Who would have thought that absence of tears could also be a problem? But it is… and it’s called dry eye syndrome. This is a condition caused by either reduced tear production or increased tear film evaporation.

Signs of dry eye syndrome

• Dryness, burning, and a sandy-gritty feeling in the eye that gets worse as the day goes on
• Itchiness, tiredness and eyes that are stinging
• Pain, redness, a pulling sensation, and pressure behind the eye
• Stringy discharge from the eyes
• Feeling that something—such as a speck of dust—is in the eye
• Increased sensitivity to bright light

The condition usually impacts both eyes. Curiously, because the eyes are irritated, dry eye can cause the eyes to water. But these reflex tears don’t provide any relief, they are the watery type that are released in response to injury, irritation or emotion and do not have the lubricating qualities necessary to prevent dry eyes.

What makes the eyes to go dry

Watching television, driving, extended usage of computers and mobile phones, long continuous hours of reading are some of things that cause dry eyes. As a rule, any activity that decreases blinking of eyes is known to worsen the condition.

Windy or dusty conditions, dry air, high altitudes including travel by air plane also leads to dry eyes.

Being in a smoky environment and areas where an air conditioner [especially in a car], fan, heater, or even a hair dryer is being used, can aggravate the condition.

The symptoms decrease during rainy, foggy or cool weather, as well as in humid places, such as in the shower.

Left untreated it can become serious

If the condition is left untreated, it can give rise to complications that can lead to impaired vision and, in extreme cases, even loss of vision. The vision may get blurry or the irritation can exacerbate to such a level where people may have difficulty in keeping their eyes open. This hinders work productivity and everyday activities such as driving.

Having dry eyes for a while can lead to tiny abrasions on the cornea. Some severe cases result in thickening of the corneal surface, corneal erosion, corneal ulcer, corneal scarring, thinning, and even corneal perforation.

You are at a risk of Dry Eye Syndrome if…

• You have approached menopause or are 60 plus in age, as tear production decreases with age
• You are diabetic
• You wear contact lenses very frequently
• Dry eyes also occurs or gets worse after LASIK and other refractive surgeries. Though the dryness caused by these procedures usually resolves after several months, it can sometimes become permanent too
• Deficiency of vitamin A, rheumatoid arthritis, lupus, Sjögren’s syndrome and other autoimmune diseases increase the risk to dry eyes
• Drugs such as isotretinoin, sedatives, diuretics, antidepressants, antihypertensives,  antihistamines, nasal decongestants, beta-blockers, can worsen this condition.

Simple ways to reverse the condition

Blinking frequently, especially while using the computer and taking repeated breaks while using any kind of a screen are basic steps to minimise discomfort. Avoid rubbing your eyes as it increases irritation. Inflammation of the eye-lids can occur with dry eye syndrome and paying particular attention to cleaning the eyelids with a mild shampoo and placing warm compresses twice a day can improve both conditions. Do not splash water into open eyes since it can make the condition worse. Children should reduce TV and other gadget viewing. A good night’s sleep is very essential to take care of dry eyes. One should also keep the body hydrated by drinking enough liquids.

Environmental control

Avoid spending too much time in dry environments and try to avoid smoky and dusty areas. If you are using devices such as air conditioners, hair dryers, and heaters, make sure they are not directed towards your eyes. Lowering your computer screen below eye-level, so that your gaze is directed downwards, helps to prevent straining of eyes. Using a humidifier, especially in winter, also helps by adding moisture to the dry indoor air.

Rehydration

For mild and moderate cases, lubrication is the most important part of treatment. Putting preservative-free artificial tears and gels in your eyes every few hours can provide relief.

Lubricating tear ointments containing white petrolatum, mineral oil and other similar lubricants can also be used. Certain specified drops can be used with contact lenses. Additional humidity can be created by wearing specially designed glasses that form a moisture chamber around the eye.

Medication

Mild steroid drops can be used to suppress tears that occur in response to inflammation.

Consumption of dark-fleshed fish containing dietary omega-3 fatty acids is associated with a decreased incidence of dry eye syndrome.

Conserving tears

Natural and artificial tears can be made to stay longer through the following means:

Blocking tear drainage

In each eye, there are little openings that drain tears into the tear ducts. Tears get drained from the eyes to the nose via these channels. To prevent tears from being drained completely, these channels can be closed either completely or partially with punctal plugs. These are tiny devices that can be inserted into the tear duct openings to block them.

Customised contact lenses

Persons with severe dry eyes may benefit from customised contact lens. It creates a fluid-filled layer over the cornea, which prevents it from drying.

Most patients have mild-to-moderate cases, and can be treated with some workstation and lifestyle changes and, if required, symptomatically with lubricants. This provides adequate relief from symptoms.

This was first published in the May 2014 issue of Complete Wellbeing.

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Causes of eye damage

Cataract:

Clouding of the transparent lens of the eye is called a cataract. Oxidative stress, which causes damage to the lens proteins is proposed to be a cause of cataract and hence an appropriate antioxidant could halt the process and delay vision impairment caused by cataract.

Age Related Macular Degeneration [ARMD]:

It is one of the leading causes of irreversible vision loss in many countries across the globe. As longevity increases in developing nations, ARMD is emerging as a public and personal health issue that markedly compromises the quality of life among the affected elderly.

Normal metabolic processes and UV light absorption generates free radicals and oxidants causing damage to the retinal photoreceptors. This leads to impaired function and eventually to degeneration of the macula. The macula is a central part of the retina responsible for central vision [reading, driving, handwork] and is directlybehind the lens. The macula is the area of the eye that receives the most light. These radicals and oxidants are eliminated by antioxidants, which helpin preventing cellular damage in the retina.

Diabetic retinopathy:

The effect of diabetes on the retina of the eye constitutes diabetic retinopathy, which may cause mild to moderate damage to the retina in the form of blood leaks to a severe form which can lead to blindness. The extent of oxidative stress [an imbalance in the levels of oxidants and antioxidants] is related tothe severity and duration of diabetes.

The level of antioxidants is significantly decreased in diabetes. This suggests that antioxidants can play a vital role in prevention and progression of diabetic retinopathy. Vitamin E and C are important components of cell defence against oxidative stress and more so in diabetic retinopathy.

Sources of antioxidants

There are a number of antioxidants that pack a lot of power for the eyes. These include vitamin A and carotenoids, vitamin C, vitamin E, anthocyanidins, selenium and zinc, which are found naturally in food.

Vitamin A is a super oxidant known primarily for its effect on the retina and also for improving night vision. It is found in eggs, fish, fish liver oil and liver.

Vitamin C is found in orange, grapes, papaya, tomato, and strawberries.

Vitamin E can be obtained from almonds, sunflower seeds, safflower oil, peanuts and peanut butter.

Anthocyanidins is found in blueberries and bilberries.

Carotenoids, nutrients that are not classified as vitamins, include beta-carotene, alpha-carotene, lycopenes, lutein and zeaxanthin.

Lutein is an antioxidant that has been shown to be associated with a reduced risk of macular degeneration and cataract. As an antioxidant, it is 10 times more effective than vitamin E.

Lutein and zeaxanthin are deposited specifically in the macula and their function is to reduce oxidation. They filter out blue light that is known to cause free radical damage to the eyes.

It is estimated that foods or supplements high in lutein and zeaxanthin eaten five times per week could significantly reduce ARMD. Because both lutein and zeaxanthin are fat soluble, they should be taken with meals or olive oil.

Super foods that contain carotenoids include broccoli, brussels sprouts, leaf lettuce, spinach, collard greens, sweet potatoes, carrots, mangoes, papaya, egg yolk, milk, apricots and tomatoes.

Many different brands of antioxidant supplements are sold singly and in various combinations as tablets, capsules and sprays. The manufactured quality and formulation of the supplement can influence absorption and therefore potential benefit.

It is important to remember that vitamin supplements are not a cure for ARMD or other eye conditions, nor will they restore vision already lost from the disease. However, specific amounts of these supplements do play a key role in helping some people at high risk to maintain their vision. But the best way to good eye health is to have a healthy diet with fresh fruits and vegetables.

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