What is dry eye syndrome?

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Eyes feel uncomfortable? Perhaps your eyes are failing to make enough tears, a condition called dry eye syndrome. Or your tears may be evaporating too quickly. Many people—more women than men—have this problem after the age of 50, which can cause redness, sensitivity, itching, scratchiness, and blurry vision. Potential fixes include artificial tears, humidifiers, prescription eye drops, or procedures to fix underlying eye problems.

Dr. Laura C. Fine, MD
Ophthalmologist (Eye Specialist)

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 eight million people in the United States. It 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 Sjogren's syndrome, a disorder of the immune system that causes dryness of the mouth, eyes, and mucous membranes.

 

Dry eye, or keratitis sicca, most often occurs when the tear film (the mixture of salt water, oils from melbomian glands in the lids, and dissolved mucins from conjunctival tissue glands that coat the eye surface) is disrupted or compromised. The problem rarely stems solely from insufficient tear production by the lacrimal glands, but usually involves many factors, including excessive evaporation and other disruptions.

Normally, the eye constantly bathes itself in tears. By producing tears at a slow and steady rate, the eye stays moist and comfortable.

Sometimes people do not produce enough tears or the appropriate quality of tears to keep their eyes healthy and comfortable. This condition is known as dry eye.

The eye uses two different methods to produce tears. It can make tears at a slow, steady rate to maintain normal eye lubrication. It can also produce large quantities of tears in response to eye irritation or emotion. When a foreign body or dryness irritates the eye, or when a person cries, excessive tearing occurs.

The continuous production and drainage of tears is important to the eye's health. Tears keep the eye moist, help wounds heal, and protect against eye infection. In people with dry eye, the eye produces fewer tears or tears of a poor quality and is unable to keep its surface lubricated and comfortable.

The tear film consists of three layers-an outer, oily (lipid) layer that keeps tears from evaporating too quickly and helps tears remain on the eye; a middle (aqueous) layer that nourishes the cornea and conjunctiva; and a bottom (mucin) layer that helps to spread the aqueous layer across the eye to ensure that the eye remains wet. As we age, the eyes usually produce fewer tears. Also, in some cases, the lipid and mucin layers produced by the eye are of such poor quality that tears cannot remain in the eye long enough to keep the eye sufficiently lubricated.

This answer is based on source information from the National Eye Institute.

The rate of incidence for dry eyes is high for people 65 and older and particularly women in that age group. It is estimated that more than half of all people 65 or older have at least some symptoms of the condition. Women, particularly post-menopausal women, are particularly susceptible to dry eyes.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.