Dry eyes are a very common complaint and leads to severe discomfort as well as blurry vision.
The front of the eye is the most important surface to permit sharp vision. If the tear film breaks up it leads to poor vision, especially so in circumstances where the evaporation is increased. This occurs when you fixate intently on an activity like driving or computer work, but also in environments that are dry like big shopping centers and air-conditioned rooms.
The front of the eye can be likened to a ball bearing that needs to be lubricated. The watery tears are discharged from the outside of the eye and covers the eye with every blink, and the older tears are drained through two small openings at the inside of the eyelids close to the nose. Being watery, the tears will just run down without covering the front of the eye, and therefore the tears need to be stabilized my a mucin layer and an outside fatty layer, that evenly spreads over the front surface of the eye. All three these layers as well as a normal functioning eyelid blinking function is very important for the normal functioning of the eye. Every time you blink these three layers cover the front of the eye permitting sharp vision as well as a smooth interface for the eyelid moving over the front of the eye.
If there is any deficit in this function, patients complain of hazy vision that varies according to the environment and their activities, being a common complaint with reading and computer work. It also leads to grittiness that patients experience as a foreign body sensation. The time of day that these symptoms occur can be a clue as to the possible cause. Some wake up in the morning with matty eyelids and discomfort, and in others the symptoms get progressively worse during the working day. The treatment possibilities varies according to the cause. If the tear secretion is deficient, the tears can be replenished with lubricating drops. There is a multitude of lubricating drops on the market, including gels and emulsions, as well as drops aimed at replenishing the watery tear film, and others specifically aimed at replenishing the outside fatty layer of the tear film. In severe cases a small punctal plug can be used to occlude the drainage of tears into the nose. These plugs are fitted in the rooms and provide excellent relief in severe cases, often associated with diabetes and rheumatoid arthritis.
Poor eyelid function, as well as eyelid infections can also contribute to dry eyes, and need to be addressed specifically in order to relieve the symptoms. The use of lubricating drops alone will not alleviate the grittiness. Cleaning of the eyelids with specially formulated soaps to remove the fatty deposits, as well as topical and oral antibiotics are used to treat the blepharitis. These infections are quite common and cause recurrent episodes associated with eyelid redness and tenderness, as well as a crust on the eyelid margins around the eyelashes. During every eyelid blink fresh tears are spread over the front of the eye and the old tears are pumped through small openings in the corner of the eye close to the nose. Poor functioning eyelids are unable to transport the tears over the eye from the outside to the inside, and this can sometimes be contributed to either age related changes in the eyelid position, or abnormalities in the openings at the inside corner. It is important to note that in some of these situations tears will run down the cheek, giving the impression of excessive tears, where the opposite is actually true. These tears running over the inferior eyelid should actually be spread over the eye for the normal functioning of the eye but does not contribute at all to the health of the eye if they run down the cheek.
Get in touch if your dry eyes are concerning you, we would be happy to examine you and suggest treatment.