Dry Eye Syndrome (DES) Symptoms and Treatment

Dry eyes are a common discomfort that most individuals encounter periodically, often arising due to factors such as allergies, seasonal illnesses, or prolonged use of outdated contact lenses. Nevertheless, the impact is significantly more pronounced for individuals grappling with dry eye syndrome, where these symptoms transcend occasional occurrences and become a persistent aspect of their daily existence.

What Is Dry Eye Syndrome?

Dry eye syndrome, also referred to as dry eye disease (DES), is a persistent ailment characterized by inadequate tear production or an insufficient composition of tears, resulting in inadequate lubrication for the eyes. This condition is alternately known in medical terminology as keratoconjunctivitis sicca or keratitis sicca. Despite the vexing nature of dry eye symptoms, it’s essential to recognize that you’re not facing this challenge alone. Astonishingly, a substantial segment of the population, numbering nearly 16 million Americans, contends with this condition on a daily basis.

Symptoms

The manifestations of dry eye symptoms exhibit a level of variability unique to each individual. Furthermore, akin to numerous medical conditions, the likelihood of its onset rises with advancing age. The array of symptoms that might manifest can present either as standalone issues or converge in various combinations.

Redness

Dry eye can give rise to the visible symptom of red or bloodshot eyes. Ordinarily, during the act of blinking, a delicate layer of tears, known as the “tear film,” is evenly distributed over the cornea—the eye’s outer layer. This tear film plays a vital role in maintaining ocular lubrication, shielding the eyes from potential irritants like dust or eyelashes, and safeguarding against infections.

Nonetheless, in instances of dry eye syndrome, tear production becomes compromised, making it challenging for the eyes to generate an adequate amount of tears. This deficiency in lubrication can cause the friction of blinking to result in the eyelids rubbing against a parched cornea, consequently leading to irritation. Consequently, the blood vessels within the sclera, the white portion of the eye, might experience inflammation, causing the appearance of redness.

Furthermore, it’s worth noting that in certain cases of dry eye, the redness could be attributed to a condition known as meibomian gland dysfunction (MGD). These meibomian glands, located on the eyelids, serve to produce oil that bolsters the tear film’s integrity. Should these glands fail to produce sufficient oil, the dry eye condition can worsen and potentially trigger inflammation, further compounding the issue.

Difficulty Blinking

Dry eye syndrome hinders the natural production of the necessary tears and oil required to uphold the integrity of your tear film. The seamless movement of your eyelids during blinking depends on a smooth surface.

Consider this analogy: just like sliding down a dry water slide can be uneven and uncomfortable, similarly, inadequate lubrication in dry eyes can result in friction that hampers the smoothness of blinking, leading to discomfort.

Stinging or Burning

Sensations of stinging or burning often arise when your eyes encounter challenges in generating an adequate supply of either oil or tears.

The act of blinking plays a pivotal role in the generation of protective oil by your eyelids, which in turn safeguards the integrity of the tear film. This vital oil layer ensures proper lubrication, and its absence can lead to a stinging sensation in the eyes.

In instances of dry eye syndrome, the ability to produce sufficient tears becomes compromised. This insufficiency of tears can result in the drying out of the cornea, inducing a burning sensation as a consequence.

Scratchy Eyes

Insufficient lubrication from your tears can lead to a sensation of your eyes being gritty, scratchy, or as if there’s an abrasive element lodged within them—akin to persistent irritation. This experience is termed a “foreign body sensation.”

Normally, the tear film functions as a protective barrier between the eyelid and the eyeball. However, in cases of dry eyes, the tear film can develop parched areas that provoke discomfort in the eyes. The positive aspect is that these dry spots are transient and can be remedied through treatments aimed at maintaining optimal eye moisture, promoting their healing process.

Dry Eye-caused Blurry Vision

When your tear film maintains proper lubrication, your vision should exhibit a normal clarity. However, the onset of dry eye can lead to the desiccation of your tear film, causing your vision to become blurred.

In a study published in the International Journal of Molecular Sciences in 2020, it was elucidated that maintaining a healthy tear film is imperative for achieving clear vision. The tear film constitutes the initial layer of your eye that interacts with incoming light. As this tear film loses moisture and dries out, the resultant effect could be a distortion in your visual perception.

Among the prevalent symptoms of dry eye, blurry vision frequently emerges and may exhibit intermittent patterns. Notably, your vision might appear clear upon awakening due to the moisture preserved during sleep. Yet, as the day progresses, dryness can swiftly ensue, leading to blurred vision.

Fortunately, remedies exist to rejuvenate the integrity of your tear film, such as the consistent utilization of artificial tears (eye drops designed to enhance eye lubrication). As your tear film’s health is reinstated, you may observe an improvement in your visual acuity as well.

Light Sensitivity

In addition to causing blurry vision, alterations in your tear film composition can also give rise to heightened sensitivity to light. As light enters your eye, it initially encounters the tear film’s surface. Ordinarily, this tear film is characterized by its lubricated and smooth nature. However, dry eye can introduce dry patches or unevenness, which can heighten your susceptibility to light.

For certain individuals afflicted by dry eyes, light sensitivity may be a transient experience. Conversely, others might endure continuous sensitivity to natural daylight or find themselves bothered by glaring headlights or streetlights during nighttime. This heightened sensitivity to light is medically termed as photophobia.

In a 2016 study featured in Expert Review of Ophthalmology, it was suggested that light-sensitive cells within the retina—the layer of tissue lining the back of the eye—might contribute to this discomfort. Researchers speculate that these cells have potential connections to nerves responsible for relaying sensory information to the head and face.

Individuals grappling with photophobia may resort to squinting or closing their eyes when exposed to light. The degree of discomfort experienced can vary significantly. While some individuals might encounter intense pain upon light exposure due to the interaction with nerve endings in the eye, others may voice complaints about excessive brightness or feel compelled to shut their eyes for relief.

Eye Strain and Fatigue

Prolonged periods of gazing at phone or computer screens can lead to eye fatigue, a condition stemming from altered blinking patterns. These habits tend to diminish the frequency of blinking. Although anyone can experience eye fatigue, individuals with dry eyes are particularly susceptible to developing strained and weary eyes. On an average note, people typically blink around 22 times per minute. However, excessive digital device use often leads to a blinking rate that surpasses half the normal pace.

Blinking plays a pivotal role in maintaining ocular lubrication and nurturing a healthy tear film. Dry eye syndrome can undermine the integrity of this tear film, while eye strain can exacerbate the situation. Notably, activities requiring intense concentration, such as reading or driving, often prompt reduced blinking.

To mitigate the risk of eye fatigue, the American Academy of Ophthalmology advocates the 20/20/20 rule: every 20 minutes, take a 20-second break to focus on an object positioned 20 feet away. This practice helps alleviate strain and maintains healthier blinking patterns.

Inability to Cry

In situations where your tears fail to flow even during emotional moments, it’s possible that you are experiencing dry eyes. This circumstance can be exasperating, as the expected emotional release through tears is thwarted when needed.

Individuals encountering dry eyes might mistakenly attribute their inability to cry to emotional repression. However, the actual cause lies in insufficient tear production by the eyes.

Nevertheless, a dearth of tears can stem from various origins, such as medication-induced side effects or residing in arid or windy environments. Notably, this can also be indicative of Sjogren’s syndrome—an autoimmune disorder that diminishes tear and saliva production within the body. If you observe concurrent dryness in your eyes and mouth, it’s advisable to engage with your healthcare provider to explore the possibility of being evaluated for Sjogren’s syndrome.

Watery Eyes

While it might seem contradictory, excessive tear production is also observed as a symptom of dry eyes. This phenomenon can be understood within the context of a specific subtype of dry eye called evaporative dry eye syndrome.

Evaporative dry eye syndrome, the most prevalent form of dry eye syndrome, arises due to a deficiency in the appropriate type of tears being produced. Tears necessitate a harmonious blend of water, oil, and mucus to offer optimal eye protection. If the meibomian glands, responsible for oil secretion, encounter dysfunction, the oil necessary for coating the tear film may become insufficient. This oil, derived from the meibomian glands, plays a critical role in retaining tears within the eyes. A dearth of oil can lead to the rapid evaporation of tears, or conversely, an excessive watery state. This intricate interplay between tear components explains the seemingly paradoxical occurrence of watery eyes in the context of dry eye syndrome.

Stringy Mucus in the Eye

This particular symptom tends to be more prevalent among individuals with moderate to severe cases of dry eye and may coincide with other conditions such as infections or allergies.

For individuals with dry eyes characterized by insufficient tear or oil production for tear film protection, blinking can lead to discomfort or strain. In response to this, the tear film endeavors to compensate for the moisture deficit by generating mucus.

This mucus often manifests as a stringy discharge emanating from the eyes. Should you notice the presence of mucus, it’s advisable to gently remove it using a clean tissue rather than resorting to eye rubbing. Excessive rubbing can instigate inflammation in the eyes, potentially exacerbating the underlying condition.

Wearing Contacts With Dry Eye Syndrome

According to a study published in Contact Lens and Anterior Eye in 2017, approximately half of the contact lens wearers encounter sensations of dryness when using their contacts for extended periods. Prolonged use of contact lenses can contribute to this dryness, as the eyes might not produce a sufficient amount of tears to counterbalance the lens-related factors.

It’s important to note that the presence of dryness while wearing contact lenses doesn’t automatically imply the presence of dry eye syndrome. However, if you encounter a sudden increase in discomfort while wearing your contact lenses, coupled with additional symptoms of dry eyes, it might be advisable to consider undergoing testing to evaluate your eye health.

When to See a Healthcare Provider

Dry eye syndrome manifests through a range of diverse symptoms. For individuals grappling with mild instances, adopting lifestyle adjustments such as incorporating regular breaks from screens and utilizing over-the-counter eye drops might effectively manage the condition.

However, if you find yourself experiencing heightened discomfort or an escalation in symptoms, it’s crucial not to delay seeking medical attention. While dry eye can often be managed effectively, allowing it to go untreated could potentially pave the way for the development of more severe conditions, potentially resulting in vision impairment.

If you identify prevalent symptoms associated with dry eye, it’s prudent to engage with a qualified eye care professional like an optometrist or ophthalmologist. By consulting these specialists and undergoing appropriate testing, you can gain insight into the root causes of your symptoms and receive an accurate diagnosis. This proactive approach enables timely interventions and appropriate management strategies.

A Quick Review

Dry eye syndrome arises when your eyes encounter challenges in generating an adequate quantity of tears or tears of the appropriate composition. Those affected by this syndrome often experience an array of distressing symptoms, which may encompass redness, blurred vision, heightened sensitivity to light, and difficulties associated with blinking, driving, and reading.

Thankfully, there exists a range of treatments tailored to address dry eye syndrome. Initiating testing in the early stages can greatly aid your healthcare provider in identifying the optimal treatment strategy for your specific case. By taking proactive measures, you not only deter the advancement of your condition but also safeguard the preservation of your vision in the long run.