Our eyes need tears to stay healthy and comfortable. If your eyes do not produce enough tears, it is called dry eye. Dry eye is also when your eyes do not make the right type of tears or tear film.
Dry eye syndrome can occur at any age, and in people who are otherwise healthy. It is more common with older age, when the individual produces fewer tears. It is also more common in women than in men.
Functioning of Tears –
When you blink, a film of tears spreads over the eye. This keeps the eye’s surface smooth and clear. The tear film is important for good vision.
The tear film is made of three layers:
• An oily layer
• A watery layer
• A mucus layer
Each layer of the tear film serves a purpose.
The oily layer is the outside of the tear film. It makes the tear surface smooth and keeps tears from drying up too quickly. This layer is made in the eye’s meibomian glands.
The watery layer is the middle of the tear film. It makes up most of what we see as tears. This layer cleans the eye, washing away particles that do not belong in the eye. This layer comes from the lacrimal glands in the eyelids.
The mucus layer is the inner layer of the tear film. This helps spread the watery layer over the eye’s surface, keeping it moist. Without mucus, tears would not stick to the eye. Mucus is made in the conjunctiva. This is the clear tissue covering the white of your eye and inside your eyelids.
Normally, our eyes constantly make tears to stay moist. If our eyes are irritated, or we cry, our eyes make a lot of tears. But, sometimes the eyes don’t make enough tears or something affects one or more layers of the tear film. In those cases, we end up with dry eyes.
There are two types of dry eye:
• Aqueous tear-deficient dry eye
The eyes’ lacrimal glands fail to produce enough of the middle aqueous layer of tears, resulting in low tear production.
• Evaporative dry eye
The eyes meibomian glands don’t produce a strong outer lipid layer of tears, resulting in tears that evaporate too quickly.
A patient with dry eye syndrome may experience a range of symptoms, including:
• a stinging or burning sensation, and a feeling of dryness, grittiness, and soreness in the eyes
• a feeling like sand in the eye
• stringy mucus in or around the eyes
• eye sensitivity to smoke or wind
• redness of the eyes
• difficulty keeping the eyes open
• eye fatigue after reading, even for a short time
• blurred vision, especially towards the end of the day
• sensitivity to light
• discomfort when wearing contact lenses
• double vision
• eyelids sticking together when waking up
Some people find the pain very strong, and this can lead to frustration, anxiety, and difficulty functioning in daily life.
Dry eyes are caused by a variety of reasons that disrupt the healthy tear film.
Reasons for tear film dysfunction are many, including
• hormone changes
• autoimmune disease
• inflamed eyelid glands or allergic eye disease.
For some people, the cause of dry eyes is decreased tear production or increased tear evaporation.
▪︎ Decreased tear production
Dry eyes can occur when you’re unable to produce enough water (aqueous fluid). Common causes of decreased tear production include:
• Certain medical conditions including Sjogren’s syndrome, allergic eye disease, rheumatoid arthritis, lupus, scleroderma, graft vs. host disease, sarcoidosis, thyroid disorders or vitamin A deficiency
• Certain medications, including antihistamines, decongestants, hormone replacement therapy, antidepressants, and drugs for high blood pressure, acne, birth control and Parkinson’s disease
• Corneal nerve desensitivity caused by contact lens use, nerve damage or that caused by laser eye surgery, though symptoms of dry eyes related to this procedure are usually temporary.
▪︎ Increased tear evaporation
The oil film produced by small glands on the edge of your eyelids (meibomian glands) might become clogged. Blocked meibomian glands are more common in people with rosacea or other skin disorders.
Common causes of increased tear evaporation include:
• Posterior blepharitis (meibomian gland dysfunction)
• Blinking less often, which tends to occur with certain conditions, such as Parkinson’s disease; or when you’re concentrating during certain activities, such as while reading, driving or working at a computer
• Eyelid problems, such as the lids turning outward (ectropion) and the lids turning inward (entropion)
• Eye allergies
• Preservatives in topical eyedrops
• Wind, smoke or dry air
• Vitamin A deficiency
Risk factors –
Factors that make it more likely that you’ll experience dry eyes include:
• Being older than 50.
Tear production tends to diminish as you get older. Dry eyes are more common in people over 50.
• Being a woman.
A lack of tears is more common in women, especially if they experience hormonal changes due to pregnancy, using birth control pills or menopause.
• Eating a diet that is low in vitamin A.
It is found in liver, carrots and broccoli, or low in omega-3 fatty acids, which are found in fish, walnuts and vegetable oils.
• Wearing contact lenses or having a history of refractive surgery.
Complications may includes –
• a worsening of eye redness
• light sensitivity
• increasing painful eyes
• deterioration of eyesight
See a doctor if you have frequent symptoms of dry eye or if your dry eye symptoms worsen. A comprehensive eye examination can diagnose the condition. This involves an external examination of your eyes, eyelids, and cornea.
Your doctor will also perform testing to measure your tear flow and the quality of your tears using a special dye for the eyes.
▪︎ Treating Dry Eye by Adding Tears
Your ophthalmologist might tell you to use artificial tears. These are eye drops that are like your own tears. You can use artificial tears as often as you need to. You can buy artificial tears without a prescription. There are many brands. Try a few until you find a brand that works best for you.
▪︎ Stop Dry Eye by Saving Tears
Your ophthalmologist may suggest blocking your tear ducts. This makes your natural tears stay in your eyes longer. Tiny silicone or gel plugs (called punctal plugs) may be inserted in your tear ducts. These plugs can be removed later as needed. Your ophthalmologist could also recommend surgery that permanently closes your tear ducts.
Your ophthalmologist might have you use a prescription eyedrop medication. This helps your eyes make more of their own tears.
▪︎ Treating Dry Eye Culprits
If your eyes are irritated, your ophthalmologist can treat those problems. They may recommend:
• prescription eye drops or ointments
• warm compresses on the eyes
• massaging your eyelids
• certain eyelid cleaners
Ayurvedic Perspective –
Ayurvedic diagnosis of dry eye strictly depends on the complaints of the patient, Two diseases which exhibit symptoms similar to dry eye are Krichronmeela and Shushkakshipaka. It can be assumed that
Dry Eye changes are initiated by Vata vitiation and later Pitta gets involved in the pathogenesis.
Ayurveda believes in treating the deviated vata. Eyes are treated with medicated or plain ghrit (ghee). The most common and effective medication is the ‘Triphala ghrit’, which is useful in treating such eye condition. The ghrit has its own nutritional values, and helps regulate functions of extra-occular muscles, eyelids and tears, thereby decreasing the dryness of the eyes, irritation and burning sensation prevailing in the eyes.
For the treatment, drops of Triphala ghrit are instilled into the eyes. A gentle massage with Triphala ghrit over and around the eyes is done for added benefit. Internal and external use of Triphala ghrit soothens and strengthens the eyes.
▪︎ Ayurvedic Therapies
▪︎ Ayurvedic Formulations
• Jeevaniya ghrita
• Amalaki churna
• Triphala churna
To be taken with honey and ghee.
Preventive Measures –
• Wear wraparound glasses when outdoors to protect eyes from wind
• Blink often
• Don’t use a hair dryer
• Wash your eyelids with baby shampoo to help release oil into the eyes
• Remove makeup daily
• If you work on a computer, look away from the screen at least every 20 minutes
• Take an antihistamine to relieve allergy symptoms
• Drink 8 to 10 glasses of water per day to prevent dehydration
• Stop smoking
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