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Symptoms of dry eye

Have you ever had that feeling of something in your eye when you knew they were clear? Do your eyes ever feel itchy or gritty or tired, particularly at the end of the day? You may have Dry Eye.

Dry eye or keratoconjunctivitis is common. In fact, studies estimate up to 30% of people may experience dry eye at some point in their lives. It is more common in people over 60 – particularly menopausal women. Whilst dry eye is not normally serious, in extreme cases it can damage the eye and vision. Whilst there is no cure, most people can be kept comfortable using eye drops.

Every blink spreads tears across the surface of the eye and these tears form a tear film which hydrates, lubricates and protects the surface of the eye so that vision stays clear and comfortable. When the tears produced are insufficient to replenish the tear film, or the tear film is unstable, eyes can feel gritty, scratchy and irritated, an issue more commonly known as dry eye

Symptoms of dry eye include

  • Itchy, burning or scratchy sensations in or around the eyes

  • Dryness, grittiness, stinging or soreness in the eyes that worsens through the day

  • Red eyes

  • Watery eyes, particularly when exposed to wind

  • Occasional blurred vision and sensitivity to normal light

Type of dry eye

In simplistic terms there are two forms of dry eye:

1. Tear deficient dry eye (poor tear film quantity)
Not enough tear film is produced or it is poorly distributed across the surface of the eye.

2. Tear sufficient or evaporative eye (poor tear film quality)
Enough tears are produced but evaporation of moisture from the surface of the eye causes dry eye symptoms.

The Tear Film...a healthy tear layer consists of three distinct layers each one works differently and together keep your eye surface moist and lubricated

  • AQUEOUS (WATERY) LAYER
    • This is produced by the lacrymal gland. It is the central component of the tear film and accounts for about 98% of tear volume. It consists mainly of water but also contains other substances such as electrolytes and proteins, which nourish the eye. This layer also washes away irritants, keeping the eye healthy.
  • MUCIN (BASE) LAYER
    • This is the inner and foundation layer of the tear film which anchors the film to the cornea. It is produced from goblet cells within the conjunctiva. Its key functions are to facilitate film distribution evenly over the corneal surface and adherence to the corneal epithelium.
  • LIPID (PROTECTIVE) LAYER
    • This layer is composed of oils secreted by the meibomian glands. This is the outermost layer of the tear film covering the aqueous and mucin layers and providing a barrier which delays tear evaporation and retains moisture. The lipid layer also protects the eye surface from contamination.
    Dry eye syndrome (also known as keratoconjunctivitis sicca) is the final common outcome of a number of different conditions which affect the tear film that normally keeps the eye moist and lubricated.

    Tears are a complex mixture of water, salts, lipids, proteins, and mucins. The lacrimal glands produce the aqueous components (water, salts, proteins), the Meibomian glands produce the lipids, and conjunctival goblet cells produce the mucins.

    A reflex increases flow as a response to emotion, irritation of the eye, and other nervous stimuli. Excess tearing frequently occurs in people with dry eye syndrome, for example in windy conditions.

    Tears are distributed across the eye surface by blinking, and are drained by the lacrimal ducts into the nose.

    The external surface of the eye, the tear-secreting glands, Meibomian glands, and eyelids function as an integrated unit to secrete and clear tears. Abnormalities in any component of this functional unit can result in an unstable and unrefreshed tear film and the set of symptoms called dry eye syndrome.
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    Causes of dry eye

    Dry eye is common, studies estimate that up to 30% of people may experience it at some point in their life. It is more prevalent in people over 60 - particularly women. Dry eye syndrome, or dry eye disease, occurs when the eyes do not make enough tears, or the tears evaporate too quickly as the oil glands are blocked or abnormal. This leads to the eyes drying out and becoming inflamed (red and swollen) and irritated. Dry eye is not normally serious and although there is no cure most people can be kept comfortable using eye drops regularly.

    Some groups of people are particularly vulnerable to dry eye, these include:
    - Men and women over 60
    - Women during menopause
    - Digital screen users (computers, tablets etc.)
    - Long-term use of certain medicines (such as beta-blockers, antidepressants and anti-histamines)
    - Sufferers of certain medical conditions, such as Sjögren’s syndrome.

    If however the main problem is a blockage of the oil secreting glands, then the condition is called blepharitis, meibomian gland dysfunction or lid margin disease.

    Diagnosis of dry eye

    Dry eye can easily be mistaken for other conditions, such as conjunctivitis, so it may be advisable to ask your optician to check your eyes. Diagnosis of dry eye can be done with a dye to colour the dry patches. There are two main dyes used for diagnosis:

    The Flourescein Dye test
    This is a harmless yellow-orange dye that can show the eye specialist how long it takes for dry eye patches to appear. The specialist will put a couple of drops into your eye and will ask you to blink a few times. Then you will need to keep your eyes open without blinking to see when the dry patches form.

    The Lissamine Green test
    A non-toxic dye, known as Lissamine Green, is diluted with saline and dropped on the surface of your eye with a paper strip. The distinctive green colour of the dye allows the specialist to see early damage to the surface of the eye.
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    Treatment of dry eye

    Mild dry eye syndrome can be relieved with the following:

    • Regular use of lubricating eye drops

    • Treating the underlying cause

    • Wearing specialised eyewear



    It is not usually a serious condition unless the underlying cause is inflammation or certain diseases where there is an overactive immune system, so if symptoms persist it is advisable to seek medical advice.

    In severe cases, dry eye syndrome may be treated with surgery to block the drainage tear ducts. This is either with temporary plugs or by permanently sealing the drainage hole. However, the ophthalmologist will first ask if you have been using eye drops regularly.

    You can help ease or prevent dry eyes by:

    • Keeping your eyes and eyelids clean and protecting them from the environment by using glasses

    • Lubricating your eyes with eye drops

    • Using your computer or laptop correctly to avoid eye strain by, for example, glancing away from the screen at regular intervals

    • Using a humidifier to moisten the air

    • Avoiding air conditioning or sitting directly in front of a fire

    • Eating a healthy diet that includes flaxseed oil and omega-3 fat

    Use of Clinitas for dry eye

    Although dry eye cannot be cured, regular use of Clinitas will help to repair the irritated tissues. This leads to a reduction in inflammation which may, in turn, improve natural tear production.

    A Clinitas product should be applied 3-5 times daily initially and then the frequency of use can be adjusted to suit the sufferer’s needs.

    Clinitas Soothe is preservative free and therefore can be used more frequently and over extended periods. However, there are no restrictions on how long any Clinitas product can be used.

    Click here to find out more about our dry eye drops

    Approved: JB027 MAY 2018

    Preservatives

    Some eye drops contain preservatives to prevent harmful bacteria growing inside the medicine bottle. If your symptoms mean you need to use these eye drops more than 6 times a day, it's better to use preservative-free eye drops.

    This is particularly important if your ophthalmologist has told you that you have severe dry eye disease. Preservatives used in large quantities or over a prolonged period of time – months or years – may damage the delicate cells on the surface of the eye or cause inflammation.

    Both Clinitas Soothe & Clinitas Soothe Multi are preservative free.
    If you wear soft contact lenses, you may also need to use a preservative-free lubricant, as preservatives attach to the contact lens and damage the eye. Both Clinitas Soothe & Clinitas Soothe Multi are suitable for contact lens wearers.

    If you have any difficulty putting in your drops, please discuss this with your doctor or optometrist. There are mechanical devices to help squeeze bottles, multi-dose bottles with valves, and single dose containers that may be easier for you.