Dry Eyes

Dry eyes (keratoconjunctivitis sicca) is very common in Singapore. It not only affects the elderly but also young adults. You may be affected by dry eyes due to a combination of factors which includes either a decrease in tear production, increased tear evaporation, or both.

Factors that may exacerbate dry eye symptoms include:

• Contact lens wear
• Working in a dry or windy environment
• Staring at computer, tablet or phone screens, or books for a prolonged duration
• Certain medications that reduce tear production, for example: antihistamines for running nose

You may experience one or a few of the following symptoms for dry eyes:

• Itch
• Burning sensation
• Redness of the eyes
• Foreign body sensation (eg. feeling like there is sand in the eyes)

You will need to have your eyes assessed to determine the appropriate treatment modalities. Avoid situations or environments that make your dry eyes worse.

In mild cases, use of artificial tears up to four times a day may be adequate. In severe cases, we recommend the use of preservative free artificial tears, which can be used as frequently as required. Eye ointments are also used and these tend to lubricate the eye for longer periods, but may lead to slightly blurred vision. These ointments are useful at night.

In severe cases, the use of biological tear substitutes (i.e. autologous serum) can be initiated. Serum is the fluid component of blood that remains after clotting and has been used in patients with severe dry eye disease. Disadvantages of this modality of treatment include the invasiveness of collecting serum and risk of infections.

In patients exhibiting signs of inflammation; usually with severe dry eyes, the use of eye drops that can reduce inflammation may be recommended. Examples of such eye drops are steroids and cyclosporin. As these medications have potential side effects, the use of such medications should be undertaken with close medical supervision.

Tear conservation approaches are also available. Tears drain though openings on our eyelids (punctum) into the nose. These openings can be blocked with the use of temporary or permanent occlusion techniques to reduce the drainage of tears from the eye and therefore reduce dryness.

Moisture chamber eye-glasses and humidifying devices have also been suggested to be effective.

Concurrent eyelid disease may also contribute to dry eye symptoms. Treatment and management of these issues will be useful in alleviating dry eye symptoms. Please refer to the Blepharitis/Meibomitis section for further information.