Do your eyes sting and water? Does your vision get blurry while you are driving or reading a newspaper? These are all symptoms of dry eye. While “dry eye” may sound like a simple problem, this condition can actually be quite challenging to treat.
Most people with dry eyes complain that their eyes are actually watery. This seems counterintuitive at first. Why would your eyes be watery all the time if they are dry? When your eyes are dry, they sting, and this pain causes reflex tearing. This reflexive tearing helps for a short time, but the tears eventually evaporate and your eyes dry out again. This creates an endless cycle of dryness and over-tearing that can be quite aggravating.
Here are twelve tips that you can try which may help with your symptoms. Many of them are simple home remedies.
1. Artificial Tears (Rewetting Drops)
The simplest cure for dry eyes is the application of artificial tears to rewet the surface of the eyes. These drops can be bought over the counter and come under many brands and generic forms.
Most of these drops recommend using one drop in both eyes four times a day, or as needed. Try using them at regularly spaced intervals to see if they help with your symptoms. Timing is everything - it’s better to use drops before your eye actually starts hurting.
2. Consider Switching your Rewetting Drops
Most generic artificial tears work fine. However, you should keep in mind that most rewetting drops contain a preservative that keeps bacteria from growing inside the bottle. This preservative can actually irritate the eyes if used too often.
Certain eye-drop brands, such as Refresh and Genteel, use a milder preservative that is less irritating to your cornea. You can also purchase single use eye-drops that contain no preservatives, though these can be expensive and inconvenient as you can’t recap the bottles.
3. Avoid Eye Drops Designed to “Get the Red Out.”
Drops like Visine are designed to eliminate eye redness. These drops contain a drug that causes the red blood vessels on the surface of the eye to constrict. This constriction makes the eyes look whiter. However, this type of eye drop doesn’t help much with rewetting and the chemicals can actually irritate the eyes. In other words, these drops reduce the symptoms (redness) but don’t actually fix the problem (drying).
Decongestant nasal sprays work by a similar mechanism – Afrin constricts the blood-vessels in your nose so you produce less nasal secretions. However, overuse of decongestants can create a dependence upon them, such that your nose runs when you stop using sprays. The same phenomenon occurs with these “decongestant eyedrops,” where you end up with rebound eye redness when you stop using them. Use these red-eye drops sparingly.
4. Night-time Gels
If you find that your vision is particularly blurry the first thing in the morning, you may not be closing your eyes completely when you sleep. This is very common as we grow older and our eyelids become lax. If your eyes aren’t completely closed, the bottom half of your cornea is exposed to nighttime air and dries out. This creates blurriness in the morning and irritated eyes throughout the day.
One simple solution is to use a rewetting gel at bedtime. These gels rewet the eye like regular tears, but are thicker, last longer, and provide soothing moisture all night long. You wouldn’t want to use a gel like this during the day, because they can blur your vision. However, they are OK for bedtime as you are going to sleep anyway and won’t need crisp vision while you sleep.
5. Sleep with a Humidifier
Low humidity is not much of a problem in Florida, but the air is definitely drier during the winter months. Also, heating units can pull moisture from the air and this further irritates eyes that are prone to dryness. If you suffer from chronic ocular irritation, you may want to consider sleeping with a humidifier in your room. A humidifier can even help with certain breathing problems, although you need to keep your unit clean to avoid mold buildup.
For extreme cases of dryness, you can purchase special “Lasik goggles” which work like swimmer’s goggles to keep your tears from evaporating. Turning your eyes into a moist “greenhouse” is overkill for most of us and few people want to sleep wearing glasses. A humidifier is a better starting point.
6. Use Eye-drops with Reading and Television
Humans are very good at concentrating. We have the ability to watch a television, drive a car, or read a book for prolonged periods of time. When you concentrate, however, you don’t blink as often! This leads to dehydration of your tear film into the air around you. If you find your vision becomes blurry when reading or watching television, your blink-rate may be the culprit.
Try using rewetting drops with these high-concentration activities. You could also take a “commercial break” every ten minutes and force yourself to blink a few times. Whatever you do, try not to stress about how often you’re blinking … that kind of thinking will drive you crazy!
7. Warm Compresses
The quantity of tears you produce isn’t the only issue when it comes to your comfort. The tear film isn’t just made of water, but is composed of oils, proteins, enzymes, and antibiotic molecules. To keep your eyes healthy, you need a good balance of these different solutions to produce “quality” tears.
For example, you have microscopic glands at the base of your eyelashes that produce oil. This oil mixes with your tears to keep the water from evaporating too quickly! If these oil glands become clogged, your tears will dissipate quickly and cause irritation and reflexive over-tearing. You can open these oil pores with the use of warm compresses. Once a day, run a washcloth under warm water, and lay this cloth over your closed eyes for a few minutes. This acts like a “sauna” for your eyelids and will help open up those pores and get that oil flowing.
8. Lid Scrubs
Many of us have debris that forms at the base of our eyelashes. This debris builds up, and causes a “sandy” or “gritty” sensation in the eyes, especially upon awakening in the morning. For some people, this buildup is so bad that the debris actually falls into the eyes and exacerbates the symptoms of dry eye.
You can remove this debris with good eyelid hygiene. Once a day, take a warm washcloth and add a dab of baby shampoo to get a good lather. Then, with your eyes closed, wipe along your eyelashes. The combination of warm water, shampoo, and massaging action will clean off your lashes and open those tear glands.
9. Medications
There is only one FDA-approved eye drop that can actually increase your own natural tear production. Called Restasis, this medication can actually improve the quality of your tears and the surface of your cornea. This medication doesn’t work for everyone, but for those susceptible to its positive effects, it seems to really help. This medication is prescription only, and should not be used if you have any active eye infection or viral infection of the eye.
Your doctor may also prescribe a course of oral antibiotics called doxycycline. This antibiotic isn’t used to fight bacteria, but instead one of its beneficial side effects is to change the consistency of oil on your skin and improve the quality of your tear film.
10. Punctal Plugs
Tears from your eyes have to go somewhere! Many of your tears evaporate into the air, but much of the excess drains into your nose through tear ducts located in the corner of your eyelids. These little drains explain why you get a runny nose when you cry.
One tactic to deal with excessive drying is to place temporary silicone plugs into your tear drainage ducts. This allows your natural tears to remain longer before draining away. The plugs are nearly microscopic and can’t be seen without a magnifying glass. Plugs can be very effective and can be inserted during your normal eye appointment. They are also easily removable, and so their effect is reversible.
11. Sunglasses
Environmental factors play a huge part in keeping your eyes well lubricated. Sunglasses are an inexpensive method to block wind and sun from dehydrating your eyes. You can think of sunglasses as “eye armor” that shields your eyes from the drying effect of the elements. Wrap-around style sunglasses are particularly effective at keeping the eyes cool and moist.
If you normally wear glasses, you may want to consider prescription sunglasses for outdoor activities and driving. You can also get glasses with transitional lenses that change tint when you go outside.
12. Avoid Air Pollution
Air pollution, especially smoke, is very irritating to the eyes. The microscopic particles in a breath of smoke (either yours or secondhand smoke) are naturally attracted to the wet surface of your eyes. These particles mix into your tears, rub against the surface of the cornea, and change the surface tension of your tear film. This leads to eye irritation and dryness, with episodic reflexive tearing.
If you smoke, you should really try to quit. Not only will your eyes feel better, but quitting smoking is the number one thing you can do to prolong your life.
Dry eyes are not the only cause for ocular irritation. Many other eye conditions, such as blepharitis or misdirected eyelashes, may be causing your symptoms. If you continue to have problems, you should see an ophthalmologist who will look at your eyes under a microscope to pinpoint your problem more accurately.
