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A Comprehensive Look at Dry Eye Syndrome
By Gifty Kwakye
Just as the last bouts of winter rolled out of Maryland and spring began painting the trees with pretty shades of green, my mother came down with a bad case of seasonal allergies. She sneezed, coughed and felt absolutely miserable for weeks, getting only mild relief from several over-the-counter medicines she tried. The worst part, in my opinion, was her temporary loss of taste given her love for spicy traditional Ghanaian dishes. I admit we all took turns teasing her about this, especially as she began to feel better. But things took on a slightly serious turn after she returned from work one day and complained of intense eye irritation, pain and blurry vision. Both eyes were clearly blood-shot from the constant hours of rubbing she had put them through.
She described a sensation of sand in her eyes but despite several examinations we could not detect a single foreign object. What was particularly concerning for me was the persistent and aggressive manner in which she rubbed at her eyes, which could have caused serious injuries to her cornea. After two days of watching this develop with no improvement, I sent her off to see our family physician, hoping he will be able to detect and remove whatever was in her eyes. She returned home several hours later with a prescription for artificial tears and a diagnosis of Dry Eye Syndrome—a relatively common disease affecting over 30 million Americans.
What is DES?
Our eyes are naturally covered with a thin layer of tears which provide constant lubrication and moisture to aid in vision and general comfort. Research demonstrates that tears are made up of three essential layers which serve the following functions:
Name |
Container |
Functions |
Lipid layer (outer) |
oils |
provides a barrier that prevents evaporation of the aqueous layer |
Aqueous layer (middle) |
water and proteins |
promotes spreading of the tear film and control infectious agents; also flushes out dust, debris or foreign objects that might get onto the eye |
Mucous layer (inner) |
mucin |
coats the cornea and allows for even distribution of the tear film |
Source: Table Adapted from http://en.wikipedia.org/wiki/Tears
When one or all of these layers fail to function adequately, a person may experience dry, itchy eyes accompanied by other symptoms such as pain, light sensitivity, redness, blurry vision or a burning sensation. Others complain of a constant gritty sensation, like sand in their eyes, which can cause mild to severe discomfort. Interestingly, a few people report intermittent excessive tearing in addition to their irritating dry eye symptoms. Doctors believe that this is a reflex response to counteract the dryness sensed on the surface of the eyes through the production of large amounts of tears to restore moisture. However, since too much is produced, it generally spills down the cheeks and does not stay long enough around the eyes’ surface to be beneficial. Once the reflex system is turned off, the eyes return to their dry state again. Symptoms tend to worsen towards the end of the day after continuous use of the eyes for reading or watching television. Similar to seasonal allergies, DES seems to have an environmental-weather component with increased symptoms occurring during dry, windy, high temperatures or low humidity periods.
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