Dry eyes are more than a modest problem.  They can be the cause of great stress.

Sufferers wake up with scratchy eyes, and have to take drops frequently just to avoid discomfort.  

When untreated, dry eyes are more likely to get infections or redness, and their owners are more likely to be irritable. 

Let’s take a look at the problem, and consider solutions.

1. What are tears?

Tears are really a mixture of three layers over the surface of the eye; water, oil, and mucous.  The water layer is closest to the cornea, while the oil or lipid layer is secreted by the mebomian glands of the lids.  The lipid layer keeps the water from evaporating.  The mucous layer on the top is there to protect the other two layers from blasts of air and particles that might prove irritating.  The final protective layer of the eyeball is the lids, which blink to renew the spread of the three layers, and to refresh the eyeball surface.  Tears are produced inside and along the edges of the lids, and drain out through the punctum or hole in the inner margin of each of our upper and lower lids, close to the nose.  The tear ducts then carry them away into the nose.  This is why crying is also associated with blowing your nose!

2. What makes eyes go dry?

There are many factors that lead towards dry eyes.  These include staring too long at computers, tablets or cell phones, where the eyes are trying to stay open for focus and concentration.  The same can happen with prolonged study of books, or staring at the road while driving on a long trip.   LASIK surgery (to restore normal vision to people who need glasses) can also be drying in later years.  People with certain skin diseases like acne rosacea and Sjogren’s syndrome may suffer from dry eyes.  Even birthdays can cause dry eyes, starting at about the age of 50.  In younger people, makeup and facial soaps can add to the problem, as can wearing contact lenses for excessive periods of time (even if the manufaturer promises you can leave contacts in overnight).  Ambient dust or other small particles can also bedevil the dryness problem.  Certain medications can also cause dryness as a side effect; be wary of drops that “remove redness” as these too can make the problem worse.

3.  What can I do about it?

Try to establish root causes.  If your room air is dusty, try to control it with air filtration or other measures.  If you wake up with dry eyes, make sure your pillow is not a bag of dust by washing or dry-cleaning it.   If makeup is a problem, use hypoallergenic products, and learn how to apply them properly.   If you stare for hours at computers, then try to take your breaks outside, and focus on distant objects to give your eyes a break from the short distance stare.  If non-prescription drops are not sufficient, please see your doctor.  While your family doctor can initiate investigations, including for general health issues, you will need to see a specialist to further examine the eye, including to measure the production of tears with a strip of litmus paper and stained eye drops.  As you will see on our post on the subject, it is important to have the full array of modern tools to examine the eye, not just a hand-held light with an eye chart at the end of the room.  Once the doctor assesses the problem, then a menu of options apply. 

Punctal plugs can be inserted into the drain holes of each lid, commonly the lower ones.   If you have tried non-prescription drops, make sure you use them often and correctly. (see our article on Eye Drops Made Easy)   

 If the problem is with dry wax in the meibomian glands of the edges of each lid, then try to use warm compresses such as a face-cloth.

Press firmly over each eye for a minute or so, and the dry balls of wax in each gland opening will melt away.  Shampoo in the eyes, (almost!) can also be effective in dissolving the waxy gland material; use a gentle shampoo like Baby Shampoo, and rub it into each eye, almost opening the lids.  After leaving it for a minute, then rinse under the shower. 

Use regular drops like Refresh or Systane, just for lubrication and moistening. 

Above all, make sure you have your eyes examined regularly, and protect them with sunglasses, or appropriate goggles for handywork or sports.