Dry eye is a condition in which there are insufficient tears to lubricate and nourish the eye. Tears are necessary for maintaining the health of the front surface of the eye and for providing clear vision. People with dry eyes either do not produce enough tears or have a poor quality of tears. Dry eye is a common and often chronic problem particularly with older adults.

Dry eyes can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on the evaluation of the quantity and quality of tears produced by the eyes, may include:

• Patient history to determine any symptoms the patient is experiencing and the presence of any general health problems, medications taken, or environmental factors that may be contributing to the dry eye problem.
• External examination of the eye, including lid structure and blink dynamics.
• Evaluation of the eyelids and cornea using bright light and magnification.
• Measurement of the quantity and quality of tears for any abnormalities. Special dyes may be instilled in the eyes to better observe tear flow and to highlight any changes to the outer surface of the eye caused by insufficient tears.

Using the information obtained from testing, your doctor can determine if you have dry eyes and advise you on treatment options.

Treatment

• Medication changes may be made if they have been associated with dry eye.
• Over-the-counter topical medications, such as artificial tears, gels, and ointments, may be recommended.
• Environmental and lifestyle changes, such as cutting back on screen-time and taking eye breaks, may be recommended. You may also be encouraged to take regular breaks to squeeze your eyes shut several times in an effort to replenish basal tears and spread them more evenly across your eye. Additionally, it may be recommended to wear sunglasses that wrap around the face and have side shields that block wind and dry air from your eyes and help reduce symptoms.
• Dry eye medications may be prescribed. Restasis and Xiidra are the only prescription medications approved by the U.S. Food and Drug Administration for treating dry eye. Corticosteroid eye drops may be prescribed short-term to reduce eye inflammation.
• Surgical options may be recommended. One possible procedure includes the insertion of punctal plugs (made of sillicone or collagen) to partially or completely plug the tear ducts at the inner corners in an effort to avoid tear drainage. In severe cases, surgical closure of the drainage ducts by thermal punctal cautery (surgical closing with the application of heat) may be recommended to close the tear ducts permanently.
• Scleral contact lenses may be recommended to relieve the discomfort in severe cases.

National Eye Institute supported researchers are studying the underlying causes of dry eye to better understand the disease and to develop novel treatments. Researchers are investigating factors that influence the ability of corneal nerves to sense tear evaporation. For more information, visit their website.