How does the eye maintain its lubrication?
Dry Eyes Afflict Many of Us. Consider the tear film that coats and lubricates the eye to be a three-layer sandwich, with each layer being produced by a different gland. The upper and lower eyelid meibomian glands produce an oily outer layer that stabilizes the film. Blurred vision is likely if the film breaks up too quickly. Following that are two sets of lacrimal glands, which supply the watery tears. The innermost layer is the mucin layer, which attracts water and aids in the spread of the tear film across the surface of the cornea. Even if the tear supply is adequate, a lack of mucin can prevent the cornea from wetting and damage its surface.
Both the meibomian and lacrimal glands have receptors for the sex hormones androgen and oestrogen, and a decrease in hormone levels may explain why dry eye symptoms increase in menopause women and in men receiving anti-androgen therapy for prostate cancer. Indeed, the most common cause of dry eye is the evaporation of moisture from the eyes caused by dysfunction of the meibomian glands, which results in tear film instability.
Sometimes the attempted solution, such as using multiple-use eye drops containing preservatives, can aggravate the eye irritation. After using such drops, I developed chronically red eyes, which were quickly resolved when I switched to preservative-free single-use lubricants. While single-dose eye drops are only approved for one use, Dr. Udell says it’s usually safe to use them for up to two days to save money and waste, as long as the tip isn’t touched and is covered after each use.
Medications used to treat other conditions can impair tear production. Antihistamines, beta-blockers, oral contraceptives, diuretics, and medications used to treat Parkinson’s disease, anxiety disorders, asthma, chronic obstructive pulmonary disease (C.O.P.D.), and abnormal heart rhythms are common culprits.
What can you do to get rid of dry eyes?
Dry eye problems can be exacerbated by smoky or extremely dry air, which can be caused by indoor heating and air conditioning. Long before the pandemic, I started wearing eyeglasses outside to shield my eyes from dryness and grit, especially on windy days and always when riding my bicycle. Wind, glare, and airborne allergens can all be blocked out using a variety of glasses.
Wear goggles if you swim to keep salty or chemically treated water from irritating your eyes.
Dr. Udell also recommended applying warm compresses to the eyelids in the morning and at night to help the meibomian gland operate. Every night, I carefully cleanse my eyelids from the nose outward with a warm washcloth. If you wake up in the morning with “sleep in your eyes,” repeat the washcloth cleansing, then apply artificial tears.
