From Dr. Helen’s Daily Journal:

“My eyes feel really dry, Doc.” I hear this often, not only from my refractive surgery patients, but also from my contact lens patients and even patients who visit the office for routine eye exams. Usually patients will complain about one or more of the following symptoms: burning eyes, a scratchy feeling, blurred vision, and excessive tearing. Before identifying the solution, I always investigate what may be the cause, and these are the most common causes of dry eye that I have uncovered:

1. Caffeine: many people drink coffee or tea throughout the day and don’t realize an excessive amount can have a diuretic effect and dehydrate them.

2. Medications such as antihistamines, blood pressure medications, birth control pills and anti-depressants can cause dryness of the eye.

3. Autoimmune disorders or other systemic diseases such as Rheumatoid arthritis, thyroid disorders, Sjogren’s syndrome, Lupus or even a vitamin A deficiency can cause dry eye.

4. Hormonal changes as women approach menopause can result in eye dryness.

5. People are not usually aware that our blink rate is reduced when we stare at computer screens, tablets, kindles and phones. Blinking coats the eye with needed moisture.

6. Poor nutrition and hydration often contribute to dry eye problems.

7. Insomnia, or schedules that don’t allow for enough quality sleep is a common cause.

8. Smoking will dry the eye.

9. Low humidity conditions can cause dry eye. During the winter months indoor air is often dry from heating. Air inside airplanes is often very dry and those visiting the desert may experience this condition.

10. Laser vision correction, LASIK, PRK, and epic-LASIK can cause dry eye for about 6 months, although this varies from one individual to another.

11. Dry eye often occurs when patients are not following a prescribed contact lens wearing schedule or use contact lens solutions that were not prescribed by their eye doctor.

Once aware of the causes, patients can make some lifestyle changes to reduce the dryness. In addition, there are a number of solutions I recommend that are quite helpful. The simple solutions include taking essential fatty acids, Omega 3 and 6 supplements. Also, using lubricating eye drops: artificial tears, tear gels and ointments targeted to increase water production works well. Use a cool mist humidifier at home and at work and follow the 20/20/20 rule, every 20 minutes take a 20 second break from staring at a computer screen, television or phone and look 20 feet away.

Under the supervision of a qualified eye doctor, you may also try a prescription for Restasis (cyclosporine 0.05%). This usually works very well. Topical anti-inflammatories such as steroid drops or NSAIDs help to reduce the inflammatory component in dry eyes. In addition, a very small plug can be placed in the eye’s tear ducts which act as the tear drainage pipe for the eye. These are called punctual plugs. Some dissolve and some are more semi-permanent and can hold the tears in your eyes longer, like plugging up a sink. Finally, just like flossing your teeth can prevent cavities, proper lid hygiene using a commercial eyelid scrub solution can help with dry eye. The oil glands (meibomian glands) on the lid margins produce oil that is very important to preventing the water layer of tears from evaporating. By cleaning your eyelids, the oil glands can work more effectively.

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