Dry eye syndrome, also known as dry eye disease or keratoconjunctivitis sicca, is a common eye condition that affects millions of people worldwide. This condition occurs when the eyes do not produce enough tears, or when the tears evaporate too quickly, causing the eyes to become dry, itchy and irritated. This condition results in blurring of vision, discomfort, light sensitivity and other symptoms due to disturbances to the eye’s tear film.
According to a local study entitled ‘Prevalence and Risk Factors of Dry Eye Disease’, the prevalence of dry eye syndrome is estimated as 7 per cent to 34 per cent worldwide, occurring at a higher frequency in the elderly above 50 years of age and twice as high in women than in men. In Malaysia, dry eye syndrome was only considered a disease on its own in 2007.
Symptoms & Causes
“The symptoms of dry eye syndrome include burning sensation akin to stinging, sandy sensation when closing and opening the eyes, soreness, watery eyes, light sensitivity, heavy eyelids, deteriorating vision and red bloodshot eyes. The syndrome severely reduces the patient’s ability to read, drive and use screens for a prolonged period of time, significantly affecting the quality of life, particularly in middle-aged and elderly patients,” says Dr Norazlina Binti Bachik, Clinical Director of KPJ Centre for Sight.
There are many causes of dry eye syndrome, divided between internal and external causes, with dry and humid climate like ours being one of the external causes.
“Some of the internal causes of the disease include hormonal imbalance or changes, namely declining or lack of oestrogen in pre-menopausal or post-menopausal women, inflammatory systemic disorders like rheumatoid arthritis and Sjogren’s Syndrome, allergic eye disease, and consumption of drugs like anti-histamines and certain anti-hypertensives,” explains Dr Norazlina.
“Meanwhile, the external factors include chronic contact lens wear, long hours on gadgets like computers or handphones and environmental factors like heat and wind. Drier climate specifically aggravates the condition and patients must take better care of themselves especially in our country,” she adds.
Diagnosing Dry Eye Syndrome
In addition to women in general and the elderly, Dr Norazlina also highlights that people who are in tropical countries especially those who receive year-round sun, those working outdoors like construction workers and those on long hours of intense desk-bound computer work in air-conditioned rooms are more prone to dry eye syndrome.
After assessing whether a potential patient with symptoms similar to dry eye syndrome fall into at risk groups as mentioned above, further tests are conducted for diagnosis. The examination entails assessing the eye surface particularly looking for signs of dryness on the cornea. This can be achieved through using dyes like fluorescein or Lissamine green or Red Bengal stains. Meanwhile, tear meniscus (a thin layer of tears that collects along the lower edge of your eyelid when your eye is open, keeping your eyes moist) can give us an idea of how much tears are present in one’s eye.
Treating Dry Eye Syndrome
Unfortunately for dry eye syndrome, there is no single treatment involved, but rather it must be a multi-angle approach.
“Usually, we begin treatment for local eye conditions such as blepharitis by using lid scrubs or warm compresses on the eyelids to improve the flow of meibum.* A judicious use of lubricants either in the form of drops or gel or even ointment also takes place, depending on the severity of the dryness. Mitomycin C eyedrops can also be helpful in inflammatory cases,” says Dr Norazlina.
(*Note: Blepharitis is a common inflammation of the eyelids, and meibum is an oily substance that helps keep tears from evaporating too quickly.)
Apart from medication, some lifestyle changes also need to be undertaken such as avoiding long constant hours on gadget use by taking frequent breaks, wearing sunglasses or any other eye protective gear when doing outdoor activities to prevent direct effect on the eyes from wind or sunlight, ensuring adequate daily water intake and even taking supplements like fish oil.
What advice would Dr Norazlina give to individuals living in drier climates who are concerned about developing dry eye syndrome or experiencing discomfort and vision problems related to their eye health?
“To start with, wearing protective eye gears like sunglasses with ultraviolet light blocking properties when going outdoors is very important. Lubricating eyedrops use will also help to alleviate the symptoms through the day. Once the root cause of the dryness has been identified, compliance to the treatment instituted by the eye doctor must be adhered to ensure the effectiveness of the treatment regime.
Don’t forget to stay healthy by drinking enough fluids and taking balanced healthy diet, with supplements taken as needed.”