Dry eye, dry eye syndrome, causes and treatment. Pain and dryness in the eyes: causes and treatment Why dryness in the eyes
Dry eyes are an unpleasant sensation caused by irritation of receptors in the conjunctiva of the eyelids or cornea. The main reasons for this eye pathology are a decrease in the amount of tear fluid secreted or an increase in the rate of its evaporation. As a result, friction between the epithelium of the sclera and conjunctiva of the eyelids increases, provoking the development of the inflammatory process. This is also facilitated by the addition of a secondary viral or bacterial infection.
Since dry eyes are only a symptom, its manifestation is also possible with numerous diseases of the eyes and other organs and systems of the body. Often, dry eyes are accompanied by additional symptoms, such as burning, pain, a feeling of sand in the eyes, watery eyes, etc. All these symptoms are combined into a single symptom complex called dry eye syndrome. This term is universal and is registered in the International Classification of Diseases.
Diagnosing the causes of this syndrome is often a difficult task. It is impossible to ignore dryness in the eyes, since its complications can lead to disability of the patient. Therefore, diagnosis, first of all, is aimed at eliminating the most common and dangerous causes of this condition. When none of them is confirmed, they start looking for less likely causes associated with diseases of the blood, connective tissue, tumor formations, etc.
Treatment of dry eye syndrome is divided into etiological, pathogenetic and symptomatic. Treatment of complications often falls to the lot of operating ophthalmologists.
Etiological treatment is aimed at eliminating the cause of the disease. Pathogenetic treatment is designed to interrupt the development of the mechanism by which the disease proceeds. It is prescribed in addition to etiological treatment or when the cause of the disease is not clear, but the general features of its mechanism are known. Symptomatic treatment is focused only on the elimination of the clinical manifestations of dry eye syndrome.
Anatomy of the mucous membrane of the eye, lacrimal glands and eyelids
Knowledge of the structure of the mucous membrane of the eye ( in this context - corneas), lacrimal glands and eyelids allows you to thoroughly understand the mechanism of development of dry eye syndrome. Anatomy of the cornea
The cornea is a thin, transparent, convex disk located on the anterior surface of the eyeball. The cornea is positioned so that light passes through it before reaching the retina. When passing through it, the light is somewhat refracted and focused. The refractive power of this structure is, on average, 40 diopters.When examining the incision of the cornea, it was found that it is not homogeneous, but consists of 5 layers.
Anatomically, the cornea consists of the following layers:
- anterior epithelium;
- Bowman's membrane;
- stroma ( ground substance of the cornea);
- Descemet's membrane;
- posterior epithelium.
It is important to note that the cornea is a transparent medium thanks to a substance called keratan sulfate. This substance is produced by the cells of all its layers and occupies the intercellular space.
In addition, mention should be made of the precorneal tear film, which is not part of the anatomical layers of the cornea, but plays an extremely important role in ensuring its integrity and maintaining metabolism. Its thickness is only 10 µm ( one hundredth of a millimeter). Structurally, it is divided into three layers - mucin, watery and lipid. The mucin layer is adjacent to the anterior corneal epithelium. The watery layer is in the middle and is the main one. The lipid layer is external and prevents the evaporation of fluid from the surface of the cornea. Every 10 seconds, the integrity of the precorneal tear film is broken and the cornea is exposed. As it is exposed, irritation of the nerve endings increases, leading to another blinking and restoration of the integrity of the precorneal tear film.
The cornea is innervated by the ophthalmic branch of the trigeminal nerve. The fibers of this nerve form two plexuses - subepithelial and intraepithelial. Nerve endings are devoid of myelin sheath and species. In other words, their thickness is extremely small and they specialize in perceiving only mechanical stimuli, which, when a certain threshold value is reached, transform into pain.
The nutrition of the cornea occurs both due to blood vessels and due to the diffusion of nutrients from the intraocular and lacrimal fluid. Blood vessels are located along the periphery of the cornea in the limbus ( junction of the cornea to the sclera). With prolonged inflammatory processes of the cornea, vessels can grow from the limbus to the center of this anatomical structure, leading to a significant deterioration in its transparency.
Anatomy of the lacrimal glands
A tear, washing the cornea and conjunctiva of the eyes, is formed in the main and numerous additional lacrimal glands. The main lacrimal gland is located in the upper lateral corner of the eye and is anatomically divided into two sections - the upper ( orbital) and lower ( palpebral). The border between the two parts of the lacrimal gland is the tendon of the muscle that lifts the eyelid. On the one hand, the gland adjoins the orbital part to the fossa of the frontal bone of the same name. Externally, it is held in its bed by its own ligaments, Lockwood's ligament and the muscle that lifts the upper eyelid.On section, the lacrimal gland has an alveolar-tubular, lobular structure. A small duct emerges from each lobule, which independently opens into the conjunctival cavity of the eye or flows into a larger duct. In total, from 5 to 15 ducts of the main lacrimal gland open into the conjunctival cavity.
We should also mention accessory lacrimal glands ( Krause and Waldeyer), which are located mainly in the arch of the conjunctiva of the upper eyelid and range from 10 to 35.
Both the main and accessory lacrimal glands are innervated from several sources - the first and second branches of the trigeminal nerve, branches of the facial nerve and sympathetic fibers of the upper cervical ganglion. The inflow of arterial blood is provided by the lacrimal artery, and the outflow is provided by the vein of the same name.
Tears are 98% water. The remaining 2% is made up of proteins, individual amino acids, carbohydrates, lipids, electrolytes as well as lysozyme. Based on the composition of the tear fluid, one can easily conclude about its functions.
The physiological functions of the lacrimal fluid include:
- nutrition of the stratum corneum of the eye;
- flushing of foreign bodies from the surface of the cornea;
- destruction of pathogenic bacteria;
- maintaining the structural integrity of the cornea;
- slight light refraction ( 1 - 3 diopters) and etc.
eyelid anatomy
The eyelids are anatomically evolved skin folds designed to protect the organ of vision from the harmful effects of external factors.In the human body, the upper and lower eyelids are distinguished. The size of the upper eyelid is approximately three times the size of the lower one. Normally, closing the eyelids completely isolates the eye from light and environmental factors. The free edges of the eyelids contain numerous follicles from which eyelashes grow, also playing a protective role. In addition, numerous ducts of the meibomian glands, which are nothing more than modified sebaceous glands, exit into the cavity of the aforementioned follicles and onto the free edge of the eyelids.
Structurally, the eyelid consists of three layers. The central main layer is a dense connective tissue plate called the cartilage of the eyelid. On the inside, it is covered with the conjunctiva, which is a multilayer cylindrical epithelium. This epithelium contains a large number of mucus-producing goblet cells. In addition, it contains numerous single lacrimal glands.
On the outside, the tendon of the muscle that lifts the eyelid, as well as a layer of skin, adjoins the cartilage of the eyelid. The skin of the eyelids is the thinnest in the entire body and is a stratified squamous keratinized epithelium.
Causes of dry eyes
There are many factors that cause dry eyes. In order to systematize them, several different classifications have been proposed. The most used classification is considered depending on the pathogenetic mechanism by which dry eye syndrome develops. The causes of dry eyes are divided into the following groups:
- pathological conditions associated with a decrease in the production or release of lacrimal fluid;
- factors leading to a decrease in the stability of the precorneal tear film.
Pathological conditions associated with a decrease in the production or release of tear fluid
- autoimmune diseases ( Sjögren's syndrome, complications of radiotherapy of the head and neck, graft rejection);
- diseases of the hematopoietic system ( malignant tumor processes, anemia, etc.);
- endocrine disorders ( climacteric syndrome, hypothyroidism, diabetes mellitus, etc.);
- infectious diseases ( cholera, leprosy, HIV, tuberculosis, typhoid, etc.);
- dermatological diseases ( ichthyosis, neurodermatitis, herpetic dermatitis, etc.).
In autoimmune diseases, there is a failure in the process of recognition by the cells of the immune system of its own tissues, as a result of which it perceives them as foreign. Thus, there is a development of a pathological immune response directed against healthy tissues and organs.
The most common autoimmune condition associated with dry eye syndrome is primary or secondary Sjögren's syndrome. Primary Sjögren's syndrome is characterized by autoimmune damage to the exocrine glands, with the salivary and lacrimal glands being the most common targets. Secondary Sjögren's syndrome develops several years after the disease of another systemic connective tissue disease ( systemic scleroderma, systemic lupus erythematosus, primary biliary cirrhosis, etc.) and is one of the variants of its clinical course.
More rare causes of dry eye syndrome are complications of radiotherapy to the neck and head, as well as graft rejection. Radiotherapy ( radiation therapy) is performed to destroy abnormal cells or reduce the size of a malignant tumor before surgery to remove it. Unfortunately, in some cases there is a concomitant irradiation of the tissues of the lacrimal gland, as a result of which its cellular structure is somewhat modified and it is attacked by the immune system as foreign.
There is also a risk of developing an autoimmune response after a donor cornea transplant due to incomplete antigenic compatibility ( mismatch of receptors on the outer surface of cells).
Diseases of the hematopoietic system
In the course of randomized clinical trials, a link was noted between a decrease in the excretory function of the lacrimal gland and the occurrence of a number of diseases of the hematopoietic system. The above connection was traced with such diseases as malignant lymphoma, lymphosarcoma, lymphocytic leukemia, hemolytic anemia, thrombocytopenic purpura, etc.
The association of dry eye syndrome with malignant diseases of the hematopoietic system is most often explained by the development of paraneoplastic syndrome. Its manifestations and mechanisms can be extremely diverse and include an autoimmune response to cells similar in antigenic structure, the production of biologically active substances by the tumor itself, or other non-specific reactions of organs to the presence of foreign cells in the body. Hemolytic anemias are most likely also associated with dry eye through autoimmune mechanisms.
endocrine disorders
The endocrine system is responsible for maintaining the constancy of the internal environment of the body by releasing hormones and other biologically active substances into the blood that have one or another effect. A failure in the operation of this system in almost all cases leads to disruption of the operation of several organs of one system or even several systems.
Dry eye syndrome can develop with diabetes mellitus, menopausal syndrome and hypothyroidism. With a long course of diabetes, complications such as angiopathy and polyneuropathy develop. Angiopathy is a lesion of the endothelium ( inner shell) of both small and large blood vessels. As a result, there is a narrowing of the lumen of the vessels and the blood supply to all organs and systems worsens. The kidneys, retina, brain and vessels of the lower extremities are most susceptible to this process. The lacrimal gland is no exception, however, a violation of its function is not always clearly manifested, especially given the slow progression of pathological changes. Neuropathy implies a violation of the integrity of nerve fibers, leading to a slowdown in the transmission of impulses. As a result of this, various changes can occur both in the central and peripheral nervous systems. In particular, there may be a decrease in the rate of secretion of the lacrimal glands due to a violation of their innervation.
Climacteric syndrome is a set of symptoms that occur after the female body stops producing sex hormones - estrogens and progesterone. Due to the fact that the work of the endocrine organs is closely interconnected, the cessation of the secretion of some substances leads to a violation of the internal environment of the whole organism. Clinically, this is manifested by mood swings, jumps in blood pressure, bouts of general malaise, excessive sweating, insomnia, etc. In addition, menopausal syndrome can be manifested by impaired secretion of the lacrimal glands, which causes a feeling of dryness in the eyes.
Hypothyroidism is a disease in which there is a lack of secretion of thyroid hormones. Depending on the level of damage, primary, secondary and tertiary hypothyroidism is distinguished. Primary hypothyroidism is associated with disorders at the level of the thyroid gland, secondary - the pituitary gland and tertiary - at the level of the hypothalamus. With a decrease in the concentration of thyroid hormones in the blood, a drop in the level of basal ( constant) secretion, including exocrine glands ( lacrimal, salivary, etc.). It should be noted that such a violation affects not only the main lacrimal gland, but also single additional glands located in the conjunctiva of the eyes.
infectious diseases
The long course of such infectious diseases as leprosy, tuberculosis, HIV or cholera is accompanied by a long-lasting syndrome of general intoxication. This syndrome is associated with subfebrile condition ( body temperature below 38 degrees) and a compensatory increase in the secretion of the lacrimal glands as part of a mild course of dry eye syndrome. Less often, there is some depletion of the reserves of the lacrimal gland, in which the amount of tears first normalizes, and then gradually decreases.
Dermatological diseases
Skin diseases associated with dry eye syndrome include congenital or acquired ichthyosis, neurodermatitis, herpetic dermatitis, etc.
Congenital ichthyosis is a serious disease in which thickening of the skin occurs, followed by its exfoliation in the form of plates resembling fish scales. The severity of the disease depends on the severity of the gene mutation. The most severe forms occur in newborn boys. Acquired ichthyosis is characterized by the appearance of similar scales on the extensor surfaces of the joints, debuting, approximately, from the age of twenty. Unlike congenital ichthyosis, the acquired form develops against the background of malignant neoplasms, diseases of the connective tissue, gastrointestinal tract, and hypovitaminosis. In addition to changes in the thickness and relief of the skin, there is severe itching and a violation of the secretion of the lacrimal glands.
Neurodermatitis or atopic dermatitis is a pathological condition in which the skin and mucous membranes of an allergic nature are affected. In addition to the above manifestations of the disease, there are often deviations in the work of the autonomic nervous system responsible for the innervation of the lacrimal glands. Thus, a decrease in the secretion of lacrimal fluid may be an indirect sign of neurodermatitis.
Herpetic dermatitis refers to the defeat of the skin and mucous membranes by the herpes simplex virus of the first or second type. In the first type, blistering rashes are localized mainly in the region of the nasolabial triangle. In the second type, rashes can be localized on any part of the body, but more often they occur in the genital area, which indicates a frequent sexual transmission of this infection. In the case when the rashes are localized in the eye area, there is a risk of their spread to the conjunctiva, cornea or lacrimal gland. Damage to the lacrimal glands develops quite rarely, but this possibility should not be completely ruled out.
Factors leading to decreased stability of the precorneal tear film
Reasons included in this group include:- scars of the cornea and conjunctiva;
- neuroparalytic keratitis;
- lagophthalmos or exophthalmos;
- allergic conditions;
- stagnation of the lacrimal fluid due to a violation of its outflow;
- use of fans;
- long work behind the monitor;
- wearing contact lenses;
- the use of low-quality cosmetics;
- air pollution ( dust, smoke, chemical fumes, etc.);
- side effects of certain medicines.
Corneal and conjunctival scars
One of the conditions under which physiological rupture of the precorneal film occurs ( approximately once every 10 seconds), is a high degree of correspondence between the surfaces of the cornea and the conjunctiva of the eyelids. When there is some roughness on these surfaces due to postoperative scarring or foreign bodies, the degree of surface tension of the precorneal film decreases, leading to its premature rupture and the development of dry eye syndrome.
Neuroparalytic keratitis
Neuroparalytic keratitis is an inflammation of the cornea associated with a decrease in its sensitivity. Normally, the rupture of the precorneal film leads to irritation of the cornea, which, in turn, leads to another blinking and wetting of the eye. When the sensitivity of the cornea is reduced, the tear film breaks, and blinking does not occur for a long time, because the patient's brain does not receive the necessary signal. The longer the surface of the eye remains dry, the more pronounced the inflammatory process becomes, leading to clouding of the cornea and deterioration of vision.
Lagophthalmos or exophthalmos
Lagophthalmos is a pathological condition in which incomplete closure of the eyelids occurs due to a discrepancy between their size and the size of the eye. This condition can be both congenital and acquired due to trauma, reconstructive surgery, etc.
Exophthalmos refers to the protrusion of one or both eyeballs beyond the orbit. Bilateral exophthalmos is noted in patients with hyperthyroidism, while unilateral exophthalmos may be the result of trauma, aneurysm, hematoma, or tumor. As a rule, exophthalmos leads to lagophthalmos.
In patients with lagophthalmos, even with full closure of the eyelids during sleep, a strip of the cornea remains open, subject to drying and the development of dry eye syndrome.
Allergic conditions
An allergy is an excessive response of the body's immune system to contact with a harmless substance. The most common allergens are dust mites, plant pollen, insect venom, citrus fruits, chocolate, peanut butter, strawberries, etc.
When an allergen gets on the mucous membrane of the eye or nose, it swells, injection ( plethora) sclera and conjunctiva. The patient experiences a feeling of sand in the eyes. The lacrimal glands compensatory increase the rate of release of tear fluid in order to eliminate the interference in the eye.
Stagnation of the lacrimal fluid due to a violation of its outflow
Normally, after the tear fluid has been on the surface of the cornea for some time and performed its functions, with the next blinking, it shifts to the conjunctival fornix, flows to the medial ( internal) corner of the eye and is removed from it into the nasal cavity through the system of lacrimal ducts.
With the failure of the aforementioned channels due to a congenital defect or inflammation, stagnation of the lacrimal fluid occurs, accompanied by a change in its composition. It contains more bacteria and dust particles, which irritate the mucous membrane of the eyes. As a result, an inflammatory process develops, leading to edema and plethora of the sclera, and then to the dry eye syndrome.
Use of fans
Under normal humidity and air temperature, as well as the absence of wind, the time for evaporation of moisture from the surface of the eyes is approximately 10 seconds. This is followed by the closing of the eyelids and the next moistening of the eyes with the newly received lacrimal fluid. However, with an increase in ambient temperature, a decrease in air humidity and a headwind, this indicator decreases several times. In urban conditions, this effect is achieved through the active use of air conditioners, fans and air heaters.
Prolonged work at the monitor
It has been scientifically proven that when working at a monitor, the blinking frequency is at least halved. This fact leads to excessive drying of the cornea and the development of dry eye syndrome.
Wearing contact lenses
Contact lenses are polymer products that are placed on the cornea to correct vision. Ideally, they should completely repeat the shape and size of the cornea. The materials from which contact lenses are made vary in quality and price. High quality products have excellent transparency and do not cause passive irritation of the conjunctiva. In addition, there are certain rules for the use of contact lenses, compliance with which allows you to exhaust the entire limit of this product, declared by the manufacturer, as much as possible.
Thus, buying inexpensive lenses, ignoring the rules for their storage and use, as well as untimely changing them, the patient risks developing reactive keratoconjunctivitis.
Use of low quality cosmetics
Manufacturers of inexpensive cosmetics use numerous substances that have similar characteristics to expensive counterparts, but cause more harm to health. Often the negative effect of such cosmetics is imperceptible, since it develops over a long period. Women who use it change color and turgor ( tension) skin, swelling under the eyes and wrinkles appear, which they unknowingly attribute to early signs of aging. In some cases, contact dermatitis or conjunctivitis develops, manifested by a feeling of dry eyes.
Air pollution
The presence in the air of dust particles, smoke, chemical fumes from varnishes and solvents adversely affects not only the respiratory system, but also the mucous membrane of the eyes, causing irritation and inflammation. This effect is enhanced with increasing air humidity, when these particles are combined into larger droplets.
Pregnancy
It has been repeatedly noted that during pregnancy, women are prone to developing dry eye syndrome. The mechanisms by which this syndrome develops have not been fully elucidated, however, a significant change in the hormonal background and an increase in basal body temperature are considered as the most likely causes.
Side effects of certain medicines
Unfortunately, there are no drugs without side effects. Their diversity often amazes patients who decide to read the instructions before taking the drug. Side effects can develop both locally and systemically.
Topically applied drugs that reduce the stability of the precorneal tear film include drugs such as beta-blocker eye drops ( timolol), anticholinergics ( atropine, scopolamine), low-quality preservatives, as well as local anesthetics ( tetracaine, procaine, etc.).
Systemic drugs that cause dry eyes include some antihistamines ( diphenhydramine), hypotensive ( methyldopa), antiarrhythmic ( disopyramide, mexiletine), antiparkinsonian ( trihexyphenidyl, biperiden) drugs, combined oral contraceptives ( ovidone) and etc.
Diagnosis of the causes of dry eye
Diagnosis of the causes of dry eyes is an algorithm in which, first of all, the most common causes of this condition are excluded, and then the rarer ones and those associated with damage to other organs and systems. To confirm the diagnosis of dry eye syndrome and determine its cause, it is necessary to use the maximum number of available sources of information. You should start with the simplest sources - taking an anamnesis and an objective examination, and, if necessary, resort to expensive and, at the same time, narrowly focused laboratory and instrumental studies.
Clinical picture of dry eye syndrome
Clinical signs of the disease vary depending on the severity of the disease.Severity of dry eye syndrome
| Severity | Patient's complaints | Objective changes |
| Light |
|
|
| Medium |
|
|
| heavy |
|
|
| Extremely heavy |
|
|
In addition to anamnesis data and an objective examination, Norn and Schirmer tests are used to diagnose dry eye syndrome.
Norn test
The Norn test is performed to determine the stability of the precorneal tear film. Before the study, the patient is instilled with a 0.2% solution of fluorescein on the upper region of the eyelids and asked to blink once. After this, the patient is examined in a slit lamp, the time between the opening of the eyelids and the rupture of the precorneal tear film is recorded. Normally, the time of its rupture is from 10 to 23 seconds. If the tear film breaks before the required time, then the cause of this should be sought among a number of diseases that predispose to this. If the duration of the tear film is within the normal range, then you should resort to a Schirmer test.
Schirmer's test
Schirmer's test is performed to determine the level of basal ( constant) secretion of the lacrimal glands. Before the start of the test, one strip of filter paper measuring 5 x 50 mm is placed in the lower conjunctival sac of both eyes of the patient. Then the patient is asked to close his eyes and the countdown begins. After 5 minutes, the filter paper strips are removed and the distance to which they are wetted is measured. The evaluation of the results depends on the age of the patient. At a young age, a value of 15 mm is considered normal, at an older and older age - 10 mm. If the length of the wetted paper is less than 5 mm, then the test is considered positive, which means a decrease in the level of basal secretion of the lacrimal gland. The causes of this condition should be looked for in the corresponding list of diseases.
Thus, using the history and physical examination data, as well as the above functional tests, it is possible to determine the direction in which to look for the cause of dry eyes. Further diagnosis is based on laboratory and instrumental studies.
Laboratory research methods for dry eye syndrome
Laboratory methods for studying the biological environment of the body make it possible to finally determine the cause of dry eyes, or at least get closer to it.Laboratory tests to confirm dry eye syndrome include:
- cytology of a scraping or imprint of the conjunctiva;
- immunological examination of blood and lacrimal fluid;
- crystallography of the lacrimal fluid.
Scraping and imprint are methods for collecting conjunctival cells. When scraping, a gentle movement is made with the edge of the glass slide over the surface of the conjunctiva. After that, the resulting mass is placed in the center of another glass slide, a drop of saline or other solvent is applied to it, stirred and examined under a microscope.
When taking an imprint, one of the surfaces of the glass slide is applied to the conjunctiva for a few seconds, and then taken away and immediately examined under a microscope.
With dry eye syndrome, there may be a decrease in the number of goblet cells, the presence of a certain amount of dead epithelial cells with signs of keratin deposition in them ( the main protein that makes up the skin), normally absent in the tissues of the conjunctiva.
Immunological examination of blood and lacrimal fluid
This study is performed to determine the state of the immune system. Based on its results, it becomes possible to prescribe the necessary treatment.
Crystallography of tear fluid
Crystallography of the tear fluid is performed by applying a drop of tear to a glass slide and then evaporating it. After evaporation of the liquid part of the tear, microcrystals of various shapes and structures remain on the glass slide, the study of which makes it possible to determine the type of eye disease ( inflammatory, degenerative, neoplastic, etc.).
In addition to the above methods, additional narrowly focused studies may be required to identify diseases in which dry eye is a secondary symptom.
These studies include:
- complete blood count and general urinalysis;
- circulating immune complexes;
- determination of rheumatic tests;
- determination of the level of thyroid hormones;
- determination of the level of glycosylated hemoglobin;
- determination of antibodies to the herpes virus, HIV, etc.;
- examination of bone marrow punctate;
- sowing sputum and blood on special nutrient media, etc.
A complete blood count can detect anemia ( decrease in the number of red blood cells in the blood) and inflammatory reactions. Evaluation of the shape and size of erythrocytes ( red blood cells) allows you to navigate the types of anemia. Assessment of the leukocyte formula ( percentage of different types of leukocytes (white blood cells)) allows you to determine whether the inflammation is predominantly bacterial or viral.
Urinalysis allows you to exclude diseases of the kidneys and urinary tract, one of the manifestations of which may be dry eyes.
Circulating immune complexes
Determination of an increased number of immune complexes circulating in the blood is one of the signs of an autoimmune disease, which is a common cause of dry eye syndrome.
Definition of rheumatic tests
Rheumatological tests include determination of the concentration of C-reactive protein, ASL-O ( antistreptolysin-O) and rheumatoid factor. An increase in these indicators, together with the corresponding clinical picture and anamnesis, makes it possible to diagnose one of the systemic diseases of the connective tissue.
Determination of the level of thyroid hormones
Thyroid hormones are responsible for maintaining many bodily functions. Including they regulate the work of the sympathetic and parasympathetic nervous system, which, in turn, regulates the intensity of the work of the lacrimal glands.
Determination of a reduced level of T3 ( triiodothyronine) and T4 ( thyroxine) indicates hypothyroidism, in which the basal level of secretion of the lacrimal gland decreases. Additional testing may be needed to determine the cause of hypothyroidism ( anti-TPO, thyroid-stimulating hormone, thyroid scintigraphy, computed tomography of the brain, etc.).
Determination of the level of glycosylated hemoglobin
This test determines the average level of glucose in the blood over the past 3 - 4 months and is considered the most preferred method for assessing the effectiveness of diabetes treatment and the patient's discipline. An increase in its indicators above normal values allows the diagnosis of diabetes mellitus, which, in turn, can be the cause of dry eye syndrome.
Determination of antibodies to the herpes virus, HIV
Diagnosis of the above diseases is based on the determination of immunoglobulins in the blood ( antibodies) of type M ( in the acute phase of the disease) and G ( in the chronic phase of the disease). When they are found, the likelihood that dry eyes is one of the rare manifestations of these diseases becomes significant.
Study of bone marrow punctate
A bone marrow sample is taken from the sternum or iliac wing with a special syringe, the needle of which is equipped with a penetration depth limiter. When studying this sample under a microscope, the state of all hematopoietic germs is determined. Based on these data, the type of anemia, leukemia or other hematological disease is determined.
Sowing sputum and blood on special nutrient media
Sowing of sputum and blood on nutrient media is carried out in order to grow microorganisms present in these biological fluids. After the appearance of colonies of microorganisms, their type and reaction to various types of antibiotics are determined in order to identify resistance to them. When causative agents of infectious diseases such as tuberculosis, leprosy or typhoid are detected, a parallel is drawn between this disease and dry eye syndrome.
Instrumental research methods for dry eye syndrome
Instrumental research methods allow you to study the structure and properties of the lacrimal fluid using special technical tools.In order to study the tear fluid, methods such as:
- thiascopy;
- determination of osmolarity.
Tiascopy
Tiascopy involves microscopy of the precorneal tear film in order to study its structure. In particular, the thickness of the mucous, watery and lipid layers is assessed, after which a conclusion is made about its stability.
Determination of osmolarity
The osmolarity of the tear fluid directly affects the strength of the tear film. Normally, this indicator is a relatively constant value, however, in some diseases, its value may change. The purpose of this study is to determine the possibility of secondary drying of the tear film.
How to get rid of dry eyes?
Treatment of dry eye syndrome is divided into medical and surgical. Both types of treatment, first of all, are aimed at eliminating the cause that caused the development of this syndrome. This approach is considered the most rational from a prognostic point of view. Some use is found in folk remedies, but their effectiveness varies.
When the cause of the syndrome cannot be identified, resort to pathogenetic and symptomatic treatment. Under pathogenetic treatment is meant the impact on the mechanisms of development of this syndrome. In particular, one of these methods is the correction of the osmolarity of the precorneal tear film by instillation of artificial tears into the eye or the use of tear stimulants.
Symptomatic treatment includes the use of hormonal and non-hormonal anti-inflammatory drops ( gels, ointments), antiallergic drugs, the aforementioned artificial tears, etc.
Surgical treatment is actively used when medical methods do not bring the desired result. As a rule, they are aimed at correcting defects of the cornea or eyelids, as well as treating complications of dry eye syndrome.
Medical treatment of dry eye syndrome
Medication is the first step in treating dry eye. Its direction and duration depends on the etiology of the underlying disease.Also, in the medical treatment of dry eye syndrome, the following are used:
- artificial tears;
- tear stimulants;
- hormonal and non-hormonal anti-inflammatory drugs;
- metabolic drugs;
- antiallergic drugs;
- antibiotics;
- other medicines aimed at the treatment of diseases, one of the manifestations of which is dry eyes.
Artificial tears are used to correct the deficiency of one's own tear fluid. They vary in density and composition. In mild disease, the use of liquid media is recommended ( eye drops). In the moderate and severe form of the disease, it becomes necessary to extend the time the drug stays on the surface of the cornea, therefore, they resort to the use of denser media ( eye gels and ointments). However, in extremely severe forms of the disease, they again return to taking liquid medicines, however, without the content of preservative substances in them. Most artificial tears are made from hypromellose, polyacrylate, and dextran. The required degree of viscosity is achieved by adding auxiliary substances.
The following commonly prescribed artificial tear drops are a good example:
- Cationic emulsion to moisturize the eyes and prevent further development of the "dry eye" syndrome - Cationorm. Drops envelop the surface of the mucous eyes creating a protective film, which in turn prevents the rapid evaporation of natural tears. Cationorm does not contain preservatives in the composition, it can be used over contact lenses.
- Eye drops with ultra-high molecular weight hyaluronic acid - Okutiarz. The composition contains only those components that are naturally present in the tissues of the eye, due to which they quickly moisturize the surface of the eye, relieving dryness and discomfort for a long period. Does not contain preservatives.
- Eye gel with carbomer in maximum concentration - Oftagel. It has a good moisturizing effect, increasing the viscosity of tears and forming a protective moisturizing film on the surface of the cornea. It relieves dry keratoconjunctivitis and other diseases accompanied by dry eye syndrome. It can be used once at night, it also relieves eye fatigue and discomfort.
The most commonly used tear stimulants today include pentoxifylline, administered systemically at a dose of 100 mg 2 to 3 times a day for 6 to 8 weeks.
Hormonal and non-hormonal anti-inflammatory drugs
Anti-inflammatory drugs are one of the most practiced groups of drugs for the treatment of eye pathologies. Blocking the inflammatory process prevents the development of severe organic eye lesions that cause dryness.
Most nonsteroidal ( non-hormonal) eye drops include diclofenac ( diklo F), indomethacin ( indocollier), ketorolac ( ketadrop) and etc.
Among the hormonal anti-inflammatory eye drops, the most famous representatives are sofradex, tobradex, etc. These drugs are combined, because in addition to the anti-inflammatory component ( dexamethasone) also contain antibacterial ( neomycin, gramicidin, framycetin, tobramycin, polymyxin B). The advantage of ophthalmic preparations combined with dexamethasone is an extremely pronounced anti-inflammatory effect, as well as the possibility of their use for the treatment of transplant rejection after corneal transplantation.
Metabolic drugs
Among the drugs of this group, dexpanthenol is most widely used, which is used in the form of ointments and gels, which are laid behind the lower eyelid several times a day. The effect of this drug is to increase the concentration of pantothenic acid in the tissues of the eye, which is actively involved in the metabolism of most enzyme systems of the body, while enhancing its regenerative properties.
Among antiallergic drugs in ophthalmology, three groups of drugs have found application - mast cell membrane stabilizers ( mast cells), lysosomal stabilizers ( lysosomes - small cellular organelles containing enzymes that are extremely toxic to the cell) membranes and antihistamine drugs. Membrane stabilizers prevent the release of histamine and lysosomal enzymes into the allergic focus, thus preventing its spread. Antihistamines block H 1 receptors for histamine, preventing it from carrying out its effect aimed at maintaining and strengthening the allergic process.
The most common mast cell stabilizers are ketotifen, nedocromil sodium, and cromoglycic acid. Anti-inflammatory drugs act as stabilizers of lysosomal enzymes ( diclofenac, dexamethasone). Representatives of antihistamines are loratadine, cetirizine, suprastin, etc. Antihistamines such as azelastine and spersallerg, etc. are used in the form of eye drops.
Antibiotics
Antibacterial drugs in ophthalmology are often used as part of combined medicines. They are used quite often, because even in the absence of the bacterial nature of the inflammatory process, there is always a high risk of its attachment. The most commonly used antibiotics in ophthalmology include tetracycline, gentamicin, tobramycin, etc. Most often they are used topically in the form of ointments, but if necessary, they are combined and administered systemically.
Antivirals
The range of antiviral drugs in ophthalmology is not large, despite the fact that a fair proportion of eye infections are of a viral cause. The most used representatives are idoxuridine and acyclovir, which are administered both topically and systemically. Antiviral therapy is often combined with immunomodulators ( interferons).
Other medicines aimed at the treatment of diseases, one of the manifestations of which is dry eyes
In the case when diseases of other organs and systems are the cause of dry eyes, medicines should be used to cure these pathologies.
In particular, cytostatics are used for malignant formations of the hematopoietic system. In case of anemia, additional administration of the missing substances is resorted to ( vitamin B12, folic acid, iron) or to the use of hormones ( with cytolytic autoimmune anemia).
In menopausal syndrome, combined oral contraceptives are indicated ( trisiston, rigevidon, etc.). However, it should be remembered that drugs in this group significantly increase the risk of developing breast cancer and uterine cancer, cerebral stroke and deep vein thrombosis. In this regard, before you start taking oral contraceptives, it is recommended that you and your doctor carefully weigh their benefits and harms.
Hypothyroidism is treated with thyroid hormone replacement therapy. In diabetes mellitus, treatment is prescribed depending on its type. The first type uses long-acting and short-acting insulin. In type 2 diabetes, drugs are used that improve the penetration of glucose into the cells of the body, thus stimulating a decrease in its level in the peripheral blood.
Treatment of infectious diseases is carried out taking into account their pathogen. For bacterial diseases cholera, tuberculosis, typhoid) treated with antibiotics. For viral diseases ( HIV, herpes simplex virus, cytomegalovirus) are treated with antiviral drugs.
If dry eye syndrome develops as a side effect of one of the medications taken, you should stop taking it and, if possible, switch to the use of second- or third-line drugs.
Surgical treatment of dry eye syndrome
Surgical treatment is resorted to in cases where medications have exhausted their reserves and have not had the desired therapeutic effect.There are the following types of surgical interventions for dry eye syndrome:
- blockage of the lacrimal ducts;
- decrease in the area of evaporation of the tear fluid ( tarsorrhaphy);
- implantation of additional lacrimal glands;
- treatment of complications corneal ulcer, corneal perforation, etc.).
Blockage of the lacrimal ducts is carried out in order to accumulate tear fluid in the vaults of the eyelids. As a result, when blinking, the cornea is more abundantly washed with tears, which is the purpose of the operation. The most common methods of carrying out this surgical intervention are the blockage of the lacrimal openings with special plugs, as well as their coagulation using a laser or an electric scalpel.
Reducing the area of evaporation of tear fluid
Reducing the area of evaporation of the lacrimal fluid is achieved by stitching the edges of the eyelids and narrowing the palpebral fissure. This surgical intervention is performed if the blockage of the lacrimal ducts was not enough to restore the normal level of secretion of the lacrimal glands.
Implantation of additional lacrimal glands
Transplantation of additional mucous glands from the oral cavity into the soft tissues of the eye appendages is an effective, but rather laborious method of treating dry eye syndrome. Its effectiveness largely depends on the professionalism of the surgeon.
Treatment of complications
The most common complication of dry eye syndrome is a deep corneal ulcer, often resulting in corneal perforation. Surgical treatment of such ulcers consists in transplanting tissue flaps from the conjunctiva, oral mucosa, dura mater, cartilage, etc.
The effectiveness of such operations depends on the extent of the defect, the tissue used for transplantation, the instrumentation, the technique used, the experience of the surgeon, etc.
Folk remedies for the treatment of dry eye syndrome
In the treatment of dry eye syndrome, some traditional medicine may be effective. It should be remembered that they are not able to increase the amount of tear fluid released. In addition, they cannot change the organic defects of the eyes and lacrimal ducts. Their ultimate effect lies in the antiseptic and metabolic effect on the epithelium of the eye. In other words, traditional medicine only helps to cure some eye diseases, while the leading role belongs to traditional drug treatment.With conjunctivitis, it is recommended to use lotions from the infusion of Marshmallow officinalis, since they reduce the severity of the inflammatory process and have some disinfecting effect. The tincture is prepared by pouring 3-4 tablespoons of the crushed plant into 1 cup of boiling water. After 8 - 10 hours from the resulting infusion every 2 - 3 hours, you can make lotions for the eyelids.
A good metabolic remedy is an infusion of blueberry leaves and hop cones. It is prepared in a similar way, but it should not be used externally, but inside 2-3 sips 30 minutes before meals 3-4 times a day.
When forming purulent masses on the surface of the eye, lotions from rosehip infusion should be used. The highest quality infusion is prepared in a thermos. 100 - 200 g of rose hips should be placed in it, pour boiling water over it, close tightly and leave for 6 - 8 hours. Only in such conditions does the broth turn out to be sufficiently concentrated.
Washing the eyes with decoctions of sage, chamomile and calendula reduces the severity of pain and the feeling of sand in the eyes. With viral conjunctivitis, St. John's wort has a pronounced therapeutic effect, which is used as a decoction both topically and orally, 1-2 tablespoons 2-3 times a day before meals or an hour after meals.
Prevention of dry eye syndrome
Preventing a disease is always much easier than treating it. In any kind of activity, there are occupational hazards, knowing which you can intervene in a timely manner and minimize their impact on the body. According to statistics, dry eye syndrome develops under the following circumstances:
- increased eye strain working at a computer monitor, reading, etc.);
- low humidity ( desert climate, work in some factories and enterprises);
- high ambient temperature ( desert climate, work of a baker or stoker, etc.);
- constant air currents ( fans, air conditioners, drafts, etc.);
- irritating factor ( toxins, allergens, dust particles, cosmetics, contact lenses, etc.).
What should you do to keep your eyes moisturized?
In order to keep the eyes moist, it is necessary to recognize in advance situations in which the balance between the release of tear fluid and its evaporation from the surface of the eyes is disturbed. In particular, it is necessary to limit the time of working at the computer, and if this is not possible, then at least once every half an hour take a break for 5-10 minutes, during which it is recommended to close your eyes.When using air conditioners and fans, make sure that the air flow is directed slightly away from people.
What to avoid with a tendency to dry eyes?
If you have a tendency to dry eyes, you should avoid factors that aggravate it. Thus, care should be taken not to be exposed to high temperatures, low humidity and air currents. As stated above, while working at the monitor, you should periodically interrupt and monitor the normal blink rate.If an irritating factor leading to dry eyes is known, then it should be excluded. These factors include allergens, contact lenses, dust, evaporation of certain organic substances, etc.
In addition, one should not forget about diseases, one of the manifestations of which is dry eyes. Due attention should be paid to their prevention, and in case of infection, it is necessary to consult a doctor in a timely manner and start taking the necessary medicines.
Can contact lenses be used for dry eyes?
The use of lenses for dry eye syndrome is allowed, however, with certain conditions, since quite often the contact lenses themselves provoke its development. It should always be remembered that contact lenses are foreign bodies for the eye, no matter how tightly they fit to the cornea. There are many conditions under which contact lens irritation would be minimal.
Rules for the use of contact lenses include:
- compliance with the wearing time with the type of lenses;
- gradual transition from one type of lens to another;
- compliance with hygiene measures;
- observance of the expiration date;
- avoiding the harmful effects of external factors, etc.
Correspondence of wearing time with the type of lenses
According to the permissible duration of wearing, lenses are divided into three types - daily, long-term and continuous wear. The longer the lens is worn, the more physiological materials it consists of.Daily lenses are allowed to be worn only during wakefulness. Before going to bed, the lens must be removed. Extended wear lenses can be worn around the clock for up to 7 days in a row, but it is recommended to remove them every 3 to 4 days and give the epithelium of the eye some rest. Continuous wear lenses are designed for an average of one month, however, as in the previous case, it is recommended to take a break after 10 to 15 days.
Gradual transition from one type of lens to another
When changing types or manufacturers of contact lenses, as well as when switching to contact lenses after wearing glasses, some inflammation of the tissues of the eye may develop due to irritation. To prevent this from happening, it is recommended to start wearing lenses gradually - first for 30 minutes a day, and then increase the wearing time until the target value is reached.Compliance with hygiene measures
Like any product, contact lenses have a certain service life, the value of which directly depends on the quality of care for them. Proper care implies, first of all, compliance with hygiene standards, which also reduce the risk of developing dry eye syndrome.There are only three basic rules for lens hygiene. First of all, you should perform all manipulations with the lenses with clean washed hands. It is also important to periodically change the solution in the tanks in which the lenses are outside the period of use. The more often the solution is changed, the better. The lens storage solution should be appropriate for the type of lens, and ideally the manufacturer. Finally, it's important not to leave your lenses anywhere other than a special reservoir. Drying the lens can completely ruin it in just a few hours.
Compliance with the expiration date
You should always carefully read the instructions that come with contact lenses from the manufacturer. Particular attention should be paid to the date of manufacture, expiration date and the period of maximum use of these optical products.Wearing lenses longer than the manufacturer's stated period, even with careful care, predisposes to excessive irritation of the eye tissues and the development of their dryness.
Avoidance of the harmful influence of external factors
The physical and chemical properties of the lenses directly affect its optical characteristics, as well as the degree of affinity of the lenses to the tissues of the eye. Unfortunately, today there is a huge amount of seemingly harmless substances that change the physical and chemical properties of lenses. These include hair sprays, aerosols, cosmetics, some eye drops, dust particles, chlorine from the water supply, etc.In order for the purchased lenses to fully serve their life and not cause eye irritation, you should, if possible, not expose them to contact with the above substances. If eye drops are indicated to the patient, then an ophthalmologist should be consulted regarding their interaction with contact lenses. If they are incompatible, it is recommended to change drops or lenses and choose the optimal combination.
What to do with dry eyes in a child?
If a child complains of dry eyes, then, first of all, household factors that provoke the appearance of this symptom should be excluded. If there is no result, you should contact your family doctor, who will examine the patient and prescribe treatment. If the alleged disease is beyond his competence, then the child will be referred for a consultation with the appropriate specialist. It should be remembered that not always a feeling of dryness in the eyes is a symptom of the disease. Often it appears under the influence of factors such as prolonged eye strain when working at a computer or reading from paper, being under a fan or air conditioner, at high ambient temperature or low humidity. Other likely causes of dry eyes are low-quality cosmetics, polluted air, and the use of certain medications. Thus, by eliminating all of the above factors, the child may stop complaining about dry eyes. If this symptom persists, then you should consult a specialist.
If your child has dry eyes, you may need to contact:
- ophthalmologist;
- pediatrician;
- infectious disease specialist;
- hematologist;
- dermatologist, etc.
If the child uses contact lenses, then for a while they should be discarded. If dry eyes appear after repeated use of the same lenses, then the ophthalmologist will help with their replacement with more suitable ones.
A pediatrician treats many diseases, one of the manifestations of which is dry eye syndrome. In particular, such diseases include allergies, diabetes mellitus, hypothyroidism, etc.
An infectious disease specialist should be consulted when dry eyes are caused by fever of unknown etiology, enterovirus infections, cholera, HIV, etc.
For blood diseases such as anemia, acute and chronic leukemia, you should consult a hematologist.
A dermatologist will help if dry eyes develop due to ichthyosis, herpetic dermatitis, neurodermatitis, etc.
What drops to use for dry eye syndrome?
Dry eye syndrome can be both an independent disease and one of the manifestations of diseases of other organs and systems. Depending on this, the treatment of this disease is prescribed. When dry eye is primary, only symptomatic treatment is effective ( artificial tear) and pathogenetic treatment ( tear fluid stimulants). If dry eye is secondary, then the disease against which it manifested itself should be treated. For this purpose, drops with antibiotics, antiviral, anti-inflammatory and anti-allergic substances are used. Combined drugs are especially popular.
Types of eye drops
| Types of eye drops | Mechanism of action | Representatives |
| artificial tear | The mechanism of therapeutic action is to create a protective film on the surface of the mucous membranes of the eye, which prevents the rapid evaporation of the patient's own tears. |
|
| Tear stimulants | At this stage, eye drops containing in their composition substances that stimulate tear production are under development and testing. |
|
| Non-steroidal anti-inflammatory substances | These drugs block the enzyme cyclooxygenase, which plays a key role in the synthesis of inflammatory mediators ( prostaglandins, prostacyclins and thromboxanes). |
|
| Hormonal anti-inflammatory drugs | The drugs of this group cause the development of an anti-inflammatory effect by blocking the synthesis and release of inflammatory mediators. Compared with non-steroidal anti-inflammatory drugs, hormonal drugs have a more pronounced effect due to the impact on a larger number of mechanisms. |
|
| Antibacterial drugs | The mechanism of action of antibiotics is the destruction of cellular structures necessary for the life and reproduction of bacteria. |
|
| Antivirals | Antiviral drugs destroy the shell of the virus and its information core. If it is not possible to destroy the information core, then the reproduction of the virus is blocked, which leads to a significant decrease in its concentration. |
|
| Antifungal drugs | The mechanism of antifungal action consists in the destruction or blocking of the regenerative processes of the fungal membrane, which causes their destruction. |
|
| Antiallergic drugs | The mechanism of action of antiallergic drugs is to block the release of allergic mediators, as well as to block their receptors, due to which the mediators are unable to show their effect. |
|
| Combined drugs | Most often, eye drops with anti-inflammatory, antibacterial and vasoconstrictive effects are combined. |
|
What are the consequences of dry eye syndrome?
Dry eye syndrome is closely associated with the development of an inflammatory process, the intensity and prevalence of which determine the consequences of this disease. With proper and timely treatment, dry eye syndrome is resolved quite safely without any consequences. However, if the patient does not pay attention to dry eyes for a long time, it eventually leads to inflammatory changes in the cornea, and in the worst case scenario, in other tissues of the eye.
The adverse effects of dry eye syndrome include:
- keratoconjunctivitis;
- corneal ulcer;
- thorn;
- corneal perforation;
- inflammation of the internal environment of the eye;
- corneal keratinization;
Keratoconjunctivitis
Keratoconjunctivitis is an inflammation of the epithelium of the cornea and conjunctiva of the eyelids. In addition to dry eyes, this complication is manifested by pain, a feeling of sand in the eyes, redness of the sclera and conjunctiva, and photophobia.Corneal ulcer
A corneal ulcer is a deep funnel-shaped depression in its thickness, caused by a pronounced inflammatory process, often of bacterial origin. In most cases, a corneal ulcer is a consequence of keratoconjunctivitis.Belmo
Belmo is a keratinized area of the cornea through which light does not penetrate. It occurs as a result of the healing of a corneal ulcer or an equivalent corneal injury in severity. The patient feels the thorn as a dark spot in the same point of view. Outwardly, the thorn is seen as a cloudy whitish spot on the surface of the cornea.Corneal perforation
Corneal perforation is one of the most serious complications of dry eye syndrome, as it significantly reduces intraocular pressure and increases the risk of retinal detachment, which in turn leads to blindness. In addition, corneal perforation in dry eye syndrome develops mainly due to the critical deepening of its ulcer. An ulcer, in turn, develops due to a bacterial infection. Thus, corneal perforation opens the way for infection to the internal structures of the eye.Inflammation of the internal media of the eye
Inflammation of the internal media of the eye is most often the result of corneal perforation. Such a complication often leads to a significant decrease in visual acuity or complete loss of the eye as an organ of vision.Keratinization of the cornea
Corneal keratinization is a consequence of its chronic inflammation with periods of exacerbation. As a result, instead of a transparent smooth cornea, a cloudy and rough keratinized epithelium is formed, sprouted with small blood vessels. The patient's vision gradually decreases until complete blindness, due to the fact that sunlight ceases to penetrate the retina.Blindness
Blindness in dry eye syndrome can develop due to retinal detachment due to corneal perforation, leakage of aqueous humor and a sharp decrease in intraocular pressure. Another cause of blindness is the keratinization of the cornea described above.Such a pathology as dry eyes can develop for many reasons, become a manifestation of dangerous abnormalities in the human body. Symptoms affect one organ at once, then appear on the second. The deviation negatively affects the quality of life of the patient, as it provokes disturbances in the work of the visual apparatus, and sometimes the eye hurts a lot. If you constantly feel dry even during sleep, you need to consult a doctor and find out why this is happening.
Causes
There are many factors that cause dry eyes. The development of discomfort can be affected by deviations in the work of the visual organ, chronic diseases, hormonal disruptions in the patient's body. Many medications cause these side effects. Incorrectly selected medications and prolonged use also dry the mucous membrane. Causes of dryness: work in adverse conditions, means of correcting vision. Often, dry eyes in the morning and at night develop in people over the age of 60 years.
Associated causes of pathology
Dry and tired eyes can cause many diseases that affect tear fluid. The most common cause is blepharitis, with this ailment there are failures in the production of fatty secretions by the meibomian glands. Also, dry eyes cause deviations, such as:
- lagophthalmos;
- shingles;
- rheumatoid arthritis;
- diabetes;
- Sjögren's disease (all mucous membranes in the human body dry out);
- deviations in the work of the thyroid gland;
- sarcoidosis;
- hepatitis C;
- connective tissue pathology.
Hormonal disorders
The syndrome manifests itself in women with hormonal changes provoked by pregnancy or menopause. More often, dry eyes occur in women, as they are more prone to fluctuations and disturbances in the production of hormones. With menopause, the female visual body produces much less fluid necessary for complete hydration, and the nasal mucosa also suffers from this. Also, dry eye syndrome develops during gestation and during lactation. Incorrectly selected hormonal contraceptives and drugs prescribed for the treatment of diseases can negatively affect.
At the age of 50-60 years, patients often complain that their mucous membranes in the mouth and eyes are dry, microcracks appear on the lips, and there is a white coating on the tonsils. This may indicate not only dehydration, but also more dangerous deviations (liver disease, infections, VVD, gastrointestinal ailments).
Medicines
Drug therapy greatly affects the functionality of the visual organ. Dryness in the eye may be due to the use of certain ophthalmic drops, which are designed to reduce intraocular pressure. Pathology also causes the use of:
- diuretics;
- antibiotic and anti-inflammatory drugs;
- antihistamines;
- antidepressants;
- decongestants;
- drugs to normalize blood pressure;
- systemic chemotherapy for cancer.
Other factors
Discomfort can occur if contact lenses are used incorrectly. Dry eyes can be caused by incorrect use of contact lenses or wearing them for a long time, lack of vitamins, constant sitting at the computer, especially at night, or work that requires a lot of concentration. The syndrome can also develop after vision correction by surgery (laser and other surgery). Some cosmetic products provoke allergic reactions, dry out, cause irritation and severe discomfort. Sometimes the mucous membrane of the eye dries out when a person works in difficult conditions, this includes labor in dusty workshops, in the scorching sun or wind.
Associated symptoms
Symptoms usually appear in both eyes at once. Tightness makes itself felt throughout the day, aggravated by the evening. With an exacerbation of the course of the disease, the patient may experience photophobia, a sharp loss of vision. At the same time, the eyeballs are very sore, redness of the tissues and swollen skin appear. After exposure to high temperatures or after exposure to smoke, the patient's condition may worsen. Dry eyes during pregnancy can be a sign of dangerous abnormalities. Symptoms include things like:
- eye redness;
- inflammation of the cornea;
- gluing of the eyelids after sleep;
- discomfort (dryness, itching);
- burning and pain in the eyes;
- violations of the quality of visual function.
Diagnostic measures
An ophthalmologist will prescribe diagnostic procedures to determine the cause of the disease. When the cornea dries up, in order not to aggravate the patient's condition, the disease must be treated at the initial stage of development. Doctors recommend seeking medical help at the first symptoms. Before prescribing a suitable therapy, the doctor must determine the reason why it dries up, for this it is necessary to prescribe a number of diagnostic procedures. After a thorough visual examination and a detailed history taking, the doctor may advise to analyze the tear fluid, take a smear for cytology from the conjunctiva, and apply the Norn and Schirmer tests to analyze evaporation and tear film formation.
Treatment of pathology
Therapy is selected individually by the attending physician. Only after a thorough examination of a person, the disease can be cured. Mostly, medications are used that eliminate dryness in the nose and eyes, only in severe cases it is recommended to turn to surgical intervention, for example, if occlusion of the lacrimal ducts is diagnosed. In children under 16 years of age, surgery is usually not performed. As an aid, it is advised to try massage techniques, folk methods, a sufficient amount of vitamin A in the body is very important. If concomitant symptoms are detected, drugs are selected to eliminate them: In case of insufficient moistening of the sclera, the doctor prescribes specialized gels, ointments and drops.
With insufficient moisture of the sclera, gels, ointments or drops are often used, which are designed to moisturize the eyes and normalize lacrimation on one or two visual organs. Preparations are selected individually only by an ophthalmologist. It must be remembered that self-medication can aggravate the patient's condition and provoke complications. Sometimes, with pathology, it dries in the nose; for this, it is recommended to moisten the eyes and parched mucous membranes with special drugs to stimulate lacrimation.
Under the current working and living conditions, the eyes are affected by many different factors, which are far from always positive. For this reason, questions such as dryness, eye, causes and treatment are becoming more and more relevant, can vision fall in this condition or not? In order to give a complete answer, you need to consider the essence of the problem.
Why do eyes get dry
A topic such as "Dry eye: causes and treatment" concerns many ordinary people. Often the cause of such manifestations is a pathological condition, which is called "xerophthalmia". The essence of this problem is reduced to insufficient hydration of the conjunctiva and cornea of the eyes due to a lack of tear fluid and instability of the tear film.
This film covers the anterior surface of the eye. Its thickness is approximately 10 µm. The key task of this film is to protect the eye from environmental influences, the ingress of various small foreign bodies and dust, inclusive. Moreover, it is with her participation that the cornea is supplied with oxygen and nutrients, due to which a natural immune defense against infections is formed.
The structure of the tear film
When studying dry eyes, the causes and treatment of this disease, it is worth paying attention to the structure of the tear film, which consists of three layers:
The deepest is the mucin layer. It is produced by the conjunctiva. In addition, it is this layer that covers the cornea, due to which its surface is even and smooth. The main function of this layer is to hold the tear film itself on the corneal epithelium.
Water layer. It is produced by the lacrimal glands. This layer consists of dissolved electrolytes and biologically active substances. It supplies the epithelium of the conjunctiva and cornea with oxygen and nutrients. Moreover, thanks to the water layer, metabolic waste products, carbon dioxide molecules and epithelial cells that have died out are removed.
lipid layer. It is produced and coats the outer side of the aqueous layer. Its key function is to protect and glide the upper eyelid. It also prevents excessive heat transfer from the epithelium of the water layer and its evaporation.
Within the framework of the topic: “Dry eye: causes and treatment”, attention should be paid to the fact that every 10 seconds the tear film breaks, stimulating blinking. As a result, there is an update leading to the restoration of the film.
In one minute, approximately 15% of the entire tear film is renewed. In this case, evaporation of 8% occurs.
It can develop if the above-described gaps have a multiple form. Various factors lead to breaks of this type: a violation of the secretion of mucins, lacrimal fluid and lipids, as well as a very rapid evaporation of the film itself.
Causes of Dry Eye Syndrome
There are various conditions in which there is a decrease in the production of tear fluid. The most common include the following:
Endocrine disorders during menopause and premenopause. This is a deficiency in the production of estrogen.
Avitaminosis.
Severe neurological disorders, Parkinson's disease, kidney disease, pregnancy, inflammatory eye diseases and various disorders in the functioning of the organs of vision, severe malnutrition, infectious and skin diseases.
Autoimmune conditions (Sjögren's disease) and connective tissue diseases. In this case, uncontrolled proliferation of connective tissue in the body is implied, accompanied by blockage of the excretory ducts of the lacrimal glands. The ducts block fibrous foci, which leads to a violation of the full production of tear fluid. As a result, its incorrect distribution over the cornea occurs.
Considering dry eyes, the causes and treatment of this disease, you need to pay attention to the negative effects of antiarrhythmic and antihypertensive drugs with their long-term use. The result of this practice can be a decrease in the production of fluid in the body or dehydration. As a result, the total volume of tears decreases and their viscosity increases. The use of eye ointments and drops that contain anticholinergics, beta-blockers and anesthetics can negatively affect the production of tear fluid.
Various conditions that result in the inability of the eye to close completely can also lead to dryness. For proper hydration, the eyelids must be closed completely.
Using contact lenses that are the wrong size or poor quality.
Properly selected contact lenses do not contribute to the development of myopia, but can affect the change in the tissues of the eye surface, which is often accompanied by discomfort and dry eye syndrome. A comprehensive solution helps - the use of ophthalmic gel and eye drops.
Helps to eliminate the causes of discomfort gel "Korneregel". It contains carbomer on a soft gel base, which retains full hydration, and dexpanthenol, which has a healing effect. When taking Korneregel, contact lenses should be removed or, using a prophylactic gel, applied at the end of the day, at night.
Those who feel discomfort and dryness throughout the day should choose Artelak Balance drops, which combine a combination of hyaluronic acid and vitamin B12. Hyaluronic acid forms a film on the surface of the eye that provides moisture. The moisturizing effect of hyaluronic acid prolongs the special protector. Vitamin B12 is an antioxidant that protects cells from free radical damage.
For those who experience discomfort occasionally and usually by the end of the day, Artelak Splash drops, which contain 0.24% hyaluronic acid, are suitable.
There are contraindications. It is necessary to read the instructions or consult with a specialist.
Violation of the rest and sleep regimen, environmental factors can also play a negative role in the development of the dry eye symptom.
The cause of dry eyes in the morning may be directly related to one or more of the factors mentioned above.
In general, the development of dry eye syndrome is more typical for people living in such climatic zones that require the use of air conditioners and heating systems. This is due to the fact that exposure to dry air leads to the evaporation of fluid from the surface of the eyes.
Who is at risk
Considering dry eye, causes and treatment of this disease, it is important to determine who should be wary of such a problem. First of all, such a disease can manifest itself in residents of megacities, since the level of air pollution has a direct impact on the incidence of dry eye syndrome.
Residents of high mountainous areas may also face a similar problem. As for living conditions that can affect the condition of the eyes, they include prolonged work at the computer. According to studies, more than 70% of women and 60% of men working in the office at the PC have problems with the function of the lacrimal glands.
The topic "Dry eye - causes and treatment at the age of 50" is also relevant. , since women of this age group are faced with a decrease in the level of estrogen in the blood. This, in turn, leads to inadequate hydration of the eye.
Dry eye syndrome - symptoms
In most cases, the symptoms of this problem are not clear, but sometimes, due to the development of complications, quite noticeable disturbances in well-being can appear.
These are the following signs of the disease:
redness of the eyes;
Clumping of the eyelids in the morning;
Feeling of "sand in the eyes" and dryness, which may increase during the day;
When blinking, visual clarity is lost.
If the eyes in this condition are exposed to heat or smoke, the severity of symptoms may be much higher.
This disease also has more severe forms of manifestation:
Severe pain in the eyes that is difficult to endure;
visual impairment;
Increased sensitivity to light;
Significant redness of the eyes that does not go away for a long time.
In some cases, even trauma to the cornea is possible. Therefore, when such symptoms appear, you should consult a doctor.
Treatment methods
If dry eyes appear, the causes and treatment in children and adults should be established by a qualified doctor. Therefore, diagnostics are initially carried out: cytology of a smear from the conjunctiva, analysis of the lacrimal fluid, biomicroscopy, as well as the Norm and Schirmer tests (they determine the rate of formation and subsequent evaporation of the lacrimal fluid).
After the cause of the development of the disease is determined, various methods of treatment can be used, from to surgical intervention.
Within the topic of "dry eye, causes and treatment", drops deserve special attention, since they can be used to neutralize the problem at various levels of development.
Doctors often prescribe medications that restore a stable tear film to the surface of the eyes. If you have to deal with a mild form of the syndrome, drops that have a low viscosity level are often used. If the patient has a moderate and severe form, then drops and gels of medium ("Lakrisin") and high viscosity ("Oftagel", "Vidisik", "Korneregel", "Lakropos") are prescribed.
It should be noted that gels with high viscosity turn into a liquid state in the process of blinking. This allows you to provide the desired level of hydration of the cornea.
Anti-inflammatory and antibacterial agents
Often, dry eyes are inflamed. In this case, antibiotics may be prescribed, as well as immunosuppressants. We are talking about such drugs as hormonal drops "Dexamethasone", "Oftan", "Maxidex" and drops with cyclosporine "Restasis".
Studying dry eye, causes, treatment and effective impact on this problem in general, you need to pay attention to antibacterial agents. They are used to neutralize inflammatory diseases, which often cause dry eyes. We are talking about ointments with tetracycline and erythromycin. Assign them, as a rule, a course for 7-10 days. They are used before bed.
There are other methods that can effectively treat dry eyes. Causes and treatment (reviews confirm this) often imply such an effective method of influencing the disease as an implantable container in which the tear fluid is located. Install it in the lower eyelid.
Surgical impact
There are several types of minor surgeries that can affect dry eyes. With their successful implementation, the normal production and maintenance of the required amount of tear fluid is restored.
An example is the occlusion of the tear ducts, which drain fluid from the eyes. If they are blocked, then the liquid will begin to accumulate on the outer surface of the eye, which leads to its moistening. To block the ducts, plugs are used, which are removed if necessary. This procedure is not complicated, but it can significantly improve the patient's condition.
If after this operation the problem has not been resolved, cauterization of the tear ducts can be used.
Folk methods
There are a few more methods that are worth mentioning when studying the topic "dry eye - causes and treatment." Folk remedies overcome many common diseases and this syndrome is no exception.
Here are a few examples of this approach:
Chamomile decoction. It is necessary to brew chamomile. In the resulting broth, cotton pads are moistened and applied to the eyes for 10-20 minutes. It is advisable to do this while lying down.
Tea lotions. The same principle is used with the use of cotton pads, only ordinary tea is brewed, and strong.
The use of honey This healing product dissolves in water and is used in the form of compresses.
In general, when studying dry eyes, the causes and treatment of this disease with folk remedies, it is worth noting that it is important not to forget about an integrated approach to the recovery process.
Prevention
In order to prevent the appearance of dry eyes or to consolidate the result of treatment, you need to follow a few simple principles:
Make sure that the humidity level in the house is approximately 30-50%;
In the cold season, use humidifiers;
Protect your eyes from exposure to direct air currents and especially strong winds;
Use sunglasses.
conclusions
Obviously, dry eyes can be the result of a whole group of different factors. For this reason, both before and after treatment, it is important to ensure that the cause of the problem does not continue to have a negative impact on the shell of the eye.
Dry eyes are a common problem among office workers. It is worth noting that it is not an independent disease, but a combination of symptoms provoked by an impressive list of conditions and factors. It is noted that dry eyes in most cases are accompanied by:
- a feeling of the presence of sand when blinking;
- strong cuts;
- itching
- hypersensitivity to bright natural and artificial light;
- lacrimation;
- temporary blurred vision;
- decrease in performance behind the monitor.
Dryness and irritation of the eyes is accompanied by discomfort when trying to see bright objects. Blurred vision appears when reading, watching TV. Sometimes lumps of mucus of a viscous consistency gather in the corners of the eyes. Patients prone to infections suffer from recurrent conjunctivitis. Tearing, unlike the normal state, does not bring relief. With dry eye syndrome, the fluid has an unbalanced composition. This prevents the desired effect from moisturizing.
Dry and tired eyes
Sometimes tear fluid is released in its natural volume. However, its composition is seriously disturbed: water predominates, and proteins and fats, along with mucus, are not enough. As a result, the tear evaporates, and the patient complains of dry and tired eyes. Among the reasons for this condition are:
- chronic kidney and liver diseases;
- beriberi - deficiency of vitamins A, B, C;
- chronic fatigue syndrome, lack of sleep;
- pregnancy, lactation;
- rigid diets;
- incorrectly fitted contact lenses.
Dryness and redness of the eyes
Due to the regular presence in a room with artificial lighting, the retina is seriously tired. As a result, the patient notices dryness and redness of the eyes. However, symptoms can also indicate:
- conjunctivitis;
- uncontrolled intake of drugs;
- exposure to volatile chemical compounds;
- inevitable age-related changes.
To find out what influenced the occurrence of dry eye syndrome - a disease or the environment, you can go through self-diagnosis on our website. In 2-3 minutes, you will receive an estimated diagnosis, as well as recommendations for visiting a doctor. Then it will be necessary to make an appointment to avoid aggravating the problem.
Symptoms, including fatigue and dryness, are due to dysfunction of the lacrimal glands. Lubrication for the eyeball and eyelids is not enough, moisturizing is not enough. Dryness of the eye, the causes of which are internal, also occurs when there is a malfunction in the functioning of the endocrine system. If there are problems with the liver, the eyes can also suffer. Thyroid dysfunction also provokes a decrease in the amount of tear fluid secreted. Also, a feeling of dryness in the eyes appears in menopause in women. The volume of all produced mucous fluids decreases.
Other internal reasons include:
- diabetes;
- systemic connective tissue diseases (scleroderma, rheumatoid arthritis);
- the action of a number of drugs (diuretics, antidepressants, antihistamines, tranquilizers);
- medications for hypertension;
- vasoconstrictor sprays, drops.
- dry indoor air, long work and eye strain;
- non-compliance with the rules for wearing contact lenses for the eyes;
Diagnostics
Severe dry eye is well diagnosed. A practicing ophthalmologist with experience will conduct a thorough examination, analyze complaints and symptoms. Diagnostic methods:
To make a diagnosis, it is proposed to pass the Schirmer test. The paper is inserted under the lower eyelid for 5 minutes. The level of tear fluid secretion depends on the degree of wetting.
Which doctor treats dry eyes?
If you have dry eyes, you should consult a doctor of the following specialty
who will make the correct diagnosis. After the examination, the doctor will prescribe the necessary diagnostics in your case. Some diseases are difficult to diagnose as they say "by eye". Therefore, you need to trust the doctor when prescribing research. After all the tests, the doctor will be able to draw up the correct course of treatment. Remember: accurate diagnosis and correct diagnosis are already 50% of success in treatment!
Treatment
Dryness of the mucous membrane of the eye disappears if the internal cause of the symptom is eliminated. However, under some conditions, it is impossible to get rid of the problem by 100%. For example, in postmenopausal syndrome, discomfort is relieved only as a result of regular use of gel products. If they are canceled, the problem returns. It is worth noting the external factors that cause dry eyes. They lead to rapid evaporation of the liquid even during normal production. The cause of the syndrome is often the constant presence near the air conditioner, in a room with dried air from the heating system. In such conditions, dry eyes immediately occur. The causes and treatment of this syndrome are analyzed and selected by a specialist individually.
If the problem is associated with an unfavorable microclimate, it is enough to install an air humidifier and ventilate the room more often. In the case when dryness and burning in the eyes torment a patient whose activities are associated with prolonged work at the monitor, the ophthalmologist may prescribe:
Computer vision syndrome is seen in many teenagers and adults. Rare blinking due to excessive tension, radiation and elevated air temperature lead to rapid evaporation of the liquid, fatigue of the eye muscles.
Dry eye (dry eyes, dry eye syndrome) is an eye condition that occurs when there is insufficient moisture and / or lubrication of the outer surface of the eye with tear fluid or just a tear. With dry eyes, there is a feeling of "sand in the eyes", eye irritation, "burning", "stinging" in the eyes.
Older people usually suffer from dry eyes. Recently, however, dry eyes often occur in young people who spend a lot of time at computers. Contact lens wearers may experience dry eyes in air-conditioned rooms, dry air, high winds, and other conditions that are unfavorable to the eyes.
Artificial tears are commonly used to relieve the symptoms of dry eyes, and special moisturizing/lubricating drops are available for contact lens wearers.
dry eye syndrome
Dry eye syndrome occurs when the surface of the eye is poorly hydrated and lubricated. Hydration and lubrication of the eye is provided tear film formed on the surface of the eye by tear fluid. Thinning of the tear film or a violation of its composition leads to drying of the cornea of the eye, there is a feeling of dryness, irritation of the eyes. The eye becomes hypersensitive to the dryness of the air, to the wind, to cigarette smoke. Violation of normal moisturizing and lubrication of the eyes can occur for various reasons.
The tear film consists of 3 layers. The main middle layer is a watery layer, consisting of 98% water and containing proteins and salts in addition to water. The watery layer is what we usually call the tears that we have when we cry or laugh. The aqueous layer is created by the lacrimal glands located above each eye at the outer edge. The lacrimal glands constantly secrete a small amount of tear fluid, which, when blinking, is evenly distributed over the surface of the eye.
Small glands located at the edges of the eyelids (meibomian glands) secrete fats (lipids) that make up the outer layer of the tear film. The lipid layer prevents the evaporation of moisture from the main aqueous layer, serves as a protective barrier and gives the surface of the tear film smoothness, thereby providing conditions for the correct refraction of light rays when passing through the tear film.
The conjunctiva (thin transparent membrane that covers the inner surface of the eyelid and, with the transition to the eye, the sclera of the eye (the "white" area of the eye)) secretes a small amount of a mucous substance (mucin). The mucin layer smooths out all the microroughness of the cornea surface and contributes to the uniform distribution of the lacrimal fluid over the surface of the eye.
After washing the outer surface of the eye, the lacrimal fluid is discharged through the lacrimal canaliculus into the so-called lacrimal sac, and then into the nasal cavity.
Factors that cause dry eyes
Anyone can experience dry eye, but it is more common in older adults. It is believed that dry eye occurs in about 7% of people around the age of 50-60 and in 15% of people aged 70 and over. Moreover, women experience dry eyes more often than men.
- Age. With age, our eyes produce less tear fluid, and it is not enough for normal wetting of the eye. The composition of the tear film also deteriorates. Lack of tear fluid and a violation of its composition are manifested in adverse external conditions (dry air, smoke, etc.).
- Medications. Some medicines, when used long-term, have dry eyes as a side effect or worsen dryness already present. These drugs include: diuretics (diuretic drugs), some antidepressants, antihistamines, oral contraceptives, beta-blockers (propranolol, atenolol, etc.), eye drops used to treat other eye diseases, drugs to treat peptic ulcers, and some others. drugs.
- Diseases. In some people, dry eyes appear as a symptom of a general illness in the body. For example, dry eyes can develop with rheumatoid arthritis, Sjögren's syndrome, systemic lupus erythematosus (SLE), and others.
- Unfavorable external conditions causing increased tear evaporation
For instance:
Low air humidity (due to central heating or air conditioning)
A long stay at the monitor (TV, microscope, etc.) leads to a decrease in the frequency of blinking, often with a wider than normal opening of the eyes. This causes increased tear evaporation, a decrease in the volume of tears secreted by the glands, and a decrease in the rate of tear fluid exchange.
Windy weather
Incomplete covering of the eye with eyelids (for example, in the case of thyroid eye disease); sleep with partially closed eyes.
- Damage to the outer surface of the eye, eyelids etc. as a result of illness, eye injury or surgery.
- Blepharitis (inflammation of the eyelids)
- unknown reason. Some young people produce less than normal tears for no known reason.
Dry eye symptoms
Dry eye symptoms include:
Sensation of a foreign body (“sand in the eyes”), eye irritation, “stinging”, “burning”. Red eyes may be indicative of other more serious eye problems.
Slight blurring of the image that appears at times (dry eyes usually do not lead to permanent deterioration of vision). Deterioration of visual performance by the end of the day.
Photophobia (bright light causes discomfort).
Poor tolerance to wind, smoke, air conditioning, etc.
For those who use contact lenses, wearing them becomes uncomfortable (feeling of "sand in the eyes", eye irritation, stinging, burning, redness of the eyes).
Dry eye may not feel like "real dryness" at all. As you can see from the list above, the symptoms can be very different.
What causes dry eyes
Complications of dry eye are quite rare. Sometimes there is inflammation of the conjunctiva (conjunctivitis) or the cornea (keratitis). In severe cases, corneal ulceration occurs (small ulcers form). Rarely, ulcers penetrate the cornea through and through (this condition is called corneal perforation).
If redness of the eyes or persistent visual impairment (more severe than temporary blurring of the image), you should consult an ophthalmologist. It is also necessary to visit a doctor in cases where there is a feeling of pain in the eye, and not just a "sand sensation" or irritation of the eye.
How is dry eye diagnosed?
A doctor usually diagnoses dry eye based on symptoms. However, since dry eyes may be a symptom of another condition (such as Sjogren's syndrome), the doctor may ask the patient about other symptoms and perform a more detailed eye examination.
To confirm the diagnosis of dry eye, a special test (Schirmer's test) is performed. To do this, a special narrow paper strip is inserted under the patient's lower eyelid and left for 5 minutes. According to the degree of wetting of the strip in 5 minutes, it is determined whether the patient's eye secretes enough tear fluid.
Dry eye treatment
Artificial tear preparations
Artificial tears come in the form of eye drops or gel. An artificial tear usually relieves negative symptoms well. These drugs are sold over the counter in pharmacies, but can also be prescribed by a doctor with a prescription. In the beginning, they may need to be applied frequently (an hour or more) to relieve symptoms. With improvement, artificial tear preparations can be used less frequently (3-4 times a day). They may need to be used regularly.
Different types of artificial tears are produced, differing in composition. It happens that in some people a certain type of drops causes irritation. In this case, you should switch to other drugs.
Please note that some types of artificial tear drops contain benzalkonium hexachloride as a preservative. If such drops are used for a long time, then this preservative can damage the cornea of \u200b\u200bthe eye. Therefore, if artificial tear drops are used more than 4 times a day for a long time, then it is better to use drops that do not contain benzalkonium hexachloride.
Eye ointments (lubricants)
To relieve irritation and lubricate the eyes, eye ointments (lubricants) are used, which are applied at night under the eyelid. Ointments are sold in pharmacies without a prescription or by prescription. Eye ointments should not be used during the day as they can reduce the effectiveness of eye drops and cause blurring. Also, do not use ointments if you are using eye drops for other eye conditions (such as glaucoma). Eye drops will not work well if eye ointment is already applied to the surface of the eye.
Other treatments
Artificial environment preparations and eye ointments that relieve irritation in most cases successfully eliminate the symptoms of dry eyes. In cases where they do not help, the ophthalmologist may recommend stronger medications to increase the production of tear fluid. Sometimes a surgical method is used to block the outflow of tear fluid from the eye. Some methods are aimed at eliminating the cause that causes dry eyes.
Contact lenses and dry eyes
Dry eyes are one of the most common reasons for not wearing contact lenses. Especially often, dry eyes when wearing contact lenses are felt towards the end of the day, when working in adverse conditions (air-conditioned, smoke, etc.), with a long stay at the monitor. If the wearer of contact lenses constantly faces the problem of dry eyes, then this problem should be discussed with the contact doctor. They may recommend switching to a different type of contact lens (with a different moisture content or biocompatible materials) or using a different multipurpose contact lens care solution.
Moisturizing/lubricating drops are also used to eliminate or at least reduce the symptoms of dry eyes.
Note also that contact lenses should not be worn when using many eye drops. The preservatives in these drops may cause dry eye symptoms. You should also not wear contact lenses while using eye ointments.