Dry eye syndrome

Dry eye syndrome (DES) is diagnosed in millions of people around the world. Almost half of all visits to ophthalmologists are caused by this problem, and the number of people with this diagnosis is only growing. Over the past 30 years, DES has been detected 4,5 times more often than before. Why?

To understand this, you need to understand what dry eye syndrome is and what causes it to develop.

What is dry eye syndrome

Dry eye syndrome is a condition that occurs when the surface of the cornea ‘dries out’ due to tear film instability. It covers the cornea and conjunctiva of the eye, nourishes and protects them.

Normally, every time we blink, the tear film is renewed. But for many reasons, the production of the tear film can be disrupted, and its quality can deteriorate, then our eyes do not receive enough moisture and dry eye syndrome develops.

At the first stage, the quality of the tear suffers. Due to the fact that the tear film becomes less viscous, tears literally flow from the eyes. At the next stage, tears, on the contrary, become insufficient. The tear film is unstable, and the eyes are left unprotected.

Severity of dry eye syndrome

Causes of dry eye syndrome

There are several reasons why eyes dry.

1. Violation of the function of the meibomian glands that produce a lipid secret that stabilizes the tear film;

2. Dry air. Air conditioners and centralized heating – all these benefits of modern civilization dry the air and reduce the stability of the tear film, which provokes the development of the “dry eye” syndrome;

3. Hormonal changes. Menopause for almost every second woman becomes a provocateur of the development of DES (Professor Brzhesky V.V.). This is due to the change in the level of sex steroid hormones – estrogens, androgens and progesterone. The same hormones affect the functioning of the lacrimal glands, meibomian glands, glandular cells of the conjunctiva. Therefore, by the way, taking oral contraceptives is also a factor in the development of the “dry eye” syndrome;

4. Contact lenses. Constant use of lenses leads to a decrease in the volume of tears on the surface of the eye and, as a result, to dry eyes;

5. Operations on the eyes, for example, laser vision correction;

6. Constant use of eye drops containing preservatives. For example, beta-blockers for glaucoma or corticosteroids for other eye diseases;

7. Computers, tablets and smartphones. All these devices have taught us to absorb huge amounts of information. The pictures on the screens change so quickly that we unconsciously begin to blink less. The cornea does not receive moisture and dries faster;

8. Poor nutrition and beriberi.

9. Use of low-quality cosmetics.

The causes of the “dry eye” syndrome can also include taking certain medications (antidepressants, tranquilizers), exposure to external stimuli, such as wind or ultraviolet radiation, poor eye hygiene, inflammatory diseases of the eyelids (blepharitis) and much more.

In most of these cases, the cells of the lacrimal gland begin to “fail” due to the so-called oxidative stress – the damaging effects of a large number of free oxygen radicals. It has been proven that free radicals adversely affect the structures of the visual apparatus, in particular, the cells of the lacrimal glands, which produce components of the lacrimal fluid.

Antioxidants are used to neutralize the effects of free radicals. They interact with them, donating the missing electron to free radicals, thereby neutralizing their chemical activity.

Symptoms of dry eye syndrome

The main symptoms of dry eye syndrome are:

• feeling of dryness in the eyes;
• burning;
• lacrimation (especially with wind and frost);
• photophobia;
• redness of the eyes;
• sensation of a foreign body, sand in the eyes;
• blurred vision.

These symptoms mean that the lacrimal glands are not working properly. What is the risk?

First, with a lack of tear fluid, microcracks may appear on the surface of the cornea, causing microerosion. Secondly, the risk of developing infectious eye diseases increases. Thirdly, in the absence of treatment, the quality of vision can be significantly reduced. ⠀

But there is no need to panic, it is better to immediately go to the ophthalmologist and get recommendations for the treatment of dry eye syndrome.

Diagnostics

Diagnosing dry eye syndrome is quite simple and can take about 20 minutes. ⠀

First, the doctor examines the eyes, determines the condition of the skin of the eyelids, the frequency and nature of blinking, analyzes the condition of the tear film, conjunctiva and cornea.

Further, the specialist, as a rule, conducts two tests: determines the stability of the tear film (Norn’s test) and measures the total tear production (Schirmer’s test).

Treatment of dry eye syndrome

Treatment of dry eye syndrome is a complex task. First you need to determine the cause of the problem. If the violation of tear production is associated with the influence of some external factors (dry air, prolonged work at the computer, the use of contact lenses, etc.), you must either completely eliminate their influence or minimize it. Replace lenses with glasses, purchase air humidifiers, normalize computer work, etc.

If DES develops against the background of hormonal changes, it may be necessary to consult not only an ophthalmologist, but also a gynecologist or endocrinologist. If the cause is associated diseases, you need to adjust the treatment program with the appropriate specialist.

Treatment for dry eye syndrome includes:

• stimulation of tear production;
• creating conditions for reducing the outflow of tear fluid;
• creating conditions to reduce the evaporation of the tear film;
• the use of drugs – tear substitutes.

Tear substitutes are mainly intended to relieve the unpleasant symptoms of dry eye syndrome. They help eliminate the feeling of dryness, burning and sand in the eyes.

Important! The choice of an artificial tear preparation depends on the severity of the dry eye syndrome.

For mild DES, low viscosity tear substitutes are preferred. High-viscosity preparations are used to treat moderate and severe dry eye syndrome. Due to their consistency, these “artificial tears” remain on the surface of the eye longer and their duration of action increases. But often such tear substitutes cause blurred vision and cause discomfort, which limits their use.

There are other disadvantages of “artificial tears” preparations: they often have to be instilled during the day, they do not sufficiently protect the surface of the eye, since they are devoid of those components that natural tear fluid has. Finally, such tear substitutes only moisturize the surface of the eye, that is, they fight the symptoms of DES without eliminating its cause – a malfunction of the lacrimal glands caused by oxidative stress.

How else can you restore the tear film? In some cases, for the treatment of dry eye syndrome, specialists may recommend more radical methods to the patient, for example, laser stimulation of additional lacrimal glands. Another option is to reduce tear flow so that natural tears remain in the patient’s eye longer. This problem is also solved surgically – the lacrimal ducts are simply closed.

The relationship of dry eye syndrome with other diseases

People who have thyroid problems are more likely to develop dry eye syndrome than others. This is especially true for women aged 40-65. Against the background of hormonal changes, they may develop diffuse toxic goiter, nodular goiter, autoimmune thyroiditis, and hypothyroidism. They provoke including pathological changes in the eyes.

In some cases, the development of the “dry eye” syndrome is not affected by these diseases themselves, but by the medications that a person takes. Those who use for a long time should monitor the condition of their eyes:

• drugs to normalize blood pressure (blockers);
• antiarrhythmic drugs;
• antidepressants;
• medicines for the treatment of gastrointestinal problems;
• allergy medications;
• oral contraceptives, etc.

To avoid vision problems, you need to regularly undergo screenings and, if any of the diseases described above are found, add the item “examination by an ophthalmologist”.

Prevention of dry eye syndrome

Lifestyle plays a huge role in the development of eye diseases. Get enough sleep, eat a balanced diet, lead an active lifestyle and say goodbye to bad habits – all this is important both for the health of the body as a whole and for the health of the eyes.

We must not forget about eye hygiene. It implies not only regular washing off of makeup, but also periodic rest for the eyes. When working with gadgets, they experience tension that needs to be relieved by being distracted and looking into the distance for at least 20 seconds.

We list the simple rules of prevention:

• Use humidifiers or do wet cleaning, especially in winter.
• Drink plenty of fluids.
• Eat varied, include in the diet foods rich in omega-3 fatty acids, vitamins A, E, C, zinc: green vegetables, carrots, eggs, nuts, citrus fruits.
• Try to protect your face from the wind: point the fans in the other direction, do not drive a car with open windows.
• Take breaks while reading or using computers, smartphones: every 20 minutes, interrupt for 20 seconds to look into the distance – 20 steps away from you.
• Swap contact lenses for glasses.
• Wear sunglasses with filters that block as much UVA and UVB rays as possible.
• Keep an eye on hygiene in the area of ​​​​the eyes and eyelids, use high-quality cosmetics.
• Get screenings to help identify hormone problems and make preventive visits to your ophthalmologist.

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