Red, gritty and scratchy eyes can have a number of causes and possible treatments. In addition to discomfort and fluctuating vision, dry eyes can lead to styes and infection. At Westside Optometry we consider dry eyes a symptom of ocular surface disease (OSD). Regular eye examinations can prevent complications and provide the opportunity for you to get help with treatment.
If you have ocular surface disease, you may notice discomfort any time of the day. For some people with lack of tear production the eyes are gritty and sore first thing in the morning. For others the symptoms worsen as the day progresses. Air conditioning, smoke, drafts, and cold temperatures become difficult to tolerate. Vision may fluctuate with poor tear quality and prolonged screen time. It may feel like there’s a foreign body in your eye, or your eyes may have a sandy feeling. You may find that your eyes are watering constantly or that strands of mucous are accumulating in spite of the fact that you are suffering from “dry” eyes.
What’s Going On? Normal tear film consists of three layers: mucin, aqueous, and lipid. Abnormalities in production, content, or distribution of these three layers or in eyelid function will cause the various conditions commonly known as dry eye.
- Lipid Problems: These are the most common cause of dry eye. Glands in the eyelid produce lipids. Greasy lotions, incomplete removal of makeup, or skin conditions like dandruff can plug the glands and prevent lipids from secreting.
- Aqueous Deficiency: This can be a side effect of certain medications you’re taking. The culprits include antihistamines, diuretics, hormones, and psychotropics.
- Mucin Deficiency: Chronic infection or trauma to the eye can cause a lack of mucin. Autoimmune diseases (Sjorgren’s syndrome, Rheumatoid Arthritis and Lupus) negatively effect the mucin layer too.
- Eyelid Problems: The eyelid may turn in or out as a result of the aging process or of scarring. Tears then spill over the eyelid, allowing the eye to become dry. Depending on the severity of the situation, this problem may need plastic surgery to repair the eyelids.
- Acne Rosacea can negatively effect the eyelids and tear quality in more than 20% of Rosacea sufferers.
Also, ocular surface disease can be aggravated by inflammation of the eyelid margin due to poor blinking, excessive make-up and blepharitis. In this case, the whites of the eyes and rims of the eyelids will be red and irregular.
It usually takes multiple approaches to control OSD. A combination of the following may improve comfort: good eyelid hygiene, the use of artificial tears and lubricating ointments, newer agents designed to heal tissue such as Cyclosporine, omega-3 supplements and punctal occlusion (the insertion of a silicone plug into the tiny opening that drains the tears). Examining controllable factors such as medications, topical creams and lotions, and minimizing environmental influences like wind, smoke and screen time can enhance treatment success.
At Westside Optometry, we use Thermal Expression and BlephEx procedures in the office for longer term relief and treatment of dry eye symptoms. Ocular surface disease can be a chronic problem but continued care and maintenance of the eyelids will minimizes symptoms and future complications.
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