I routinely woke up with crusted over eyes when I was younger. Yup- allergies. But, I, thankfully, never suffered from dry eyes. (And, those that endured my performances on stage didn’t either 🙂 .) Because dry-eye syndrome is primarily found among post-menopausal women and older people.  (Watch it, there, buster!)

But, with more and more of us staying indoors- with that wonderful air-conditioning (and, therefore, low humidity), dry-eye syndrome is becoming more prevalent. Staring at computer screens all day long (or those smartphones, silly) doesn’t help either. (We seem to forget to blink.) Couple that with an autoimmune disease, antihistamines, antidepressants, Lasik surgeries- well, we might even have an epidemic on our hands.

There are two causes for dry eye syndrome. The first is the one most people think of right away- not enough tears. (It doesn’t hurt that at least one company advertises its wares on TV, as a means to counteract this problem.) But, it turns out, that is not the main culprit- it actually is the poor quality of our tears. (‘Evaporative dry eye’ is the term now applied for this problem.)

As is shown in the diagram, our eyes are protected by an oily outer layer (which is “designed” to retard the evaporation of the watery tears), and an inner watery layer (with mucins- a gel-like material, that lets the tears adhere to our eyes). If we don’t produce enough of that oily material (from the meibomian glands) or it is of insufficient quality, then the watery layer can just escape from atop our eyes. The meibomian glands release their oils (to coat the watery tear layer) each time we blink. So, if we don’t blink enough, the oily layer gets thinner, letting the tears escape.  On top of that, the oil stays within the glands within our eyelids, getting thicker and- then clogging the gland pores (so the oil can’t get released as easily.)

This phenomenon leads to burning sensations, itchy eyes, and even blurry vision for us. (This is exactly why those of us who use contact lenses aren’t allowed to wear them 100% of the time, as well.) If the syndrome is severe, the dried eye surfaces can now have exposed some nerves; that sensation feels like we’ve been stabbed in the eyes. (Yes, Susan, that means you.) If you are also wearing contacts, this can make your eyes prone to infection- or even developing a scratch on the eye’s surface.

The treatment for this syndrome is not yet fully rationalized- in other words, it’s hit or miss. Most folks rely on over-the-counter eye drops, some of which claim to replenish the oily layer, as well. If that is upon what you are relying- a lot, you should consider buying only those products that don’t use preservatives, since the preservatives can lead to additional, different discomfort. (Yes, the preservatives do keep bacterial counts low. Just don’t keep the opened containers very long, even though fluid remains in the container.)

Some folks aim for ointments and gels- typically, those with a severe version of this syndrome. But, these treatments blur your vision, so you probably will be told to only use them at night. (They are especially useful if you don’t fully close your eyes at night, while sleeping.)

Restasis (Allergan Pharmaceuticals) is a prescription drug (the one heavily advertised on TV), to help folks produce more tears. Other folks may rely on omega-3 fatty acids (to reduce gland inflammation, affording more secretions of the oily layer). There is also evidence that antibiotics (topical or oral) may improve the oil production, alleviating the problem.

Of course, you could (that means should) try warm compresses or eye massages to unclog the eye glands- first! (I rely on 1 tsp of boric acid mixed in a quart of boiled water; let it cool a little first!) Twice a day for a five minute soak may give you the relief you seek!

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