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(Keratitis Sicca; Dry Eye Syndrome)
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- The eye no longer makes enough tears to keep the surface moist and the eye dries out.
- The eye does make enough tears, but they evaporate too quickly. The tears produced are of poor quality and are unable to coat the surface of the eye.
- Increased age—The normal production of tears decreases as we age, so it is common for older and elderly people to have some degree of dryness in their eyes.
- Some chronic conditions, such as rheumatoid arthritis,systemic lupus erythematosus, and Sjogren’s syndrome
Certain medications, such as:
- Laser vision correction surgery, such as LASIK
- Though rare in the US and most developed countries, a deficiency in vitamin A may contribute to the development of keratoconjunctivitis sicca and other serious eye problems.
- The sensation of a burning, itching, or foreign body in the eye
- Sensitivity to light
- Redness or irritation of conjunctiva
- Discomfort with contact lenses
- Slit lamp visualization—The ophthalmologist may use a special light called a slit lamp or biomicroscope to look at the film of tears on the eye surface to determine if there are enough tears to keep the eye moist.
- Dye—The ophthalmologist may use a special dye to evaluate the health of the eye’s front surface.
- Schirmer’s test for dry eye—This test involves placing a small paper wick near the eyelid to measure the amount of tears that are made by the eye.
- Lubricating eye drops—Lubricating eye drops, which are also known as artificial tears, mimic the eyes natural tears. These eye drops are available over-the-counter. They provide relief from the discomfort caused by keratoconjunctivitis sicca and help maintain the natural moistness of the eye.
- Lubricating ointments—Lubricating ointments are similar to artificial tears, except they have a much thicker consistency and last longer than eye drops. They are used to provide moisture for more severe cases of keratoconjunctivitis sicca. However, because of the thick texture, the drops may cause vision to be blurry. For this reason, they are usually used at night, before bedtime.
- Punctal plugs—In some cases, it may be helpful to place a tiny plug called a punctal plug in the tear drainage ducts on the eyelids. These devices help the tears that are produced naturally to remain on the surface of the eye longer. The ophthalmologist can insert the plug in the office. It is a quick and painless procedure. Often, your doctor will try placing temporary plugs to make sure they work well for you before placing permanent ones. However, even permanent ones can be removed if necessary. Your doctor may also choose to permanently close your tear drainage hole with a laser or cautery.
- Prescription eye drops—Cyclosporine eye drops are occasionally used to help your eye make more tears. It usually takes several weeks to months to notice an improvement.
- Oral nutritional supplements—Some studies support supplementation of omega-3 fatty acids and other nutrients to help people with dry eyes.
- Try to avoid very dry environments—Furnaces and air conditioning can dry the air, which can evaporate tears too quickly. You may want to use a humidifier, which is a machine that puts moisture back into the air to prevent dry eyes.
- Dusty and smoky areas can worsen symptoms—If possible, limit time spent in these areas.
- Avoid prolonged visual tasks—Staring at a computer screen, driving, watching television, and reading may worsen symptoms.
- Promptly use artificial tears—This is important to prevent the eye surface from drying out.
American Optometric Association http://www.aoa.org
Eye Smart—American Academpy of Ophthalmology http://www.eyesmart.org
Canadian Ophthalmological Society http://www.cos-sco.ca
Health Canada http://www.hc-sc.gc.ca
Dry eye. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 17, 2012. Accessed July 31, 2013.
Foulks GN. The evolving treatment of dry eye. Ophthal Clin N Am. 2003;16:23-35.
- Reviewer: Eric L. Berman, MD; Michael Woods, MD
- Update Date: 05/11/2013