Managing Dry Eyes

Oct 30, 2012

By Barret Procyshyn, Pharmacist at the Dauphin Clinic Pharmacy


If you suffer from scratchy, sore or dry eyes which seem to feel fatigued all the time, you are not alone. Dry eyes are a very common problem, affecting up to 30% of people. If symptoms reoccur or are continuous, it is referred to as dry eye disease. Issues often arise because the symptoms of dry eyes are often confused with allergies or eye infections, called bacterial and viral conjunctivitis.


A pharmacist will attempt to identify the true cause of those reddish or dry itchy eyes. It is important to remember if the irritation started in one or two eyes. While dry eye disease affects both eyes, an infection usually starts in one eye and can later spread to both eyes, and the redness is usually accompanied by a discharge. A viral infection may produce clear discharge; while a bacterial infection produces a colored discharge, leading to sticky eyelids in the morning. A bacterial infection may also be accompanied with colored discharge from the nasal passages due to the common cold.


A healthy eye is maintained by a tear film consisting of mucous, fats, proteins, electrolytes and chemicals which assist our immune system; which all work to protect and nurture the eye. The tear film should be nourishing eye tissue, clearing or flushing debris and lubricating the eye. When tears are dysfunctional there is damage to the eye tissue and irritation occurs.


Allergic conjunctivitis occurs in both eyes, as does dry eye disease and may cause a clear discharge, which may confuse it with a viral infection. So to find a difference, we can identify allergies by the presence of nasal symptoms such as a clear runny nose. Dry eye disease will not accompany any nasal symptoms.


Dry eye disease symptoms occur with environmental exposure, prolonged computer work and extended driving. Your eyes may have a gritty feeling or the sensation like something is in your eye. Dry eye disease causes excessive tearing and potentially mild pain. Your eyes will likely feel tired and contact lenses may be extremely uncomfortable to wear.


Before turning to medication use, there are some things you can do to help your eyes feel and see better. Avoid irritants such as cigarette smoke and windy environments. If your house has dry air a humidifier may help. Fitted glasses or goggles help during activities like swimming and skiing help significantly. When working on a computer remind yourself to blink more often and take short breaks to rest your eyes. Ensure your contact lenses are replaced at appropriate intervals.


Mild symptoms of dry eyes can be treated with ocular lubricants which are available over the counter. These work by replacing the missing tears in the eye. The pharmacy carries these products in many formulations including ointments, gels and drops. Gels and ointments remain in the eye for a longer duration but can impair vision and can be a little messy. Usually our pharmacists will recommend using drops during the day and ointments or gels at bedtime.


A major complaint of eye drops is the irritation caused by the preservatives in the drop. The preservatives are necessary in a bottle of eye drops to maintain their stability and safety. If a preservative is found to cause irritation the lubricant can be switched to one with a different preservative. The other option is to use preservative free eye lubricants. These products contain lubricant in single use packaging. They are more expensive but are very well tolerated. Some eye drops contain antihistamines and decongestants but these ingredients may actually cause more irritation in dry eye and are unlikely to help. After your pharmacist helps select the appropriate product it should be tried for a few weeks to determine its effectiveness.


If over the counter products are deemed not effective referral to a family physician or even a specialist may be necessary. There are some very effective prescription eye drops on the market as well. Everyone values their eye sight greatly but sometimes we neglect the health of our eyes. While a pharmacist can help for mild symptoms of dry eyes it is very important to see your optometrist regularly.


The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.


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As always if you have any questions or concerns about these or other products, ask your pharmacist.


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