DRY EYES

 
 
 
 
 
 
Dry Eyes
 
Dry eye is a chronic medical condition that develops when the eye's tear film fails to lubricate and protect the eye's outer surface. The condition is the result of diminished tear production, or because of a problem in the composition of the tear film. Dry eye can be caused by a variety of circumstances: contact lens use; smoking; exposure to hot, dry or windy climates; excessive use of computer and other electronic devises with a blue ray ;autoimmune diseases such as rheumatoid arthritis; thyroid conditions; menopause; increasing age; decreased blinking; the use of certain medications; and a dietary deficiency of omega-3 essential fatty acids. One of the biggest risk factors is Sjögren's syndrome, an autoimmune disease in which the white blood cells attack the body's own moisture-producing glands.
 
What Causes Dry Eye Syndrome?
 
An adequate and consistent layer of tears on the surface of the eye is essential to keep your eyes healthy, comfortable and seeing well. Tears bathe the eye's surface to keep it moist and wash away dust, debris and microorganisms that could damage the cornea and lead to an eye infection.
A normal tear film consists of three important components:
  1. An oily (lipid) component
  2. A watery (aqueous) component
  3. A mucous-like (mucin) component

Dry eye syndrome

Each component of the tear film serves a critical purpose. For example, tear lipids help keep the tear film from evaporating too quickly and increase lubrication, while mucin helps anchor and spread the tears across the surface of the eye.
Each tear component is produced by different glands on or near the eye:
  1. The oily component is produced by meibomian glands in the eyelids.
  2. The watery component is produced by lacrimal glands located behind the outer aspect of the upper eyelids.
  3. The mucin component is produced by goblet cells in the conjunctiva that covers the white of the eye (sclera).
A problem with any of these sources of tear film components can result in tear instability and dry eyes, and there are different categories of dry eyes, depending on which component is affected.
For example, if the meibomian glands don't produce or secrete enough oil (meibum), the tear film may evaporate too quickly — a condition called "evaporative dry eye." The underlying condition — called meibomian gland dysfunction — is now recognized as a significant factor in many cases of dry eye syndrome.
In other cases, the primary cause of dry eye is a failure of the lacrimal glands to produce enough watery fluid (aqueous) to keep the eyes adequately moistened. This condition is called "aqueous deficiency dry eye."
The specific type of dry eye often will determine the type of treatment your eye doctor recommends to give you relief from your dry eye symptoms.
Factors Associated With Dry Eye Syndrome
A number of factors can increase your risk of dry eyes. These include:
  • Computer use. When working at a computer or using a smartphone or other portable digital device, we tend to blink our eyes less fully and less frequently, which leads to greater tear evaporation and increased risk of dry eye symptoms.
  • Contact lens wear. Though it can be difficult to determine the exact extent that contact lens wear contributes to dry eye problems, dry eye discomfort is a primary reason why people discontinue contact lens wear.
  • Aging. Dry eye syndrome can occur at any age, but it becomes increasingly more common later in life, especially after age 50.
  • Menopause. Post-menopausal women are at greater risk of dry eyes than men of the same age.
  • Indoor environment. Air conditioning, ceiling fans and forced air heating systems all can decrease indoor humidity and/or hasten tear evaporation, causing dry eye symptoms.
  • Outdoor environment. Arid climates and dry or windy conditions increase dry eye risks.
  • Frequent flying. The air in the cabins of airplanes is extremely dry and can lead to dry eye problems, especially among frequent flyers.
  • Smoking. In addition to dry eyes, smoking has been linked to serious eye problems, including macular degeneration, cataracts and uveitis. (For details, see our infographic about why smoking is bad for your eyes.)
  • Health conditions. Certain systemic diseases — such as diabetes, thyroid-associated diseases, lupus, rheumatoid arthritis and Sjogren's syndrome — contribute to dry eye problems.
  • Medications. Many prescription and nonprescription medicines — including antihistamines, antidepressants, certain blood pressure medications and birth control pills — increase the risk of dry eye symptoms.
  • Eyelid problems. Incomplete closure of the eyelids when blinking or sleeping — a condition called lagophthalmos, which can be caused by aging or occur after cosmetic blepharoplasty or other causes — can cause severe dry eyes that can lead to a corneal ulcer if left untreated.
Also, LASIK and other corneal refractive surgery can sometimes cause dry eyes. In most cases, however, dry eye discomfort after LASIK is temporary and resolves within a few weeks of the procedure.
If you have dry eyes prior to LASIK, your eye doctor may recommend a dry eye treatment regimen before your procedure to insure the best possible LASIK results.
 
Dry Eye and Nutrition
 

Using Flaxseed Oil and Fish Oil To Relieve Dry Eye


flaxseed oil and fish oil contain important dietary fatty acids that have multiple health benefits, including prevention or treatment of dry eyes.
Other benefits include a lower risk of heart disease and a reduction of chronic inflammation that can lead to a variety of serious diseases, including cancer and stroke. Chronic inflammation also has been indicated as an underlying cause of osteoarthritis and Alzheimer's disease.
Daily supplements of flaxseed oil or fish oil, when used alone or in tandem with lubricating eye drops, appear to reduce dry eye symptoms, including burning, stinging, redness and intermittent visual disturbances. For this reason, many eye doctors now are recommending flaxseed oil and fish oil supplements for their patients who suffer from dry eyes.
Research also suggests these same fatty acids may reduce the risk of macular degeneration and cataracts.
So which is better — flaxseed oil or fish oil?

Flaxseed Oil For Dry Eyes

The nutritional value of flaxseed oil (and fish oil) comes from its omega-3 fatty acids that are needed for optimum health. Flaxseed oil contains high levels of an omega-3 called alpha-linolenic acid (ALA). During digestion, ALA is converted into two different omega-3 fatty acids — called EPA and DHA — that are used throughout the body to protect cell membranes.
laxseed oil supplements are available both in capsule and liquid forms. Although flaxseed oil capsules are more convenient, you may need to take a large number of capsules to achieve the daily dose your eye doctor recommends to treat dry eyes.
The nutritional value of flaxseed oil is easily destroyed by light, heat and oxygen. When purchasing liquid flaxseed oil, look for a cold-pressed variety and keep it refrigerated.
As an alternative to flaxseed oil, you can get the same omega-3s by grinding whole flax seeds in a coffee grinder and sprinkling the ground seeds over a salad, adding them to a smoothie or mixing them in fruit juice. If you choose this option, be sure to use the seeds immediately after grinding them to get the full omega-3 benefits.
Popular eye vitamins that contain flaxseed oil include: TheraTears Nutrition (Advanced Vision Research), Dry Eye Formula (EyeScience) and Tears Again Hydrate (Ocusoft).

Comparison Of Fish Oil With Flaxseed Oil

Fish oils and fatty fish — such as salmon, tuna and sardines — are excellent food sources of omega-3 fats essential to brain and eye health.
Fish fat contains the "long chain" omega-3s (EPA and DHA), which are the omega-3 fats the body needs for vital functions, including eyesight.
In contrast, the "short chain" ALA omega-3 fat found in plant foods such as flaxseeds must be converted to EPA and DHA in the body for beneficial eye effects. When you eat plant foods, your body converts only about 5 percent of dietary ALA into essential EPA and DHA.
Also, most Americans' diets are too high in omega-6 fatty acids — an imbalance that further reduces the amount of ALA from plant foods that gets converted to EPA and DHA. This imbalance also blunts the benefits of EPA and DHA omega-3s obtained directly from fish and fish oil.
Omega-6 fats are found in vegetable oils (corn, soy, cottonseed, safflower and sunflower) used in most snacks and prepared foods — whether packaged, frozen, restaurant or take-out.
Researchers agree that most people need to reduce their consumption of these otherwise healthful omega-6 fats, which block omega-3 absorption and promote inflammation when eaten in excess.
Fish oils, like flaxseed oil, are available in capsule and liquid forms. Some contain lemon flavoring or are processed in other ways to reduce any "fishy" taste. Cod liver oil is another good source of EPA and DHA omega-3 fatty acids.
A more enjoyable way to obtain fish oil benefits is by eating grilled cold-water fish at least three times a week. Good sources of EPA and DHA omega-3s are salmon, sablefish, tuna and halibut.
Popular eye supplements that contain fish oil or cod liver oil include: TheraTears Nutrition (Advanced Vision Research), BioTears (Biosyntryx) and HydroEye (ScienceBased Health).

So Which Is Better: Flaxseed Oil Or Fish Oil?

Because fish oil contains natural EPA and DHA omega-3s (that don't have to be converted from ALA), many nutrition experts recommend fish oil over flaxseed oil.

 
 

Grilled salmon is an excellent source of omega-3 fatty acids to fight dry eyes.


But other factors are worth considering:
  • If you are a vegetarian, ground flax seeds or flaxseed oil will likely be your preferred choice.
  • Ground flax seeds are more economical than either fish oil or flaxseed oil supplements.
  • The U.S. Food and Drug Administration (FDA) classifies omega-3 fatty acids from fish as GRAS (Generally Regarded as Safe). However, fish oil can cause stomach upset and/or diarrhea in some individuals, especially in high doses. Other possible side effects include increased burping, acid reflux, heartburn and abdominal bloating or pain. Risk of these side effects can be minimized if you take fish oils with meals and if you start with low doses.
  • A fishy aftertaste is common with some fish oil supplements. This can be reduced by refrigerating the capsules or liquid, or by purchasing brands that promise no such problems.
Concerns about mercury poisoning from fish oils generally are unfounded. When present in waterways, methyl mercury accumulates in fish meat more than in fish oil, and testing of fish oil supplements show they generally contain little or no mercury. Still, if this is a concern, using flaxseed oil as an alternative eliminates this issue.

 
 
 
 
Dry Eye Symptoms
 
Symptoms of dry eyes and dry eye syndrome include:
  • Burning sensation
  • Itchy eyes
  • Aching sensations
  • Heavy eyes
  • Fatigued eyes
Another common symptom is something called a foreign body sensation — the feeling that grit or some other object or material is "in" your eye.
And as odd as it may sound, watery eyes also can be a symptom of dry eye syndrome. This is because dryness on the eye's surface sometimes will over-stimulate production of the watery component of your tears as a protective mechanism. But this "reflex tearing" does not stay on the eye long enough to correct the underlying dry eye condition.
In addition to these symptoms, dry eyes can cause inflammation and (sometimes permanent) damage to the surface of the eye.
Dry eye syndrome also can affect the outcomes of LASIK and cataract surgery.
 
What are the treatments for Dry Eyes
 

1. Artificial Tears

For mild cases of dry eyes caused by computer use, reading, schoolwork and other situational causes, the best dry eye treatment may simply be frequent use of artificial tears or other lubricating eye drops.

Artificial tears usually are the first step in dry eye treatment.
There are many brands of artificial tears that are available without a prescription. The challenge with using artificial tears is not lack of product availability — it's the confusing number of brands and formulations available to choose from.
Artificial tears and other over-the-counter (OTC) lubricating eye drops are available in a wide variety of ingredients and viscosity ("thickness").
Artificial tears with low viscosity are "light" and watery. They often provide quick relief with little or no blurring of your vision when you apply them. But often their soothing effect is very short-lived, and sometimes you must use these drops very frequently to get adequate dry eye relief.
On the other hand, artificial tears that have a high viscosity are more gel-like and can provide longer-lasting lubrication. But typically these drops cause significant blurring of your vision for several minutes immediately after you apply them. For this reason, these drops often are not a good choice for use during your work day or when you need immediate clear vision for tasks such as driving. Instead, high-viscosity artificial tears are recommended only for bedtime use.

Also, the ingredients in certain brands of artificial tears may determine which type of dry eye condition they are better suited for. For example, one brand might work better for aqueous-deficiency dry eyes, while another brand may be more effective for an evaporative dry eye condition.
If your eye doctor recommends that you use one or more brands or formulations of artificial tears, be sure to follow the directions he or she gives you concerning when and how often you use the drops. Also, do not substitute different brands from those your eye doctor recommends. Using a different brand or multiple brands of artificial tears will make it difficult to assess the success of the dry eye treatment your doctor recommends.

2 Warm Compresses

An alternative (and potentially more comfortable) way to help open clogged meibomian glands to treat dry eyes is to simply apply warm compresses to the closed eyelids to soften the hardened meibum.
Unfortunately, for warm compresses to work well, some researchers say you have to use a compress that can maintain a temperature of 108 degrees Fahrenheit for more than 10 minutes, and the compresses have to be applied for this length of time at least twice a day.
Most people are unable or unwilling to perform this type of dry eye treatment correctly, and shorter and less frequent use of variable-temperature warm compresses typically is ineffective.

3. Nutritional Supplements

Doctors sometimes recommend nutritional supplements as part of a holistic dry eye treatment plan. Studies have found that supplements containing omega-3 fatty acids can decrease dry eye symptoms.
Good sources of omega-3s include cold-water fish such as salmon, sardines, herring and cod. For a vegetarian source of omega-3s, some eye doctors recommend flaxseed oil to relieve dry eye.
Drinking more water can help, too. Mild dehydration often makes dry eye problems worse. This is especially true during hot, dry and windy weather. Simply drinking more water sometimes reduces the symptoms of dry eye syndrome.

4. Meibomian Gland Expression

A very significant percentage of dry eye cases are caused by inadequate oil (meibum) being secreted from meibomian glands located along the margin of the eyelids.
The openings of these glands are near the base of the eyelashes, and if these openings get clogged, the oil that is critical to keeping the tear film from evaporating too quickly cannot do its job. This is called meibomian gland dysfunction (MGD), which leads to a condition called evaporative dry eye.
To treat MGD and evaporative dry eye, your eye doctor may perform an in-office procedure called meibomian gland expression. In this procedure, warm compresses may or may not first be applied to your eyelids; then a forceps-type device is used to squeeze the clogged contents (hardened meibum and possibly other substances) from the meibomian glands.
To fully express the contents of the meibomian glands and get them functioning properly, significant pressure must be applied to the eyelids, which can be uncomfortable. But the results usually are worth putting up with the short-term discomfort of the procedure.
 
 
 
 
 
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