Itchy, Burning Eyes Can be Sign of Dry Eye Syndrome

According to some estimates, up to 20 percent of the population over age 50 may suffer from chronic dry eye syndrome, a decrease in the amount of natural tears available to lubricate the eyes. These men and women suffer from itchy, burning dry eyes. If left untreated, dry eye syndrome can lead to a decrease in vision.

Shahzad Mian, M.D., director of refractive surgery at the University of Michigan’s Kellogg Eye Center, says he hears patients complain of a chronic sensation of grittiness or the sensation of a foreign body in their eyes. Others complain of burning or itching, and sometimes light sensitivity. With more advanced disease, patients have a decrease in vision.

“This is a condition that tends to occur more in women, especially post-menopausal women. Patients who use contact lenses are also predisposed to this condition,” Mian says.

In addition to contact lenses, there are a number of other environmental factors that can trigger symptoms, including looking at a computer screen for a long time or spending time outdoors in dry heat or cold, windy conditions. And some medications also can increase the risk of dry eye disease, such as allergy medications, antidepressants or some very commonly used medications for blood pressure.

“Dry eye disease can have a significant impact on quality of life because it is a chronic condition that gets exacerbated from a number of common factors. It can further progress and cause permanent damage to the eyes if not treated appropriately,” Mian says.

Susan Ludwig, 58, has had dry eye syndrome for 10 years. She says there were times when she’d just go to bed because neither drops nor warm compresses would bring relief.

“It’s almost like having sand in your eyes. They feel gritty, and if they are very dry, the over-the-counter eye drops don’t work,” she says. “The heavier drops with more lubricant blur the eyes, so it’s difficult to work through the day using those.”

For Ludwig, tiny plastic plugs that cover her eyes’ tear ducts have brought relief. The procedure, called punctal occlusion, can close the ducts either temporarily or permanently, conserving natural tears and making artificial tears last longer.

“Punctal occlusion does not adversely affect vision. In fact, it may improve the vision by improving the tear film and the state of the dry eye in the patient,” Mian says.

He says ophthalmologists believe that dry eye disease has a strong inflammatory component, so a number of new therapies that are being developed focus on trying to reduce inflammation on the surface of the eye, also helping to improve tear production.

“There is some research that suggests that nutritional supplementation may be very helpful as well. Just as in cardiac disease, omega-3 and omega-6 fatty acids may play a strong role in helping to improve dry eye conditions,” Mian says.

Omega-3 fatty acids are found in fish-oil supplements, fish such as salmon and tuna, and in walnuts. Good dietary sources for omega-6 fatty acids include cereals, eggs, poultry, most vegetable oils and whole-grain breads.

While over-the-counter lubricating eye drops are fine for self-treating mild cases of dry eye disease, people who are using these kinds of medications and not getting relief, or whose quality of life is being hampered, should seek the help of an ophthalmologist for further treatment.

In addition to a simple, painless test to measure tear production that involves placing filter-paper strips under the lower eyelids to measure the rate of tear production, ophthalmologists may also prescribe Restasis, the only prescription eye drops approved for dry eye syndrome. This medication may help improve tear production in dry eye patients.

Provided by ArmMed Media
Revision date: July 4, 2011
Last revised: by Jorge P. Ribeiro, MD