Tears play an important role in keeping the eyes healthy. A person can develop dry eye if they produce too few or low-quality tears. Dry eye specialists are medical professionals who help treat cases of dry eye, alongside identifying the conditions that are causing it.
Dry eye can be an uncomfortable and potentially harmful condition. If someone leaves dry eye untreated for too long, it can damage the surface of the cornea.
Many people can treat dry eye with over-the-counter (OTC) eye drops and gels, but some will need the help of a dry eye specialist.
This article examines the causes and effects of dry eye, the conditions dry eye specialists treat, and available treatment methods.
Dry eye specialists treat a range of conditions that cause changes in tear production. A few of them include:
- meibomian gland dysfunction, which causes tiny glands in the eyelids to stop producing the necessary amount of oil needed for tears
- blepharitis, which is inflammation at the edge of the eyelid in the location of the oil-producing glands
- evaluation of autoimmune disorders that cause dry eye, such as Sjögren’s syndrome, sarcoidosis, lupus, or rheumatoid arthritis
A specialist will conduct a thorough health history and an external examination of the person’s eye and eyelid. They will examine the eyelid and cornea using special lights.
The specialist will analyze a person’s tears for quantity and quality and any abnormalities. The specialist will also examine the meibomian glands and advise the person on the best course of treatment.
When a person blinks, a layer of tears spreads across the surface of the eye. These tears comprise three layers: oil, water, and mucus.
The eye’s meibomian glands produce oil that coats the outside surface of the tear. It provides a smooth surface for the tear and maintains the tear’s moisture.
Water makes up most of the tear, which cleans the eye’s surface. This water comes from the eye’s lacrimal glands.
The white part of the eye — the conjunctiva — produces mucus, which helps the tear’s watery layer spread across the eye. If the mucus is not present, the tear will not adhere to the eye.
Dry eyes occur when a person’s eyes do not produce enough tears, or when one or more of these layers do not form correctly, affecting the quality of the tears. In this case, the tears may not stay on the eye long enough to provide moisture or wash away debris.
There are many causes of dry eye, including environmental and medical.
Environmental conditions, such as wind, dust, air-conditioning or heating, cold, or sunlight, can dry a person’s eyes. The presence of smoke can also produce a drying effect.
Hormone fluctuations can change the way the body produces tears, particularly for people who are postmenopausal.
Medications such as antihistamines, decongestants, and diuretics can reduce the production of tears.
Medical conditions, such as autoimmune disorders — including lupus, rheumatoid arthritis, and Sjögren’s syndrome — cause dry eyes.
Activities that reduce blinking for an extended time, such as looking at a computer screen or reading, can also cause dry eye for some people.
Anyone can develop dry eye, but people over the age of 50, females, and those who wear contact lenses have
- a scratchy, gritty feeling
- stinging or burning in the eye
- light sensitivity
- blurred vision
There may also be mucus in or around the eyes, and the eyes may be producing extra poor-quality tears that do not stay on the eye’s surface.
Many people try treating dry eye on their own with OTC artificial tears.
It can be difficult to know when to consult with a doctor. If any of the following occur, a person should contact a medical professional:
- problems performing normal activities
- changes in vision, especially when using a digital device, even after purchasing high-quality glasses
- little relief from eye drops
- burning, stinging, scratching, or watery eyes
- symptoms continue following at-home treatment, such as using artificial tears, warm compress, humidifier, and reading glasses and reducing screen time
A person should work with a primary care physician or an eye doctor for a local dry eye specialist recommendation.
If a primary care physician or eye doctor is unavailable, people can consider using an online directory to find an eye doctor to ask for a recommendation. Resources include the American Optometric Association, the American Academy of Ophthalmology, and the Optometrist Network.
There are several treatments for severe dry eye that a specialist may recommend, depending on the cause.
For less severe dry eye, using artificial tears throughout the day may provide enough lubrication to solve the issues.
If normal artificial tears have not worked, a dry eye specialist may prescribe one of several types of prescription artificial tears.
For blepharitis or inflammation of the eyelid, warm compresses can relieve swelling and help reduce blockages of the oil glands. In this case, a person may also require prescription medications.
For more severe cases of dry eye, doctors will sometimes use tiny plugs to block the tear ducts so that tears stay on the surface of the eye longer. The plugs are removable, but a more permanent way to achieve this is to cauterize the tear ducts.
There is also a special type of contact lens called a scleral lens that sits on the conjunctiva. It is positioned slightly above the surface of the cornea, and fluid is placed in the space between the contact and the cornea, providing continuous moisture.
A dry eye specialist can assist people who are dealing with particularly dry eyes and the resulting discomfort.
Dry eye can result in damage to the cornea if someone does not treat it quickly enough. Therefore, if home care is not working, a dry eye specialist is an important next step.
Dry eyes result when the eyes do not produce tears in the proper amounts, or the tears do not comprise one of the three layers: water, oil, or mucus.
The goal of treatment is to provide moisture to the eye’s surface and relieve any gland blockage along the structure of the eye.
A dry eye specialist may recommend treatment, including prescription eye drops, tear duct plugs, and special contact lenses.