Dry Eye Syndrome: Causes, Symptoms, and Treatment

Dry Eye Syndrome is one of the most common conditions encountered in ophthalmic practice and affects millions of people worldwide. It results from disturbances of the tear film that covers the surface of the eye.

Environmental pollution, including smoke, dust, and airborne particles, prolonged work in air-conditioned environments, contact lens wear, and the use of certain medications are among the factors that can disrupt the tear film and contribute to the development of Dry Eye Syndrome.

Symptoms

The tear film consists of three layers: a mucin layer, an aqueous (water) layer, and a lipid (oil) layer. Together, these layers protect the ocular surface from drying, facilitate oxygen delivery, and maintain adequate lubrication of the eye.

In healthy eyes, the tear film is renewed with each blink. When blinking is impaired or tear film stability is compromised, dry areas develop on the ocular surface and the tear film breaks up more rapidly. In pathological conditions, this instability becomes persistent.

Symptoms of Dry Eye Syndrome vary considerably and may include:

• itching;
• burning;
• a gritty or sandy sensation;
• eye fatigue;
• irritation;
• pain in more severe cases.

Symptoms are often aggravated by smoke, wind, heat, or prolonged visual activities such as reading, watching television, or working at a computer.

Early manifestations may include blurred or fluctuating vision and increasing discomfort during prolonged visual tasks. Patients sometimes believe they need stronger glasses when, in fact, tear film instability is responsible for their visual symptoms.

Paradoxically, excessive tearing may occur during the early stages of Dry Eye Syndrome as a reflex response to ocular surface irritation.

Causes

A detailed medical history often helps identify the underlying causes of Dry Eye Syndrome.

Numerous systemic and topical medications may adversely affect the tear film, including:

• cardiovascular medications;
• antidepressants;
• antiallergic medications;
• sedatives and tranquilizers.

Preservatives contained in certain ophthalmic preparations and previous eye surgery may also negatively affect tear film stability.

Long-term use of oral contraceptives has likewise been associated with Dry Eye Syndrome.

Dry eye symptoms may also occur in association with various systemic diseases, including connective tissue disorders, rheumatoid arthritis, dermatological diseases, hyperthyroidism, vitamin A deficiency, inflammatory eyelid disorders, and following radiation therapy.

Dry Eye Syndrome is also common during menopause.

Treatment

Although tear film dysfunction can be effectively managed, it cannot usually be completely cured.

In some patients, psychological factors may contribute to symptom severity. A thorough explanation of the condition by an ophthalmologist is therefore an important part of treatment.

Management should begin with identifying and, whenever possible, addressing contributing systemic diseases, medications, and environmental factors such as excessive sunlight, wind, or dust exposure.

Artificial tears remain the cornerstone of treatment.

They lubricate the ocular surface, form a protective barrier against environmental irritants, and help remove substances that may damage the tear film.

Artificial tear preparations differ in their preservatives and additional ingredients, allowing treatment to be tailored to individual patient needs.

Most artificial tears are available over the counter and may be used according to the recommendations provided in the product information leaflet.

What You Should Know

It is important to remember that artificial tears do not cure underlying eye diseases. Their primary purpose is to relieve the symptoms of dry eyes.

If the eyes continue to be exposed to triggering factors such as sunlight, wind, or dust, symptoms are likely to recur.

Because artificial tears have no therapeutic interactions with ophthalmic medications, they may safely be used alongside prescription eye drops.

When multiple eye drops are prescribed, artificial tears should be instilled last.

Persistent dry eye symptoms despite regular use of artificial tears and appropriate reduction of eye strain may indicate a more serious underlying ocular disorder. In such cases, consultation with an ophthalmologist for a comprehensive eye examination is recommended.

If your eyes feel dry, irritated, or fatigued because of dust exposure, prolonged computer use, or hot, sunny weather, artificial tears can help restore ocular surface moisture and improve comfort.

Prepared by Dr. R. Jasiukevičiūtė

Pharmacy and Time, No. 6