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Five things you should know about dry eye

University of Minnesota Health Optometrist Andrew Ritter, OD, shares tips and information about dry eye symptoms and treatment.
Optometrist Andrew Ritter, OD, FAAO, who works with patients at the University of Minnesota Health Adult Ophthalmology (Eye) Clinic.

Your eyes feel dry, irritated, gritty—or maybe even too watery. You could have a condition known as dry eye, in which your tear glands fail to produce enough quality tears to lubricate the eye.

For some people, the condition produces a mild discomfort. For others, it can be a significant concern.

Regardless of the severity of the condition, people who may have dry eye should see an eye care provider for diagnosis and treatment—instead of self-treatment with over-the-counter remedies. We caught up with Optometrist Andrew Ritter, OD, FAAO, who works with patients at the University of Minnesota Health Adult Ophthalmology (Eye) Clinic. Ritter shared five things you should know about dry eye.   

There are two kinds of dry eye.

Patients with evaporative dry eye produce tears that evaporate too quickly. This occurs when glands located in the eyelid do not secrete enough of the oily substance in tears, which helps slow evaporation.

In this instance, the poor quality of the tears leads to rapid drying, even if the quantity of tears produced hasn’t decreased. The other type, aqueous-deficient dry eye, happens when your glands are not making enough of the watery component in your tears to maintain a healthy eye surface. This affects the quantity of your tears

“Either of these can cause what we call Ocular Surface Disease—or an imbalance in the tear layer,” Ritter said. “So, you’re not getting the appropriate tear balance and that creates discomfort and irritation.”

You can have dry eye even if your eye feels lubricated.

Often, Ritter’s patients are surprised to hear they have dry eye. “They’ll tell me that their eyes are always wet and they’re constantly wiping tears away,” Ritter said.

These patients typically have evaporative dry eye, and their tears do not have enough oil. Without that oil, a patient’s eyes may feel irritated and produce a surplus of watery tears to compensate. Ironically, this makes your eyes feel wetter or more watery—though the excess moisture still isn’t properly protecting the eye.

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Symptoms of dry eye include blurry vision and irritation.

“The number one complaint or dry eye symptom we see is occasional blurred vision,” Ritter said. Patients may also experience sharp pain, irritation, a gritty sensation on the eye or even a “foreign body sensation” that feels like piece of sand or an eyelash in their eye.

Patients with dry eye also say their vision comes and goes, especially when they are reading or on the computer, Ritter said. This last symptom is particularly common, because people tend to blink less when focused. Blinking spreads your tears smoothly across the eye, and long periods without blinking may make dry eye symptoms worse.

Dry eye is treatable.

Like other medical conditions, dry eye has a spectrum of severity. Some patients hardly notice the symptoms. For those patients, occasional use of artificial tear solution may be appropriate. Ritter often recommends warm compresses for dry eye sufferers. The glands that produce the oily solution in tears can become clogged. Warm compresses may help break up the clogged ducts and improve the flow of the oil. Sometimes, Ritter may also recommend antibiotics.

Redness relief drops are only a short-term fix.

Not all artificial tear solutions are equal. Ritter cautions patients against redness relief drops. The drops may make dry eye worse because they constrict the eye’s blood vessels. “They’ll make your eye look better in the short term—but in the long run the drops can cause problems,” he said. “If you feel you have dry eye, you should go see an eye care provider.” They can tell you whether drops are right for your eyes. “It’s best to not take matters into your own hands and try and treat the condition by picking out your own over-the-counter drops,” he said.