Brief overview
- Description: In dry eyes, the surface of the eye is wetted with too little tear fluid because either too little tear fluid is produced or the tear film evaporates more.
- Symptoms: Reddened, itchy, burning eyes, foreign body sensation in the eye, increased watering of the eyes, possible feeling of pressure and pain in the eye
- Treatment: Treatment of underlying diseases, use of “artificial tears”, possibly medication containing cortisone, avoid draughts and tobacco smoke, ensure sufficient humidity in rooms, ventilate regularly, do not wear contact lenses for too long, take regular breaks when working on a PC, drink plenty of fluids
- Causes and risk factors: Staring at the computer or TV screen for too long, dry room air, wearing contact lenses for too long, tobacco smoke, car exhaust fumes, air conditioning, draughts, older age, female gender, illnesses (such as conjunctivitis, diabetes, thyroid disease, autoimmune diseases), medication
- When to see a doctor? Dry eyes should always be checked by an ophthalmologist. There may be a disease behind it that requires treatment.
Dry eyes: Description
Dry eyes cause unpleasant discomfort: The eyes itch and burn and are sometimes reddened. The symptoms mainly occur during the day, but can be particularly severe after sleep. The reason for this is that tear film production is reduced during sleep and the eyes feel dry, especially in the morning.
Dry eyes: symptoms
With dry eyes, there is too little tear fluid. It feels as if you have a grain of sand in your eye. In addition, there is an increased feeling of dryness, which manifests itself in burning and itching eyes. Reddened eyes also occur frequently. The eyes often tire quickly, for example when working at a computer screen. They are also very sensitive to light.
Dry eyes can also cause a feeling of pressure in the eye. In rare cases, dry eyes hurt.
Paradoxically, increased tearing is also observed with dry eyes: due to the constant irritation, even minor influences such as a light breeze trigger tears. This can lead to blurred vision.
Other secondary symptoms are swollen eyes and mucus secretion (those affected have sticky eyelids, especially in the morning). Some patients also report headaches and dizziness in connection with dry eyes.
The symptom “dry eyes” is relatively common: around a fifth of all people suffer from it. In most cases, both eyes are affected. However, some sufferers only have a single dry eye.
What helps with dry eyes?
How dry eyes are treated depends on the cause. Simple measures and household remedies are often enough to alleviate the symptoms. In other cases, artificial tears or anti-inflammatory eye drops are used.
Home remedies and tips for dry eyes
The following home remedies and tips can help to alleviate existing symptoms or prevent dry eyes:
- Make sure there is enough moist, fresh air in the room. For example, use a humidifier and ventilate regularly.
- Do not expose yourself to direct draughts from air conditioning systems to avoid stressed, red eyes. When driving, adjust the fan so that the air jet is not directed at your eyes.
- When working at the computer, take regular short breaks (preferably every hour) during which you do not look at the screen. It also helps to blink consciously, as staring at the monitor reduces the blink rate.
- Avoid spending time in smoky rooms.
- Do not wear contact lenses for too long at a time.
- Avoid using irritating cosmetic products near the eyes.
- Drinking plenty of fluids also prevents dry eyes. You should drink at least two liters of liquid (water, mineral water, tea, juice spritzers, etc.) every day.
- Eyelid margin care: Massage your eyelids twice a day for three to five minutes with a warm, damp washcloth. This promotes blood circulation and stimulates the Meibomian glands to produce the fatty part of the tear film.
- Omega-3 fatty acids in the diet – for example in the form of linseed oil – are said to have a positive effect on the tear film. There is no clear scientific evidence as to whether they actually help against dry eyes.
Home remedies have their limits. If the symptoms persist over a longer period of time, do not improve or even get worse, you should always consult a doctor.
Medication
In most cases, dry eyes are treated with “artificial tears”. Which of the numerous drop, gel or spray preparations is helpful depends on the cause of the dry eyes: If tear production is too low, tear substitutes that supplement the aqueous phase of the tear fluid help. Oily preparations are used to improve the quality of the tear film.
Medical treatment
Dry eyes can also be helped by measures to increase the amount of tear fluid. To do this, the doctor scleroses the tear drainage tubules or seals them with plastic plugs.
If there is an underlying disease such as diabetes, treating it can also alleviate dry eyes.
Dry eyes: causes and risk factors
A wetting disorder of the surface of the eye – i.e. the cornea and conjunctiva as well as the inside of the eyelid – can be caused either by reduced tear production or increased evaporation of the tear film. The tear film consists of several layers and contains an aqueous and a fatty phase. The latter stabilizes the film by protecting it from evaporation.
If tear production is reduced, doctors refer to it as “hyposecretory”. If the tear film is produced in sufficient quantities but evaporates too quickly, doctors refer to this as “hyperevaporation”.
External influences
The most common cause of dry eyes is external influences. We blink less often when working at the computer or watching television with concentration. This can reduce the blink rate, which distributes the tear film evenly across the eye, from ten to 15 blinks per minute to just one or two blinks per minute. This is also known as office eye syndrome.
Injuries to the eyelids and eye operations can also result in sicca syndrome.
Biological causes
Tear production decreases with age. Older people therefore suffer from dry eyes more frequently than younger people.
Women are also more at risk than men, as the female sex hormone oestrogen can disrupt tear production. Hormone replacement therapy during the menopause therefore increases the risk of dry eyes.
Diseases
Wetting disorders of the eyes also occur in conjunction with various diseases. These include, for example, diabetes mellitus, thyroid disorders, chronic rheumatism and inflammatory vascular diseases.
Many immune-related diseases are also associated with dry eyes. This is because the conjunctiva, which produces part of the tear film, is involved in important immune functions of the body. In the autoimmune disease Sjögren’s syndrome, for example, the production of tear fluid is disrupted.
Other triggers for sicca syndrome are viral infections such as hepatitis C and nerve damage, such as occurs in the advanced stages of diabetes. As the surface of the eye corresponds to a transformed outer skin in terms of developmental history, various skin diseases also lead to dry eyes.
Sometimes a pronounced vitamin A deficiency leads to dry eyes. This can be caused by liver disease.
If children suffer from dry eyes, in most cases a disease is the cause.
Dry eyes: causes and risk factors – medication
Certain medications can disrupt tear production if they are taken over a long period of time. These include psychotropic drugs, sleeping pills, beta-blockers, hormone preparations and allergy medication. Corticoids (“cortisone”), which are contained in eye drops and ointments for conjunctivitis, for example, also cause dry eyes.
Dry eyes: when to see a doctor?
The causes of dry eyes are very varied and it is often difficult to differentiate between external factors and triggering diseases. Experts therefore recommend that you always consult an ophthalmologist if you suffer from dry eyes.
Dry eyes: examinations and diagnosis
The doctor can use various examinations to assess the amount of tears, composition of the tear film, corneal surface, eyelid position and tear film. This allows the cause of the dry eyes to be determined:
- Schirmer test: Using a strip of filter paper in the conjunctival sac, the doctor measures how much tear fluid the eye secretes.
- Examination of the ocular surface: The slit lamp can also be used to diagnose changes to the ocular surface.
- Tearscope: This optical device makes it possible to assess the oil content of the tear film more precisely.
- Further examination: If necessary, the doctor will examine the blood, for example to determine the hormone status or rheumatoid factors. A conjunctival swab shows whether there is conjunctivitis, which is responsible for the dry eyes.