Dry eye, or dry eye disease (DED) is a common eye disorder where the eyes don’t make enough tears, or the tears evaporate too quickly.
It can make your eyes feel dry, scratchy and irritated or watery, and feel heavy and tired at the end of the day.
Although it’s called ‘dry eye,’ one of the symptoms you experience might be very watery eyes, as the brain tries to compensate for the dryness by producing more tears.
It’s more common as we get older, with one in three people over 65 experiencing problems with dry eyes. Women who’ve reached the menopause are also commonly affected.
For some, dry eye may only cause mild discomfort, but some people experience more serious problems, and, in some cases, it can cause permanent damage to the eye’s surface. There are a lot of things you can do to help yourself, and there are times when you should seek the advice of a health practitioner.
Once viewed as a painful nuisance, dry eye disease (DED) today is considered a “critical and significant public health issue” [in the United States].
The most common symptoms of dry eye, as described by people living with the disease, are:
If these symptoms feel fairly mild there are things you can do to help yourself (see below). But if you experience any of the symptoms of dry eye disease it’s important you don’t wait until symptoms become severe before you seek help. It’s worth speaking to your GP or your optometrist, who will be able to advise you and suggest medication such as eye drops depending on what’s causing your dry eye. If this doesn’t solve the problem they may refer you to an eye specialist, known as an ophthalmologist.
Dry eye can have a significant impact on your quality of life, so it’s important to know that you don’t have to just put up with it. If your dry eye disease is affecting the quality of your sleep or is stopping you from driving, affecting you at work or stopping you doing activities you enjoy, seek help from your optometrist sooner rather than later.
There are two main types of dry eye disease:
The first step is for your optometrist or ophthalmologist to see which type of dry eye is present. Both types can be present at the same time.
The second step is to identify and treat or remove any underlying causes. You may be asked to stop certain medications, use a different type of glaucoma eye drop, use a different type of contact lens or reduce the number of hours you wear contact lenses.
There are several different options your optometrist or ophthalmologist may suggest for treatment of your dry eye disease, depending on the type and severity of your condition.
‘Artificial tears’ are eye drops used as replacement for watery tears. There are many different types available without prescription. Gels and ointments are also available and are thicker than eye drops. They usually last longer in the eye and need to be put in less frequently, but can blur the vision when they’re first put in. Daily hot eyelid massages can also help.
Preservative-free eye drops are recommended for use with contact lenses, or if drops are needed more than four times a day. Switching to preservative-free glaucoma eye drops is recommended for patients with glaucoma who also have dry eye disease.
Dry eye disease and glaucoma commonly appear together. Studies suggest that 50-60% of people who are being treated for glaucoma also have dry eye disease.
The most common cause is blockage of the meibomian gland (the tiny glands along the eyelash line that produce the oily layer that stops your eyes from drying out too quickly). Both conditions are long-term but can be managed successfully.
Daily hot eyelid massage and regular use of artificial tear supplements, combined with optimising glaucoma management, can ensure successful management of both conditions.
When you go for your appointment, your ophthalmologist (eye doctor) will want to know details about your dry eye, and other things that might affect it.
Some simple preparation may help you, and your doctor, get as much out of the appointment as possible.
Make some notes about your dry eyes to share with the doctor, e.g.
Bring any medicines you are using with you, including eye drops you have bought from the pharmacist or optometrist. Write a list of any other medicines you have tried before, even if you’re not using them at the moment.
Write down any questions you have to help you remember them in the appointment.
Bring someone with you to the appointment if you can – they can help by taking notes and remember what was talked about.
Read through any instructions you have been given from the clinic ahead of time, so you know what to expect.
Think about what you want to get out of the appointment, and make sure you tell the doctor or nurse.