Eye Health

24 July 2013

Dry eye syndrome

Dry eye is a term used to describe a group of different diseases and conditions affecting one or more components of the lacrimal system.

The tear film is a very thin, delicate moisture layer consisting of lipid (oil), water (aqueous) and mucin. The lids spread a fresh layer of tears over the eye with each blink to assist with the smooth lubrication between the surface of the eyeball and the inner surface of the eyelid.

The tear film protects the eye by washing away foreign bodies, make-up, chemicals and pollutants and serves as a barrier to infection.

Dry eye is a term used to describe a group of different diseases and conditions affecting one or more components of the lacrimal system. This results in inadequate wetting and lubrication of the eye surfaces and subsequent abrasion, inflammation and infection. Dry eye might be difficult to diagnose and can be mistaken for allergies or infections. In some cases, dry eye leads to excessive tearing, exacerbated by wind, cold weather, air conditioning and dust, and patients often find it hard to believe that the primary cause of their symptoms is dry eye. Tear layer impairment is often referred to as ‘Dry eye syndrome’

Dry eye has many causes including physical impairment of the lids, mucous membranes and/or cornea. Environmental factors such as climate changes, pollution, dust and pollen in the air contribute to symptoms of dry eye. Many systemic diseases and side effects of the medication treating these diseases lead to tear layer compromise.  Aging and hormonal changes is the most frequent cause of tear layer impairment. In most cases, it is difficult to identify any single cause, as it usually is a result of more than one factor.

When engaging in tasks requiring dedicated visual concentration, we blink our eyes less frequently. We often blame the use of computer and digital screens for our eye discomfort. An interesting study found that we blink less than normal when we read from a book and even less when we read on a digital screen. This causes the tears to evaporate from the surface of the eye causing small dry areas in the tear layer. When the eyelid moves over these dry areas without

lubrication from the tear layer, we experience a sensation of gritty, scratchy and irritated eyes. This often leads to a flush of tears when the brain tries to remedy the lack of lubrication.
Constant concentration and environmental glare during driving add to the development of dry eye symptoms such as light sensitivity, burning and redness.

There are many solutions for the treatment of dry eye including the use of eye lubricants in drop, gel or ointment form. Lid massage therapy and special lid cleaners also assist in the successful management of the condition. Sometimes the condition might be chronic and would require closer monitoring and a combination of remedies to alleviate the symptoms effectively. It is critical for you to inform and equip your optometrist with all the information about your symptoms to ensure an effective and sustained solution.

By prioritizing your annual eye examination, your SAOA member optometrist will assess the health and function of the various components of your lacrimal system to identify any potential factors explaining your discomfort or symptoms.
By having a full examination your optometrist will be in a perfect position to make recommendations for treatment or refer you for further care. . By SAOA member Deidre de Jongh.

To find your nearest SAOA optometrist, log onto www.saoa.co.za or contact 087 310 7262.

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Megan Goodman qualified as an optometrist from the University of Johannesburg and is currently practising at Tygerberg Academic Hospital in Cape Town. She has recently completed a Masters degree in Clinical Epidemiology at Stellenbosch University. She has a keen interest in ocular pathology and evidence based medicine as well as contact lenses.

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