Although it may seem odd, tearing is actually one of the most common symptoms of dry eyes. Tears are composed of a mixture of oils, mucin, and salt water produced by different glands in the eyelids. Often, the glands that produce the oils and mucin can get stopped up and do not express as well so the eye gets dry and irritated. When the eye is irritated, the gland producing salt water acts like a fire- protection sprinkler system, over-producing fluid to wash away irritants in the eye. This system works well if dust is irritating the eye, but it doesn’t work so well when dryness is the problem. Just as you use lotion instead of water to moisturize dry skin, so you need oils and mucins to lubricate the eye and not just water.
Treatments for dry eye increase the amount and quality of tears on the surface of the eye. The easiest treatment is supplementing natural tears with artificial tears. Artificial tears simulate the lubricating effects of the eye’s own tears. There are many artificial tears on the market available with variations of thickness. If one type or brand doesn’t feel comfortable, try another type. However, beware of drops that “get the red out.” They often constrict the blood vessels on the surface of the eye. However, these blood vessels serve an important function in bringing oxygen to the eye and removing waste. After medication that constricts the blood vessels wears off, the eye is often even redder than before. If you find yourself using artificial tears more than four times a day, switch to the preservative-free artificial tears so the eye is not irritated by exposure to too much preservative. Preservative-free artificial tears come in individual vials that contain about six drops. These drops can be used throughout the day, but once the day is over, they must be thrown out.
To help those stopped up glands work better, use a warm compress over the eyelids for 10 to 15 minutes. Just like butter melts from solid to liquid when heated, the oils in the glands will liquefy when heated and express onto the surface of the eye better. Usually, a washcloth soaked with hot water doesn’t stay warm long enough to be effective. There are commercial eye masks sold at pharmacies and other retail stores that heat in the microwave and will stay warm much longer. Another option is to create an eye mask by putting rice in a sock and tying the sock closed. This can be microwaved to make it warm, but start low with 10 secs and add more time as needed. Whether using an eye mask or a rice sock, make sure that it is comfortably warm and not too hot to avoid burning the eyelids.
Environmental changes like using a humidifier and avoiding air from fans blowing on the face can also help with dry eye symptoms. When outside, wear wrap- around sunglasses to help avoid wind reaching the surface of the eye. There are great motorcycle sunglasses that are made to keep the wind away from the eyes.
If these actions are not enough to make your eyes comfortable, there are prescription eye drops or procedures such as the placement of punctal plugs for treating dry eyes. Call your eye doctor to discuss what treatment would be best for your individual situation.
Author: Dr. Elizabeth Chiang
