A complaint that is often encountered in everyday life, are too dry eyes, the so-called sicca syndrome. Especially women between 50 and 70 complain about the annoying accompanying symptoms such as foreign body and pressure feelings, burning pain, red-swollen eyelids and plenty of tearing.
About every third patient in an ophthalmological practice suffers from dry eyes (sicca syndrome, keratoconjunctivitis sicca or dry eye syndrome). It is estimated that around ten million people in Germany are affected by different levels of sicca syndrome, including more women than men, mainly due to the hormonal changes during menopause .
Symptoms: the most common complaints in dry eyes
Dry eyes are formed when there is not enough tear fluid produced or their composition is disturbed. This causes the tear film on the eye surface to rupture too soon (ie before the next blink of the eye), resulting in dry spots.
As a result, the eyelids can no longer glide easily over the eyes when eyelid. They scrape over the ocular surface, which not only leads to unpleasant sensations, but also promote inflammation and infection and can cause damage to the outer layer of the ocular surface, the cornea.
The following symptoms are the most common signs of the sicca syndrome:
- itching
- eyestrain
- Eye pain , press
- Foreign body sensation (“sand grain sensation”)
- Eyelid strike is perceived as unpleasant
- reddened conjunctiva
- glued eyelids after waking up
- excessive tears in the eyes
- tired eyes
- photosensitivity
In many cases, however, the complaints are considered by the affected person as not requiring treatment and there is no or only inadequate therapy. However, the dry eye is not a harmless disorder, it is the most common cause of corneal perforation and can lead to impaired vision or even blindness.
Causes of dry eyes
To protect it, the eye wears a thin tear film composed of lipids, watery and mucous (viscous, slimy) components. Continuous eyelid strokes ensure that the tear fluid produced in various glands of the eye is distributed evenly over the anterior area of the cornea and conjunctiva and that the protective film does not tear. If this does not work, it causes wetting disorders of the ocular surface. The lack of moistening leads to the sicca syndrome.
Often, no clear triggers can be found. Most of the sicca syndrome is caused by internal and external causes.
Among the external factors include for dry eyes:
- long stay in rooms with air conditioning
- Drafts or overheated rooms (low humidity)
- Blower in the car
- Ozone (also from copiers, printers)
- cigarette smoke
- long-lasting and concentrated screen work (too low eyelid frequency (wink) the tear film evaporates stronger)
- inadequate lighting of the workplace
- Incompatibility of contact lenses
- insufficient glasses
- Preservatives (such as benzalkonium chloride) in eye drops used against other eye diseases (for example, glaucoma )
The “inner” factors include:
- Age-related changes in the mucous membranes
- Hormonal changes in tears during pregnancy or menopause
- Diseases of the lacrimal glands (such as inflammations)
- Narrowing (stenosis) in the laxative lacrimal ways
- insufficient sleep
- Vitamin A deficiency
- certain diseases associated with reduced production of tear fluid (Parkinson’s disease, rheumatism , atopic dermatitis , diabetes , thyroid disease)
- Sjörgen Syndrome (Immune system disorder additionally associated with dry mouth)
- Malposition of the eyelids
In addition, many medications can lead to decreased tears. These include:
- oral contraceptives (“pill”)
- High blood pressure ( beta blocker )
- Anti-allergic agents (antihistamines)
- Eye drops against reddened eyes (“whitener”)
- sedative
- antidepressants
- Diuretic agents
Diagnosis of the sicca syndrome at the ophthalmologist
The ophthalmologist has the various examination options and tests to determine whether the symptoms actually come from a wetting problem of the ocular surface or if there is another reason. For example, tension and redness can also be caused by conjunctivitis .
To do this, the doctor not only looks at the surface of the eye. Also, the wrinkles on the lid edge show the expert, whether it is dry eyes. The height of the tear film at the lower edge of the lid also plays a role. The composition of the tear film is examined by the ophthalmologist with a special slit lamp. This examination is important in order for the patient to receive the right eye drops for treatment, for example with a particularly high lipid content, if his tears contain too little of it.
Schirmer test for dry eyes
With the Schirmer test, the doctor can check the production of tear fluid. To do this, he carefully guides a small piece of paper made of special absorbent material into the lower conjunctival sac. Depending on the moistening of the examination material, the doctor will determine whether it is actually dry eyes.
If the ophthalmologist has found only a mild or moderate dry eye, the person concerned can treat the symptoms on their own. Check-ups with the ophthalmologist (once or twice a year) are recommended.
Eye drops and gels: what helps with dry eyes?
The most common treatment for sicca syndrome is the use of eye pills, gels or ointments . This will either replace insufficient tear fluid in dry eyes (“artificial tears”) or improve the consistency of the tear film. If necessary, the preparations are dripped into the conjunctival sac several times a day. The goal of the therapy is a better wetting of the ocular surface and thus a relief of the symptoms .
Most of the preparations for the treatment of the sicca syndrome of thick consistency, so they remain as long as possible on the ocular surface. The disadvantage is that vision may sometimes be limited shortly after use ( blurred vision ).
Use special eye drops
Especially recommended are preservative-free preparations. Because preservatives such as the commonly used benzalkonium chloride can damage the cornea of the eye and adversely affect the composition of the tear film.
In the case of very severe tears, the doctor may consider obliteration of the lacrimal tears (ie tear fluid discharge sites) or occlusion using small punctum plugs.
What else helps with the sicca syndrome
It is often possible to contribute a great deal to maintaining your own eye health with simple protective measures. For example, sicca syndrome sufferers should avoid drafts and smoky spaces . To protect against wind, it is recommended to wear sun or bicycle glasses.
Even a humid indoor climate and plenty of liquid drunk throughout the day (at least 1.5 liters) relieve the symptoms. Make sure you have sufficient breaks during longer screen work. In case of acute complaints, cool compresses can be applied.
Prevent dry eyes: the best tips
Today’s living and working conditions favor the emergence of dry eyes (Sicca syndrome) to a much greater extent than in times when there were no computers and air conditioning systems.
Dry eyes can be prevented with the following measures:
- Avoid overheated and smoky rooms
- Protect eyes from drafts
- if possible, no longer stay in rooms with air conditioning
- wear glasses instead of contact lenses
- sufficient sleep for the regeneration of the eye
- Use cosmetics sparingly in the eye area
- regular check-ups at the ophthalmologist
For prolonged screen work, the Sicca syndrome is prevented by the following procedure:
- Ensure adequate lighting of the workplace
- take a break of five minutes every hour
- wink frequently (the tear film is replaced by the blink of the eye)
- Pay attention to the correct distance between the eye and the screen (50 to 80 centimeters)
- Screen must be positioned glare-free (at right angles to the window)