Dry Eye Quiz: Test Your Medical IQ

Dry eye is a common condition that occurs when a person doesn't produce enough tears to adequately lubricate the eye. Causes of dry eyes include:

• Age – most people over 65 experience dry eyes at some point
• Gender – women are more likely than men to develop eye dryness, due to hormonal changes caused by oral contraceptives, pregnancy, and menopause
• Medications – some medicines may reduce tear production, such as decongestants, antihistamines, antidepressants, and blood pressure medications
• Medical conditions – certain medical issues can cause dry eye, such as diabetes, rheumatoid arthritis, lupus, Sjogren's Syndrome, and blepharitis (eyelid swelling), and allergies
• Eye issues - long-term use of contact lenses and refractive eye surgery (such as LASIK)
• Environment – dry and windy climates, exposure to smoke, staring at a computer screen

Keratoconjunctivitis sicca, also called dry eye disease (DED), dry eye syndrome, and dysfunctional tear syndrome is a chronic condition in which a person has inadequate lubrication and moisture on the surface of the eye. It is a result of either decreased tear production, increased evaporation of moisture from the eye's surface, or both. In severe cases, dry eye disease can impact vision, daily tasks, and social and workplace functioning.

Eye dryness is the main symptom of dry eyes. Other symptoms that may accompany dry eyes include:

• Eye redness
• Irritation
• Feeling of something in the eye
• Burning sensation
• Gritty sensation
• Sensitivity to light
• Blurred vision
• Excessive tearing
• Dry mouth (when caused by Sjögren's syndrome)

Home remedies to relieve symptoms of dry eyes include:

• Use over-the-counter (OTC) lubricant eye drops, gels, or ointments
• Use a humidifier
• Blink regularly and take frequent breaks when using a computer screen for long periods
• Wear glasses instead of contacts
• Wear sunglasses when outdoors
• Drink plenty of water
• Avoid smoke
• Apply a warm damp washcloth to soothe irritated eyes
• Avoid harsh cleaners around the eye area
• Take nutritional supplements containing essential fatty acids (consult your doctor)

For mild cases of dry eyes, home remedies such as artificial tears, use of a humidifier, and avoiding smoke may be sufficient to provide relief. In some cases, medications that cause dry eyes may need to be adjusted. Talk to your doctor before stopping or changing any medications.

In chronic or severe cases, medications and medical treatments may be needed.

• Prescription medications such as Restasis (cyclosporine), Xiidra (lifitegrast), or steroid eye drops may be prescribed.
• Lacrisert (hydroxypropyl cellulose ophthalmic insert) is a slow-release lubricant insert placed under the lower eye lid that liquefies over time, providing an all-day moisturizing.
• A punctal plug is a small device inserted into one of the small openings (puncta) of tear ducts in the inner corner of the upper and lower eyelids so tears are unable to drain away from the eye.
• In cases where dry eye is caused by meibomian gland dysfunction (MGD) an in-office procedure called meibomian gland expression may be performed in which a doctor squeezes the clogged contents from the meibomian glands.
• The LipiFlow Thermal Pulsation System is an in-office dry eye treatment device that fits over the eyelids and applies heat to the lids to soften hardened meibum in the meibomian glands and pulsed pressure to the eyelids to open and express clogged glands.
• Intense pulsed light (IPL) delivers short, intense bursts of light at specific wavelengths that results in changes in blood vessels near the surface of the skin. Originally developed for use in dermatology, it can help relieve dry eyes in some patients.

Complications may result from chronic or untreated dry eye, such as eye infections and a decreased ability to perform tasks such as working with computers, reading, and driving In severe cases, if left untreated, dry eye can result in eye inflammation, corneal abrasions and ulcers, and permanent vision problems.

Certain foods contain nutrients that are known to be helpful in keeping the eyes healthy. These nutrients include omega-3 fatty acids, the antioxidants lutein and zeaxanthin, and vitamins C, E and zinc.

• Good sources of omega-3s include oily fish such as tuna, salmon, and sardines; nuts and seeds (such as flax seed), winter squash, cauliflower, soybeans, green vegetables, and vegetable oil.
• Good sources of lutein and zeaxanthin include eggs, corn, kiwi fruit, grapes zucchini, and leafy greens such as spinach, kale, collards, and broccoli.
• Good sources of vitamin C include citrus fruits and juices (orange, grapefruit, lemon, lime), apples, bananas, tomatoes, and cooked spinach.
• Good sources of vitamin E include whole grain cereals, almonds, hazelnuts, sunflower seeds, sweet potato, and peanut butter.
• Good sources of zinc include fortified cereals, oats, pumpkin seeds and sesame seeds, chickpeas, quinoa, beef and pork, milk and yogurt, lobster, salmon, and eggs.

When dry eye is caused by environmental factors such as dry and windy climates, exposure to smoke, or staring at a computer screen, the symptoms will usually go away once the environment is changed. If dry eye is caused by certain medications, changing or adjusting medicines may help.

However, dry eye syndrome is typically chronic and may not be able to be cured. It can usually be managed successfully with home remedies such as the use of artificial tears, use of a humidifier at home or work, blinking more frequently. Medical treatments such as prescription eye drops or tear duct plugs can also relieve symptoms.