Dry Eyes - Other Common Eye Diseases Of Later Life: Eye Care

Content provided by the Faculty of the Harvard Medical School

Dry eyes

As people age, tear production declines, producing irritation, burning, or a slightly painful, scratchy feeling in the eye. Sometimes mucus accumulates, causing a sticky sensation. You may become sensitive to light, have trouble wearing contact lenses, or even find it difficult to cry.

This syndrome, called dry eye, is often mild and doesn't require treatment beyond the regular use of artificial tears you can buy at the drugstore. When the problem is severe, it may feel like you have sand in your eyes.

Dry eye syndrome affects more than 8 million people in the United States. Dry eye is more common in women and usually starts in middle age. People with allergies are more susceptible; the condition may accompany systemic disease such as lupus or rheumatoid arthritis. A shortage of tears is also one of the symptoms of Sjögren's syndrome, a disorder of the immune system that causes dryness of the mouth, eyes, and mucous membranes.

Dry eye syndrome may also develop in people with posterior blepharitis, an inflammation of the inner eyelid that is common in people with allergies or in those with rosacea or seborrheic dermatitis (both skin disorders). In people with blepharitis, the oil glands in the eyelid become inflamed and clog. As a result, the eyes are not bathed in the usual fine sheen of oil, and water from tears evaporates more rapidly than normal.

An October 2005 epidemiological study reported in the American Journal of Clinical Nutrition concluded that it might be possible to reduce your risk of developing dry eye syndrome by modifying your diet — in particular by eating more tuna. Researchers analyzed the diets reported by 32,470 women participating in the ongoing Women's Health Study, which was initially undertaken to determine whether low-dose aspirin and vitamin E can prevent heart disease and cancer, but has also yielded data for other diet-related issues. The researchers found that the women who reported ingesting the greatest amount of omega-3 fats (a healthy fat found in tuna, salmon, and other fatty fish, as well as in flaxseeds) were 17% less likely to develop dry eye syndrome than women who reported the lowest intake of such fats. Women who ate five to six servings of tuna each week were 68% less likely to develop dry eyes. Consuming other types of fish this often did not have such an effect.

An ophthalmologist can diagnose dry eye syndrome with a slit lamp and can test the amount of tear production. Treatment usually involves some type of topical medication, with most preparations available over the counter (see Table 3). If the problem is caused by a reduction in natural tear production, artificial tears may provide some relief. For blepharitis, the prescription medication cyclosporine (Restasis) is an option. Although dry eye may be sporadic, longtime sufferers often need to use these drugs repeatedly.

To minimize evaporation of tears, avoid exposure to dust, pollen, cigarette smoke, and other pollutants and stay out of the wind and away from hair dryers and air conditioner currents. Humidifiers may help by adding moisture to indoor air. If you have blepharitis, your ophthalmologist may advise you to apply warm compresses to your eyelids and massage them periodically to free oil from the glands.

In severe cases, an ophthalmologist may need to insert plugs into the tear drainage ducts. The plugs help natural and artificial tears stay on the eye longer by preventing them from draining out of the opening in the inner corner of the eyelid. Alternatively, your doctor may prescribe special soft contact lenses that help hold in moisture. You may also be advised to wear goggles at night to retain moisture, especially if the eye does not fully close in sleep.

Last updated:	June 19, 2007