Dry eyes are a common symptom in our screen obsessed times. They are commoner in older women. Some medications such as antihistamines and common psychiatric medications can provoke it. There are also autoimmune conditions such as systemic lupus and rheumatoid arthritis that are also associated. A big reason is screen time as the eye does not move and we are not stimulated enough to blink regularly. Your doctor can detect it using a dye called fluorescein that in health should spread evenly across the eye but is patchy when the eye is dry. The eyes have sebaceous glands like the skin that produce an oily film that stabilizes our tears. These glands are the meibomian glands and they reside in the inner lids. They can get clogged and present as firm lumps. An ophthalmologist can reduce these using a simple technique but this does not deal with the underlying causes. As dry eye progresses more and more of the glands are lost. When they are gone they cannot be revived and the patient is left with a permanent dry eye.
Industrial seed oils are best avoided as they do not contain the fat soluble vitamins that the eye needs such as vit A. Traditional animal fats provide the meibomian glands the right nutrients to form the oily layer that prevent the tearfilm evaporating.
Please avoid artificial tears that contain polyvinyl alcohol. This is toxic to the eye and best avoided. A LipiScan shows the eye doctor how badly the glands are damaged. Lipiflow is a thermal and pressure treatment done in the doctor’s office, takes 12 minutes and can give symptomatic relief for 2-3 years. If you cannot access this then a hot compress to the eyes every day and blinking hard afterwards can also be effective. Avoiding vents and using a table top humidifier can also help. One of the few useful discoveries of the research called the Women’s Health Initiative is that those would ate oily fish 2-3 times a week had less dry eye. Supplements of omega 3 long chain fatty acids, DHA, EPA and GLA have had mixed results. So enjoy salmon, anchovies, mackerel, sardines and herring.