Tears can be a sign of joy or sadness, but they are much more than just that. Tears are a crucial part of your vision and eye health. They function to lubricate the eye, deliver oxygen to the cornea, flush away debris, provide antibacterial agents, promote healing and help maintain visual clarity. Not bad for a few drops of liquid.
Tears are produced in small glands under the upper eyelid. Excess tears flow into small drainage ducts in the inner corners of the eyelids. These drain in the back of the nose. Tears are made up of three layers: oil, water and mucus with each component having a function. The outer oil layer helps prevent evaporation of the water layer which contains proteins to nourish the eye. The final layer provides a mucous coating over the cornea spread evenly and also limits evaporation.
If your eyes are constantly dry, irritated, feel scratchy or gritty, it could be dry eye syndrome. This is quite common especially after age 40 but quite treatable. Dry eyes could be caused by a change in the composition of the tears, decreased production or rapid evaporation. Certain diseases such as Parkinson’s can reduce blinking leading to dryness. Dry eye syndrome can also be a side effect of some drugs including beta blockers, diuretics, antihistamines and certain antidepressants. Environmental factors such as smoke or wind could also be causing irritation.
There are a number of steps we can take to reduce dry eye. First, and it may sound obvious, but we often do not blink enough. Think of the times you are staring at a computer screen or deeply engrossed in a book: are you blinking enough? Remember to blink, take eye breaks regularly, look around and maybe even roll your eyes (as you may be doing now). People who wear contact lenses might switch to glasses for a few hours a day or longer. This will rest the eye and improve tear action. If the air is especially dry, consider using a humidifier to increase moisture levels.
There are many over-the-counter medications that can help; choose one that is preservative-free. They are offered in different viscosities and formulations. Thinner solutions work faster but last a shorter time. One thing to avoid if you have dry eye is any solution that promises to ‘get the red out’ as it will probably contain a decongestant and may worsen dry eyes. You can also try lubricating ointments.
Another idea that could help if the problem includes blockage of the tear glands is a warm compress on the lids. This can melt semi-solid secretions that are blocking the tear glands. And it feels great, too. One ‘solution’ to watch for is a dietary supplement that promises to help dry eye syndrome — there is little or no clinical support for this claim.
If the dry eye problem is not improved by these self-treatment measures, it is probably time to visit your doctor who may refer you to an eye specialist such as an ophthalmologist or optometrist. They will provide a more in-depth evaluation of the problem and may recommend prescription medication to help.
For most people, self-treatment works perfectly well to reduce dry eyes. Think about your eyes, blink often and remember that tears are much more than little drops of salty fluid generated by intense joy or sadness.
Written by Dr. Paul Martiquet, Medical Health Officer for Rural Vancouver Coastal Health including Powell River, the Sunshine Coast, Sea-to-Sky, Bella Bella and Bella Coola.