Women are more likely than men to suffer from dry eye.

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The National Eye Institute estimates 5 million people over age 50 suffer from dry eye syndrome. This lack of a healthy tear film in our eyes leaves the person uncomfortable and prone to eye irritation. Dry eye syndrome may be due to the eyes not producing enough tears or the tears not having the proper consistency to lubricate the eye.

Besides irritation, other typical symptoms of dry eye may include:

• sensitivity to light
• itching/burning
• excessive tearing
• redness
• blurry vision

Many people ignore these symptoms, believing they’re no big deal. But untreated dry eye syndrome can threaten your sight.

Chronic dry eye is usually related to malfunctions in the eye’s lubrication system. Glands under the eyelids produce a protective coating called the tear film, which has two main components:

• A watery layer that adheres to mucus on the eyeball’s surface. The lacrimal glands supply the tears, while cells on the eye surface produce mucus. If the lacrimal glands don’t produce enough fluid, you could develop dry eyes.
• An oily film that caps the watery layer and keeps it from evaporating. This layer is produced by the meibomian glands, which line the margins of the eyelids. An insufficient oily cover allows the watery layer beneath to evaporate more quickly.

Even a simple eye blink replenishes the tear film. Watching TV or working at a computer makes you blink less, which can worsen dry eyes. Dryness often comes with inflammation, made worse by rubbing.

Gender Differences

Women are more likely to suffer from dry eye than men (3.2 million women vs. 1.7 million men over the age of 50), spending more money on dry-eye therapies. Those who’ve gone through menopause are at greatest risk, as declining hormone levels reduce tear production and subtly increase inflammation.

That doesn’t mean men shouldn’t be concerned. Dry eye becomes twice as common in men as they move from their early 50s to their 80s. The underlying cause may be declining male hormone levels, which contribute to the deterioration of the tear film. Other risk factors include eye fatigue (such as from using a computer or frequent driving), smoking, LASIK surgery, and long-term use of contact lenses.

Treatment

Dry eye is uncomfortable, even when it’s mild. Some require special drops to boost their eyes’ natural lubrication system. In most cases, you can use over-the-counter artificial tears. You may need to try drops with different formulations to see which one works best for you.

Some eye drops contain omega-3 fatty acids to help reduce the inflammation in dry eye, which may make you reach for an omega-3 supplement, like fish oil. You may want to rethink that. A 2018 study published in the New England Journal of Medicine showed omega-3 supplements had no effect versus a placebo on relieving dry eye symptoms.

Drops containing the immune-suppressing anti-inflammatory drug cyclosporine A (Restasis) may relieve symptoms for those who don’t respond to conventional treatments. Restasis reduces inflammation and improves natural tear production, although it can cause stinging, burning, and other side effects. Restasis is available only by prescription.

The U.S. Food & Drug Administration (FDA) has approved a new type of prescription medication for dry eye, called lifitegrast ophthalmic solution (Xiidra). The first in its class, Xiidra reduces dry eye symptoms and prevents damage to the eye surface. Like Restasis, Xiidra is a medicated eye drop. The FDA approved Xiidra based on four major clinical trials demonstrating that lifitegrast reduced both symptoms and signs of dry eye.

Severe Dry Eye

More severe cases of dry eye may be treated by inserting tiny plugs into your eye’s drainage system to block tear flow. These plugs force your natural tears to back up into your eye, which can help maintain moisture.

Another option is a medicated insert called Lacrisert, available by prescription. This small, rod-shaped insert is placed under the lower lid. Over the course of the day, the insert slowly dissolves to provide lubrication.

To learn more about eye care, purchase Healthy Eyes from  University Health News.