May; 32-22.

Nutrition to improve your vision. American Optometric Association. HYPERLINK http://www.aoa.org

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