Dry eye syndrome occurs when a person’s eyes don’t produce enough tears, or their tears evaporate too quickly. Dry eye syndrome is extremely common with more than 16 million Americans affected according to the National Library of Medicine. There may be as many as 6 million additional Americans living with this condition who have not yet been diagnosed.

What Causes Dry Eye Syndrome?

Tears aren’t just a physical reaction to sadness or joy—they actually play a key role in eye health. Every time you blink, a film of tears covers the eye to help keep the surface smooth and promote clear vision. This tear film is composed of three layers:

• The oily layer, which prevents the tear’s surface from drying out too quickly.
• The watery layer, which cleanses the eye and is what we think of as tears.
• The mucus layer, which helps keep the eye moist by spreading out the watery layer.

A different gland in the eye produces each of these layers. There are several factors that can interfere with these glands and one or more layers of tear film, which can eventually cause dry eye syndrome. Some of the most common factors behind dry eye include:

• Hormonal changes related to getting older, such as menopause
• Long-term use of contact lenses
• Living in a very windy, dry or smoky environment
• Eyelid conditions like entropion/ ectropion (abnormally positioned lids)
• Systemic diseases, including rheumatoid arthritis, thyroid disease, lupus and Sjogren’s syndrome
• Undergoing a refractive eye procedure, such as LASIK
• Taking certain medications used to treat allergies, congestion, depression, anxiety, glaucoma and high blood pressure

Though anyone can develop dry eye syndrome, it is more frequently seen in women aged 50 and older. Not consuming enough omega-3 fatty acids can also increase a person’s risk of dry eye.

What Are the Symptoms of Dry Eye Syndrome?

As its name suggests, many people with dry eye syndrome experience a feeling of dryness in one or both eyes, though symptom severity may be asymmetric. This dryness can be accompanied by or lead to other symptoms, including:

• Feeling like there is something in your eyes
• Eye burning, itching, stinging or redness
• A sensation of grittiness or heaviness in the eyes
• Blurry vision
• Increased sensitivity to light
• Eye discharge that may form a crust over night
• Difficulty reading or looking at a screen for long periods of time
• Discomfort when wearing contact lenses

Ironically, dry eye syndrome can also cause watery eyes and excess tear production. The eye’s lacrimal gland—which is responsible for producing the watery layer of tear film—may kick into overdrive to counteract eye dryness. This can result in uncomfortably watery eyes and a steady stream of tears known as reflex tearing.

It’s important to promptly seek medical care if you experience possible symptoms of dry eye. If left untreated, dry eye syndrome may affect quality of life, damage the cornea or even result in vision loss.

How is Dry Eye Syndrome Diagnosed?

Dry eye syndrome is often diagnosed during a routine eye visit. An ophthalmologist—a medical doctor who is trained to evaluate and treat eye conditions—may perform a slit lamp exam using a high powered microscope to get a close-up view of the eye’s surface and interior structures.

Other tests that may be used to help diagnose or rule out dry eye syndrome include:

• Schirmer’s test – A simple test that measures tear production by placing a small piece of paper by the patient’s eyelid.
• Tear breakup time (TBUT) test – A test that gauges how long a patient’s tear film remains stable (doesn’t evaporate) by placing a small, safe amount of dye onto the eye and observing the tear film through a microscope.
• Meibomian gland imaging: High definition images assist in evaluation of the number and structure of the oil-producing meibomian glands in the eyelids

What Does Dry Eye Syndrome Treatment Involve?

Treatment for dry eye will depend on the condition’s underlying cause and its severity. Generally ophthalmologists recommend one or more of the following approaches:

Over-the-Counter Products

Using over-the-counter eye drops (artificial tears) or moisturizing gels can help combat uncomfortable symptoms in people with mild cases of dry eye syndrome.

Prescription Eye Drops

Ophthalmologists may suggest prescription eye drops, such as Restasis, Cequa, Xiidra, and steroids for patients with more severe cases of dry eye syndrome.

Lifestyle Changes

As previously discussed, several factors can contribute to dry eye syndrome. Taking steps to address these factors (for example, switching medications or taking a break from wearing contacts) can go a long way toward easing dry eye symptoms. It may also be helpful to:

• Reduce screen time
• Drink at least eight glasses of water every day
• Prioritize sleep (ideally seven or eight hours every night)
• Wear wraparound sunglasses when outside
• Avoid exposure to cigarette smoke
• Use a humidifier to reduce the dryness of air in your home

Tear Duct Plugs

Small plugs can be temporarily inserted into tear ducts to address excess tear production due to dry eye syndrome. These plugs are called punctal plugs.

LipiFlow®

LipiFlow® is an FDA-approved medical device that applies localized heat and pressure to the eyelids to unblock the oil glands and allow them to resume their natural production of lipids. The result is a healthier, more stable tear film.

Surgery

Occasionally, surgery may be helpful for patients with certain underlying conditions contributing to dry eye syndrome.

Schedule an Appointment Today

Florida Medical Clinic Orlando Health’s Department of Ophthalmology provides a full scope of care to patients with dry eye syndrome and numerous other eye conditions. Practicing in North Tampa and Land O’Lakes, Dr. Mark Arey helps patients find relief from dry eye symptoms and achieve their best eye health. Schedule an appointment today by calling (813) 284-2323 or visiting our website. Dr. Arey currently offers both in-person and telemedicine appointments.

Meet Mark L. Arey, MD

Dr. Arey is a board-certified ophthalmologist specializing in comprehensive ophthalmology and premium cataract surgery utilizing femtosecond laser and advanced technology intra-ocular lenses. He also manages conditions such as glaucoma and dry eye syndrome and screens for retinal diseases including diabetic retinopathy and macular degeneration. A Central Florida native, Dr. Arey has been practicing in North Tampa since 2008. In 2018 he established Florida Medical Clinic Orlando Health Eye Specialists with the goal of providing an optimized patient experience incorporating new and emerging technologies in eye care and ophthalmic surgery. Dr. Arey was once again honored by Tampa Magazine as a 2022 “Top Doc” in their annual survey of physicians.