What Causes Dry Eyes? Diagnosis and Treatment

Did you know that dry eye symptoms are the most common reason why people head into their eye doctor’s office? It is so common that it is estimated more than 30 million people in the U.S. suffer from some form of dry eye disease and the discomfort associated with the irritation, grittiness, burning, and poor vision that comes with it. If you are fed up with your dry eye symptoms, it may be time to schedule your own visit to the eye doctor to find out what is causing your dry eyes and the treatment options available to provide relief.

What Causes Dry Eyes?

Several diagnostic tests can be used to evaluate and help determine what may be causing your dry eyes. It begins with a thorough eye exam and an in-depth conversation with your eye doctor. This first step is often the most important and revealing. In addition to determining the overall health of your eye, the time spent in an eye exam should include a discussion about your experience with symptoms and a detailed overview of your general health.

We discuss what causes dry eyes, as well as contributing factors for dry eye syndromes. Only through a complete health history can an eye doctor get the information they need to help make an accurate diagnosis and a viable course of treatment. If you are going to take the time to go to the eye doctor, you want to make sure that time is as productive as possible. To help out, here are a few tips to help you prepare:

1. Detail your dry eye symptoms. Is there a specific time of day, activity, or environment that bring on symptoms or increases their severity? Be as specific as you can about the sensations you experience.
2. Put together a list of all of the medications – both prescription and over-the-counter – that you take on a regular basis. Include any vitamins or supplements. It might be easier to simply take pictures of the containers with your phone, so your doctor can see the exact dosage and instructions.
3. Be prepared to talk about your lifestyle, particularly any recent life changes (like a move or job change). Do you have any ongoing or seasonal medical conditions? Do you wear contacts? Do you smoke? Have you recently started mountain biking? Do you have a pet? Do you travel frequently on an airplane? You never know what might be contributing to your symptoms.

As part of the eye exam, one or several tests may be used to help evaluate your eyes and get to the bottom of what might be causing your dry eye symptoms. These may include:

• The Schirmer Test: This diagnostic test is used to measure the amount of tears your eyes produce. A small strip of blotting paper is gently placed under each of your lower eyelids where it is held in place for five minutes. After removing the blotting paper strips, your doctor can measure your tear production by the amount of strip soaked by your tears.
• Epithelial Staining: This test uses eyedrops with a temporary dye in them to evaluate your tears and the surface of the eye. The dye shows how quickly your tears evaporate. It highlights any areas on the surface of the eye that don’t have adequate lubrication. Damage on the surface of the eye is also revealed.
• Meibomian Gland Evaluation: In our previous article, we discussed the glands in and around your eyes that help produce tears. Some of the glands along the edges of your eyelids are called Meibomian glands. They express an oily substance when you blink. That oil helps keep your tears from drying out, so your eyes stay properly hydrated. Meibomian glands can become blocked or stop producing enough or good quality oil. Your doctor can look at them in detail through a magnifying lens. By gently pressing on the eyelids the glands are expressed and the quality and quantity of the oil that is produced can be evaluated.
• Tear Chemistry: A sample of your tears may also be taken to get a more detailed report of the makeup of your tears.
• Diagnostic Scans: As part of the eye exam, the surface of the eye is evaluated by a variety of devices – you simply look into them – that capture images of the eye from different angles and levels of detail. These provide a lot of important information regarding the overall health of your eye.

Questions to Ask Your Eye Doctor

Once you and your doctor have enough diagnostic information, you will have a discussion about your specific situation. You might want to write down the questions you want to ask your eye doctor about what causes dry eyes. Not sure what to ask? Here are some basics to get you started:

• What do you think is causing my dry eye?
• What tests do you think I need to get a clear picture of what is going on?
• What do you recommend to treat my dry eye?
• Will my eyes get better or worse on their own?
• Can treatment prevent progression of the disease?
• What are the potential side effects of the treatment you recommend?
• Is a generic available for the medicine you’re recommending?
• Are there other options?
• If my particular health condition or medication is part of what is causing my dry eye symptoms, what is the best way to manage the two conditions?
• When should I expect the symptoms to go away?
• When should I come back to see you?

There are several treatment options for dry eye, including medications, lubricating eye drops, holistic remedies, therapeutic treatments and procedures. We provide an overview of the various treatment options your eye doctor may recommend to you.