How to Manage Dry Eyes: Tips for Comfort and Relief
- Dr. Zach Skurski
- Oct 5, 2023
- 7 min read
Updated: May 24, 2024
By Dr. Zach Skurski
Board Certified Ophthalmologist, Cornea and Refractive Surgery Specialist
Dry eyes, also known as dry eye syndrome (DES), is a broad term for a common eye condition affecting millions of people worldwide. It typically occurs when the eyes do not produce enough tears or when the tears evaporate too quickly. This can lead to a range of uncomfortable symptoms, including dry sensation, redness, itching, burning, blurred vision, and pain. While dry eyes can be a chronic and frustrating condition, there are numerous strategies and lifestyle changes you can employ to manage and alleviate its symptoms. In this article, we will explore the causes of dry eyes, the importance of early detection, and a variety of practical tips to help you manage and find relief. I'll also offer my perspective and recommendations for treatments that I use in my day to day ophthalmology and cornea practice.
The essentials boil down to treating with consistent lubrication, heat, dietary change, and lifestyle adaptations.
Contents
Causes of Dry Eye
Before diving into strategies for managing dry eyes, it's essential to understand what causes this condition. Several factors can contribute to the development of dry eyes, including:
Aging: One of the most common causes of dry eyes is the natural aging process. As we get older, our tear production tends to decrease, leading to a higher risk of dry eye symptoms.
Environmental Factors: Environmental factors play a significant role in dry eye development. Exposure to smoke, wind, dry air, and air conditioning can all contribute to worsening symptoms. Additionally, prolonged screen time on digital devices can reduce the frequency of blinking, leading to quicker tear evaporation.
Medical Conditions: Certain medical conditions can increase the likelihood of dry eyes. These include autoimmune diseases such as Sjögren's syndrome, diabetes, thyroid disorders, and rheumatoid arthritis.
Medications: Some medications, including antihistamines, decongestants, and antidepressants, can have dry eye as a side effect.
Contact Lenses: Wearing contact lenses for extended periods or not cleaning them properly can have a major contribution to dry eyes.
Hormonal Changes: Hormonal changes in women, such as those experienced during pregnancy, menopause, or while using birth control pills, can affect tear production and increase the risk of developing symptoms.
The Importance of Early Detection
Recognizing the signs and symptoms of dry eyes early is crucial for effective management. If left untreated, dry eyes can lead to more severe complications in rare cases, such as corneal damage and vision impairment. Some common symptoms of dry eyes include:
Persistent dryness, itching, or burning sensations in the eyes
Redness and inflammation
Excessive tearing (a reflex response to dryness)
Blurred vision
Light sensitivity
Stringy mucus in or around the eyes
Difficulty wearing contact lenses
If you experience any of these symptoms regularly, it's essential to consult an eye care professional for a proper diagnosis and treatment plan. Early intervention can help prevent long-term complications and provide relief from discomfort.
How to Manage Dry Eyes: My Practical Tips
While dry eyes can be a chronic condition, there are several lifestyle changes and over the counter treatments that can help manage and alleviate its symptoms. Let's explore these in detail:
1. Artificial Tears: Over-the-counter artificial tear drops and lubricating eye gels can provide immediate relief from dry eye symptoms by supplementing your natural tear film. It's essential to choose preservative-free eye drops, especially if you find yourself applying drops more than four times a day, as preservatives can exacerbate dryness if used too frequently.
Here are some examples of preservative free drops that I regularly prescribe for patients and use for myself:
Refresh Plus: There are many variations on the Refresh brand and I find that Refresh Plus is the best for everyday use.
TheraTears: Another common preservative free tear I frequently recommend for daily symptoms.
For patients who regularly experience symptoms of dryness. I typically recommend starting one of these preservative free artificial tears as needed. If symptoms remain persistent this is usually increased to at least four times a day (breakfast, lunch, dinner, bedtime), even if there are no symptoms. I find that they lose efficiency after more than about 8 times a day.
2. Warm Compresses: Commonly the eyelid's oil glands are blocked like clogged toothpaste, instead of the healthy olive oil like secretions we need. Applying a warm compress to your closed eyes can help soften the blockages and open the oil glands (Meibomian glands), improving the quality of your tears. These oils protect your tears to prevent early evaporation that leads to drying out. Use a clean, warm, damp washcloth or commercial eye mask, and gently place it over your closed eyes for about 10 minutes minutes. Repeat this process initially 1-2 times a day. I also recommend using a finger to massage the edge of the eyelids to help open up the glands.
There are many home remedies for the warm compress, including hot washcloth or towel, hardboiled egg, or uncooked rice microwaved a few seconds in a sock to name a few I've come across. Be careful that the heat is not too hot that it could cause a burn to the skin. For regular daily use, I've found that commercial eye masks that can be heated tend to be easier to manage. These can also serve as sleep masks, which I frequently recommend for night time and morning dry eye symptoms.
Here are a few examples of simple heat masks:
3. Omega-3 Fatty Acids: Omega-3s are found in foods like salmon, flaxseeds, and walnuts, can help reduce inflammation and may work to enhance the effectiveness of warm compresses. Omega-3 can help soften the oil secretions in the eye lids and make it easier to open and express these glands with the use use of warm compresses.
In my practice I typically recommend dietary supplementation with 3,000mg (3 grams) of fish oil daily. If you find you can't tolerate fish oil, try a dietary adjustment to include salmon, nuts, avocados, and extra virgin olive oil. I often recommend one tablespoon of extra virgin olive oil a day.
3. Blink Regularly: If you're like me and spend long hours staring at screens, make a conscious effort to blink more frequently. Blinking helps distribute tears evenly across your eyes and reduces the risk of tear evaporation. When we focus intently on screens or reading our blink rate goes down and this dries the eyes out. You can also use the "20-20-20 rule": every 20 minutes, take a 20-second break, and focus on an object at least 20 feet away.
4. Humidifiers: If you live in a dry climate or frequently use air conditioning or heating, consider using a humidifier in your home or office. Adding moisture to the air can help prevent excessive tear evaporation. The dry air is also why flying on planes can really irritate the eyes.
5. Stay Hydrated: Drinking plenty of water is essential for overall health and can help maintain adequate tear production. Dehydration can worsen dry eye symptoms, so make a habit of staying well-hydrated.
6. Protective Eyewear: When exposed to windy or dusty environments, wearing wraparound sunglasses or protective eyewear can shield your eyes from irritants and reduce tear evaporation.
Blue light reducing glasses are also controversial option in managing dry eye symptoms due to screen use. There is mixed scientific data but so far it seem there is little proven benefit for the use of these glasses. That being said, there is little downside to wearing them and I personally will use them from time to time, especially for longer computer session in the evening. There are a lot of affordable and stylish options on Amazon. You can find the pair I wear here.
7. Avoid Smoke and Allergens: If you smoke, I urge you to quit, as smoking can worsen dry eye symptoms, not to mention the extreme benefits of quitting. Additionally, minimizing exposure to allergens like pollen and pet dander can help reduce eye irritation. Over the counter allergy eye drops may help with allergies but these types of medications (antihistamines) can also seriously dry out eyes.
If you live in an area where air quality is affected by forest fires, city pollution, or just bad seasonal pollen, consider an air purifier to filter out any irritants. Here you can find the one that I use.
8. Limit Contact Lens Wear: If you wear contact lenses, try limiting their use, especially in dry or windy conditions. Consider switching to glasses temporarily to give your eyes a break after 10 or more hours of wear. However, in some cases, like I personally experienced before laser vision correction, contacts can act as a protective barrier and dry eye symptoms may be worse without them while wearing glasses.
9. Prescription Medications: In some cases, your eye care professional may prescribe medications like cyclosporine (Restasis, Cequa) or lifitegrast (Xiidra) to help manage chronic dry eye symptoms. These medications are typically used twice a day on a long term basis and work to reduce inflammation and promote tear production. These are frequently prescribed in the U.S., however in my experience there is often modest, if any notable benefit by patients. These medications have also not been approved in Europe due to questions about their efficacy.
10. Punctal Plugs: For moderate to severe cases of dry eyes, your eye care professional may recommend punctal plugs. These tiny plugs block the tear ducts, preventing tears from draining away too quickly and keeping your eyes moist. They come in dissolvable and non-dissolvable forms.
11. Eyelid Hygiene: Keeping your eyelids clean and free from debris can help prevent blockages in the oil glands that contribute to dry eyes. If you have a lot of crusting around your eye lashes, this is often more suggestive of a related ocular surface disease, blepharitis. Keeping the lashes clear will help reduce inflammation and irritation. This classically has been recommended as using Johnson's Baby Shampoo to gently scrub the eyelashes.
Conclusion
Managing dry eyes is a multifaceted process that involves both lifestyle adjustments and potential medical treatments. By beginning to understand the causes of dry eyes and recognizing the importance of early detection, you can take proactive steps to alleviate discomfort and prevent complications. Whether you're using artificial tears, practicing good eyelid hygiene, or making dietary changes, the goal is to maintain the health and comfort of your eyes. Remember to consult with a doctor for a full examination and a treatment plan tailored to your specific needs. With the right approach, you can enjoy relief from dry eye symptoms and maintain optimal eye health.
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