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Dry Eye Syndrome
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Dry Eye Syndrome
1:20PM 16/ 01/08
Dr. Makbul G. Mansuri
Introduction
Dry eye syndrome is one of the most common problems treated by
eye physicians. The tear film protects
your eyes and lubricates. It also reduces the risk of eye
infection and, with each blink of your eyelids; helps clear your
eyes of any debris. When your eyes become irritated by dust or are
bothered by wind, smoke or fumes, extra tears form to help wash
away the foreign material.
Decreased production of fluids from your tear glands can
destabilize the tear film, allowing it to break down rapidly and
create dry spots on the clear front surface of the eye (cornea)
that cause irritation and diminished vision. An imbalance in the
substances that make up the tear film also lead to dry eyes.
Dry eyes are a common source of discomfort, and usually dry eyes
are a chronic problem. Adults age 40 or older are most likely to
experience dry eyes. Treatment of dry eyes is aimed at restoring a
more normal tear film to minimize dryness and its consequences,
including blurred vision and discomfort.
What is dry eye syndrome?
"Dry eye syndrome" is a name that encapsulates a number of
different conditions, all of which share eye dryness. It's like "headache";
there are many different types of headaches and causes of a
headache, but they all share the same general symptoms of pain in
and around the head region. The different types of dry eye are
classified into dryness that has to do with inadequate production
of tears, what we call tear-deficient dry eye, and dry eye
syndrome that is due to enhanced loss (or evaporation) of the
tears. We don't know exactly what percentages of people with dry
eye syndrome have each type, and this issue is complicated by the
fact that many people have both types of dryness at the same time.
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Signs and symptoms
Signs and symptoms of dry eyes may include:-
1) A stinging, burning or scratchy sensation in your eyes
2) A sense of a foreign substance in your eyes
3) Stringy mucus in or around your eyes
4) Increased eye irritation from smoke or wind
5) Eye fatigue after short periods of reading
6) Sensitivity to light
7) Difficulty wearing contact lenses
8) Blurred vision, often worsening at the end of the day or after
visually focusing for a prolonged period on a nearby task
9) Both eyes usually are affected.
Causes
Tear glands and tear ducts
Tears are much more than just water. They're a complex mixture of
water, fatty oils, proteins, electrolytes, bacteria-fighting
substances and growth factors that regulate various cell
processes. This mixture helps make the surface of your eyes smooth
and clear. Without tears, good vision is impossible.
For some people, the cause of dry eyes is an imbalance in the
composition of their tears. Other people don't produce enough
tears to keep their eyes comfortably lubricated. Eyelid problems,
medications and other causes, such as environmental factors, also
can lead to dry eyes.
Poor tear quality
Tears are comprised of three layers. The mucus layer coats the
cornea, the eye’s clear outer window, forming a foundation so the
tear film can adhere to the eye. The middle aqueous layer provides
moisture and supplies oxygen and other important nutrients to the
cornea. This layer is made of 98 percent water along with small
amounts of salt, proteins and other compounds. The outer lipid
layer is an oily film that seals the tear film on the eye and
helps to prevent evaporation.
Tears are formed in several glands around the eye. The water
layer is produced in the lacrimal gland, located under the upper
eyelid. Several smaller glands in the lids make the oil and mucus
layers. With each blink, the eyelids spread the tears over the
eye. Excess tears flow into two tiny drainage ducts in the corner
of the eye by the nose. These ducts lead to tiny canals that
connect to the nasal passage. The connection between the tear
ducts and the nasal passage is the reason that crying causes a
runny nose. In addition to lubricating the eye, tears are also
produced as a reflex response to outside stimulus such as an
injury or emotion. However, reflex tears do little to soothe a dry
eye, which is why someone with watery eyes may still complain of
irritation.
Decreased tear production
Tear production tends to diminish as you get older. When you're
unable to produce enough tears, your eyes become dry and easily
irritated. The medical term for this condition is
keratoconjunctivitis sicca
(ker-uh-to-kun-junk-ti-VIE-tis sik-uh).
Although dry eyes can affect both men and women at any age, the
condition is more common among women, especially after menopause.
This may be due in part to hormonal changes. Damage to the tear
glands from inflammation or radiation can hamper tear production.
Dry eyes are also associated with medical conditions such as
diabetes,
rheumatoid arthritis, lupus, scleroderma and Sjogren's
syndrome.
Refractive eye surgeries such as laser-assisted in-situ
keratomileusis (LASIK) also may cause decreased tear production
and dry eyes. Symptoms of dry eyes related to these procedures
usually resolve after several months.
Poor lid function
Through blinking — normally at a rate of about 13 blinks each
minute — your eyelids spread a continuous thin film of tears
across the surface of your eye. Problems with your eyelids can
impair the complex blinking motion required to spread these tears,
resulting in dry eyes. Eyelid problems that may develop as you age
include an out-turning of the lids (ectropion) or an in-turning of
the lids (entropion).
Blepharitis, an inflammation along the edge of the eyelids, also
may cause your eyes to feel dry and scratchy.
Medications
The types of common medications, both prescription and
over-the-counter (OTC), that can cause dry eyes include:
1) Diuretics, drugs commonly used to treat high blood pressure
2) Antihistamines and decongestants
3) Sleeping pills
4) Birth control pills
5) Tricyclic antidepressants
6) Isotretinoin-type drugs for treatment of
acne
7) Opiate-based
pain
relievers such as morphine
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Other
causes of dry eyes
Dry eyes can be worsened by exposure to many environmental
conditions that have a drying effect, such as sun, wind, high
altitude, a dry climate, hot blowing air and the dry air that
commonly occurs in the cabins of commercial airplanes.
In addition, tasks that require intense visual concentration —
such as working at a computer, driving or reading — tend to
decrease your blink rate, thereby increasing tear evaporation.
In some people, the cause of dry eyes is an allergic reaction to
eye drops or ointments.
Self-care
-
Blinking Avoid air blowing in
your eyes. Don't direct hair dryers, car heaters, air conditioners
or fans toward your eyes.
-
Wear glasses on windy days and
goggles while swimming. The wraparound style of glasses may help
reduce the effects of the wind.
-
Keep your home humidity
between 30 percent and 50 percent. In
winter, a humidifier can add moisture to dry indoor air. Some
people use specially designed glasses that form a moisture chamber
around the eye, creating additional humidity.
-
Avoid rubbing your eyes. You
can irritate your eyes further by rubbing them.
-
Take preventive steps. Use eye
drops before, rather than after, your eyes become irritated as a
result of visually demanding activities. Try to avoid activities
that might worsen the problem.
-
Remember to blink. Consciously
repeatedly helps spread your own tears more evenly. When
performing tasks that require intense visual concentration, take
occasional breaks — adding up to about five minutes each hour —
and rest your eyes by closing your lids for several seconds.
Follow this by consciously increasing your blink rate. Be
especially careful to follow these suggestions if you have had
LASIK or a similar procedure.
Treatment
When it comes to treating dry eyes, everyone’s needs are a little
different. Many find relief simply from using artificial tears on
a regular basis.
Ayurved point of view:-
1) Tarpana
2) Aschoyatana
3) Seka
4) Pindi
5) Bidalaka
6) Nasya by various medicine
7) Oral intake of chaksushya medicine
8) Prevention
Dr. Makbul G.
Mansuri
M.S. (Ayu.) Shalakyatantra,
Lecturer Shalakyatantra,
J.S. Ayurved College,
NADIAD-387001 (Guj.)
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