Dry eye disease is a condition when the eyes do not get adequate lubrication from tears. This condition makes the eye unable to remove dust or foreign objects that irritate the eye. As a result, the eyes feel very uncomfortable.
In a healthy eye, the cornea will continue to flow with tears when the eye blinks, to nourish the corneal cells and protect the cornea from the outside environment. Tears are a mixture of fat, water, mucus, and more than 1500 proteins that keep the surface of the eye smooth and protected from the surrounding environment, irritating elements, or germs that cause infection. When the glands around the eyes don't produce enough tears or when the composition of the tears changes, the outer surface of the eye that is responsible for transmitting light into the eye can also be affected.
Another name for dry eye disease is keratoconjunctivitis sicca or dry eye syndrome. Dry eyes are more common in women than men, and the risk of dry eyes also increases with age.
Dry Eye Symptoms
Symptoms commonly experienced by sufferers of dry eyes include:
- Red eye.
- The eyes feel hot.
- Eyes like gritty and dry.
- Watery eyes due to the body's response to irritation in dry eyes.
- Sensitive to sunlight.
- Blurred vision
- It's hard to open your eyes when you wake up, because the upper and lower eyelids stick together.
- There is mucus in or around the eyes.
- Has difficulty wearing contact lenses or driving at night.
- Eyes feel tired quickly.
The severity of dry eye varies, from mild to severe. But in most cases, the symptoms are still relatively mild.
Symptoms of dry eye can get worse when the sufferer is under certain conditions, for example working by looking at a computer screen for hours, being in a dry environment for too long, or reading a book for a long time. Dry eye conditions can cause inflammation of the surface of the eye, causing scarring of the cornea or bacterial infection.
Causes of Dry Eyes
Several conditions can cause dry eyes, including:
- Reduced tear production. This condition arises because of old age, certain diseases (eg diabetes, rheumatoid arthritis, lupus, scleroderma, Sjogren's syndrome, thyroid hormone disorders, vitamin A deficiency or xerophthalmia), certain medications (eg antihistamines, decongestants, antidepressants, hypertension medications, acne medications, Parkinson's disease medications, or hormone replacement therapy medications), damage tear glands due to radiation or from laser eye surgery.
- Tears evaporate faster. This condition can be caused by weather (wind, smoke, or dry air), conditions that make you blink less often (when reading or working too long in front of a computer screen), eyelids turning outward (ectropion) or turning inward (entropion).
- The composition of tears is not balanced. Tears consist of 3 compositions, namely oil, water, and mucus, with a certain composition. When this composition changes, for example due to blocked oil glands, blepharitis, or rosacea, it can result in dry eyes.
In addition to some of the causes of dry eyes, a person's risk of experiencing dry eyes will also be greater if:
- Age above 50 years. As you get older, tear production tends to decrease.
- Experiencing hormonal changes. This condition often occurs in women who experience hormonal changes due to pregnancy, taking birth control pills, and menopause.
- A diet low in vitamin A.
- Wear contact lenses.
Dry Eye Diagnosis
To establish the diagnosis of dry eye, the ophthalmologist will ask the patient's symptoms and medical history, before conducting a physical examination.
In order to measure the patient's tear volume, the doctor will perform Schirmer's test. Through this test, the doctor will measure the level of dryness in the eye by attaching a special piece of paper that can absorb fluid in the lower eyelid for 5 minutes. Eyes are classified as dry eyes if the size of the wet paper is less than 10 millimeters in 5 minutes.
Meanwhile, to determine the condition of the surface of the eye, the test uses eye drops containing a special dye (dye test). fluorescein) can be done. After giving the patient eye drops, the doctor can look at the pattern of discoloration in the eye to see how quickly the eye is drying. Dye test fluorescein It can also show areas of damage to the surface of the eye.
To see damage to the surface of the eyeball can also be seen through the lissamine green test or a special dye on a paper. Next, the paper will be moistened with saline solution and affixed to the surface of the eye. Through the color patterns that stick to the surface of the eyeball, doctors can see early signs of damage to the eye. In addition to an eye examination, an overall physical examination will also be performed to look for causes of dry eyes,
Dry Eye Treatment
Treatment for dry eyes is aimed at helping sufferers relieve symptoms and treat the causes of dry eyes. If the cause of dry eyes is related to medical factors, the first treatment step is to address the cause. For example, if the cause is a side effect of taking medication, the doctor may advise the patient to change to a drug that does not cause dry eye side effects.
For dry eyes that are mild or only occur occasionally, patients can use eye lubricants, also known as artificial tears, in the form of eye drops, gels, or ointments that are sold over-the-counter at pharmacies. These medications can moisturize the eyes and serve as a substitute for tears.
In addition, other efforts can also be made at home to relieve symptoms or prevent dry eye syndrome, namely:
- Protects the eyes from environments that cause dry eyes, such as windy, hot, smoky, or dusty weather. Avoid this environment or use protective eyewear, and use a humidifier or air filter in the room.
- Avoid wearing eye makeup.
- Quit smoking.
- Set the length of work in front of the computer screen.
- Keep the eyes clean by using warm compresses on the glands around the eyes, and remove dirt or oil on the eyelids.
- Eat lots of omega-3 fatty acids that can improve dry eye conditions. Omega-3 is found in many types of fish, such as mackerel, tuna, sardines, or salmon.
If treatment at home has not been successful, the doctor can perform several therapeutic options, including:
- Drugs. One of the drugs commonly given to treat dry eyes is antibiotics to reduce inflammation at the tip of the eyelids and immune-suppressing drugs (eg. ciclosporine or corticosteroids) which are efficacious reduce inflammation of the cornea of the eye. However, taking corticosteroid drugs for a long time can cause side effects. Meanwhile, to encourage the production of tears, the doctor can give cholinergic drugs, as pilocarpine. If dry eyes are still not resolved, the doctor may recommend using eye drops that are made and processed from the person's blood (serum eye drops). autologous).
- LipiFlow thermal pulsation. This tool aims to open the blockage of the oil glands that cause dry eyes. During this therapy, a bowl-shaped device will be placed in the eye, and provide a gentle and warm massage on the lower eyelid,
- Intense-pulsed light therapy. Light therapy followed by massage of the eyelids can help people with severe dry eye.
- Special contact lenses. Contact lenses called scleral lens This is recommended for use by patients in order to protect the surface of the eye and maintain eye moisture.
- Operation. This procedure can be performed for severe cases of dry eye that cannot be treated with other therapies. The operation is performed by permanently blocking the tear ducts, so that the surface of the eye is always moist. Another operation is salivary gland autotransplantation. In this procedure, the salivary glands from the bottom of the lips are removed to be placed in the skin around the eyes to act as a replacement for the tear glands.
Generally, dry eye symptoms can be controlled after treatment. However, there are also some patients who still experience dry eye syndrome after treatment, even the complaints persist for life.
Dry Eye Complications
Complications that can arise from dry eye disease include increasing the risk of eye infections due to lack of tear supply, damage to the eye surface due to dry eye conditions that are left untreated, causing conjunctivitis, damage to the surface of the cornea, open sores on the cornea, and visual disturbances. Dry eye syndrome also makes it difficult for sufferers to carry out daily activities, such as reading or driving a vehicle.