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Tips to Prevent Dry Eye

Author: Premier Eye Associates

In most parts of the US, it is currently quite cold and dry. This means many of us are running our heaters and staying indoors as much as possible.

During this time of year, we also all tend to notice our bodies just feel dry–we need to apply hand lotion more frequently, chapstick, and of course, artificial tears.

But why is it that my eyes feel dry? Is there anything I can do to prevent dry eye?

The simple answer is yes. Dry eye is quite complicated, but there are things you can do to help keep your eyes lubricated and functioning properly, to hopefully prevent acute, intermittent dry eye from occurring.

Before we get too far along, we’ll need to touch base on what exactly dry eye is.

 

What is Dry Eye?

Dry eye can be an acute exacerbation of dryness (frequently seen in the winter months) or it can be a chronic disease secondary to a systemic health problem, medication, or loss of tear production function.

Our tears are made up of 3 layers–lipid, aqueous, and mucin. We need adequate amounts of all three parts in order to have proper tear wetting and eye moisturizing.

If one part is lacking, the composition of the tears will be jeopardized, resulting in tears that evaporate too quickly or provide too little nutrition to provide appropriate lubrication.

The mucin layer is the inner most layer. It is created by specialized cells called goblet cells that are located within the ocular conjunctiva (the clear, stretchy layer overlying the white part of the eye).

The mucin layer helps to keep the tear layer attached to the cornea of the eye. Without it, our tears would run right off our eyes and down our cheeks.

The aqueous layer is created by the lacrimal gland. This gland is located near the outer corner of the eyebrows. The aqueous layer makes up the bulk of our tears.

The lipid layer is the outermost layer of the tears. It is composed of healthy omega-3 fatty acids and nutrients.

The lipid layer is produced by specialized glands called Meibomian glands. Meibomian glands can be found running vertically along both the upper and lower eyelids. Each eye has roughly 70 meibomian glands (30-40 in the lower lid and 20-30 in the upper lid).

The lipid component of the tears is important for slowing the evaporation of the tears from the eyes. When the lipid component is lacking, an individual’s tears can evaporate as quickly as within 1-2 seconds, whereas a normal individual’s tears should take 10 seconds or longer to evaporate.

Lipids from the meibomian glands are constantly produced and slowly oozed out onto the eyelid margins. Each time you blink, the lipids are smeared across the eye and help stabilize the tear film, keeping it uniformly distributed across the eye.

Dry eye occurs when the tears produced are of poor quality, lacking lipids to keep the tears from evaporating too quickly (problem with the lipid layer), or if not enough tears are produced (problem with the aqueous layer).

One subtype of dry eye is called meibomian gland dysfunction (MGD). In MGD, the meibomian glands become damaged and die off, resulting in less lipid being secreted into the tears and thus dry eye.

Once meibomian glands die off, they cannot regenerate. Therefore, keeping these glands protected and healthy are of utmost importance when it comes to preventing future dry eye.

As you can see, there are many different parts to dry eye. While dry eye cannot be prevented in all individuals, there are some things you can do to help keep the eyes healthy and at least lessen the severity of dry eye symptoms down the road.

 

How to Prevent Dry Eye

The first suggestion we have is to carefully wash your eyelids each evening. Our eyelids job is to protect the eyes against unwanted debris and bacteria. This being said, much debris and bacteria can gather along the eyelid margins.

This is especially true in individuals who wear makeup, false eyelashes or lash extensions, and those who work in heavy debris jobs such as outdoors, construction, with machinery, etc.

When debris is left to accumulate on the eyelid margins, it not only increases risk of eye infection, but it also can clog the exit of the meibomian glands. When the meibomian glands are clogged, the lipids backflow down into the gland.

Stagnant lipids within the meibomian glands are a recipe for disaster. Not only does this damage the glands, resulting in possible death of the gland ultimately contributing to dry eye, but it can also attract bacteria. Bacteria infection of a meibomian gland is the underlying cause of styles, also referred to as hordeolums.

 

Warm Compresses

Another recommendation is to regularly use warm compresses and digitally massage the eyelids.

Warm compresses can be just a clean wash cloth run under warm (not hot) water for a few seconds and then rested on the eyes. Other options include specialized eye masks, such as the Bruder Mask, which contains little beads that heat up in the microwave.

Warm compresses are recommended at least 2-3 times a week for most individuals. The heat helps to liquify the lipids, making it easier for the lipids to be expressed out into the tears.

It is important to regularly liquify the lipids to ensure the glands are not becoming backed up, or lipids remaining stagnant, to help promote good meibomian gland help, thus preventing MGD.

Digitally massaging the lid margins after warm compresses helps to move the lipids up and out of the glands. Any little bit helps!

 

Become a Blinker!

Another tip for dry eye prevention is conscientious blinking, and the 20/20/20 rule. Recent studies have found that, when performing tasks that require a lot of focus (watching TV, computer work, playing video games, driving, etc.) we tend to blink less frequently.

In fact, one study found that the average human blinks roughly 20 times per minute. When using electronics, blink rate decreased to 10 or less times per minute—a significant decrease!

As mentioned earlier, we need to blink regularly to release the lipids from the meibomian glands and spread the tears out uniformly across the eyes. If we do not blink, we will not have enough lipids in our tears to keep them from evaporating quickly.

Thus, trying to be more conscious about blinking can be beneficial for keeping our eyes better lubricated. To help remember this, you can use the 20/20/20 rule. Set a reminder on your phone to take a 20 second break to look at an object 20 feet away every 20 minutes. Not only will this help your focusing system to take a much needed break from near work to help prevent eyestrain/fatigue, but it will also help remind you to take breaks to blink!

 

Artificial Tears

Last but not least, you can always use artificial tears to help supplement your natural tears, especially during the winter months when the eyes are dryer.

Artificial tears come in all sorts of different shapes and sizes. Some of our favorites include Refresh, Systane, GenTeal, and TheraTears. Try to stay away from eye drops that aim to get the red out, or other generics, as these often contain vasoconstrictors that actually make your eyes more dry over time.

As always, if you feel like your dry eye is unmanageable, or you have further questions about managing dry eye, give our office a call to schedule an appointment today!

 

Dr. Anthony Spina and the staff of Premier Eye Associates specialize in glasses, soft contact lenses, hard contact lenses, and medical eye exams. Call our eye doctor in Auburn, AL today at (334) 539-5391 or schedule an appointment online  if you are interested in learning more about preventing or treating dry eyes.  Our optometrist provides only the highest quality eye care services amongst eye doctors in the Auburn Alabama area.

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