Eye Dryness

WHEN TO SEE YOUR DOCTOR

* Your eyes are also extremely irritated, gritty, red, itchy, burning or sometimes tear excessively.

* You also have rheumatoid arthritis and dry mouth.

* You have increased sensitivity to light.

What Your Symptom Is Telling You

Blinking spreads a three-layered film of water, oil and mucus over your eyes like wiper fluid washing over a car's windshield. But once you reach age 40, the tear glands begin to slow down and you have less of this soothing eye fluid, according to George Sanborn, M.D., associate clinical professor of ophthalmology at the Virginia Commonwealth University/Medical College of Virginia in Richmond. Probably because of hormonal shifts that dry up secretions, women at or past menopause experience more severe tear turn-off than men or younger women, says Dr. Sanborn.

No matter what your age, you may develop a case of dry eyes if you're taking secretion-drying antihistamine/decongestant medications, antidepressants, diuretics or beta blockers. (See your doctor if such medications seem to be irritating your eyes.) Other things that can dry up eye moisture include sitting in a dry aircraft cabin, being outdoors on a windy day, air conditioning and home heating. Your eyes' waterworks can also dry up if you are extremely fatigued or have diabetes or a severe vitamin A deficiency (which is very rare in America) says Dr. Sanborn.

In any case, without sufficient lubricating tears to coat your eyes and swish away sand, pollen and infectious microbes, your eyes become dry and tender. This can make wearing contact lenses as uncomfortable as hiking with a pebble in your shoe. Worse, in severe cases, dry eye can lead to vision-robbing bacterial, viral or fungal infections.

Symptom Relief

Whether your eyes are slightly dry or as arid as the Sahara, it's possible to get tears flowing again.

Blanket your eyes with a warm washcloth. If your eyes become dry only now and then, try placing a warm compress on your eyelids for five to ten minutes two or three times a day, suggests Eric Donnenfeld, M.D., an ophthalmologist in private practice in Manhassett, New York. "A warm compress is sometimes all it takes to stimulate tear flow," he says.

Blink, blink, blink. Sewing, watching TV or typing at a computer are all activities during which people tend to forget to blink. As a result of staring, eye moisture evaporates, according to Paul Michelson, M.D., senior staff ophthalmologist at the Mericos Eye Institute in La Jolla, California. Taking frequent blink breaks replenishes the tear film, he says.

Reach for fake tears. For a chronic dry eye problem, over-the-counter artificial tears can soothe tender, gritty eyes. These products contain saline and a film-forming substance, such as polyvinyl alcohol or synthetic cellulose. They may be used as often as necessary. You'll need to experiment with different products to see what works best for you, says Dr. Michelson. Thinner brands, for example, need to be inserted more often but are less likely to blur vision or leave a residue on eyelashes. To insert eyedrops, gently pull down the lower lid and squeeze a drop into the corner of the eye near the nose. Hold your eyes closed for a minute. "Blinking pumps out the drops," explains Dr. Michelson.

Use preservative-free products. If you're using drops more than four times daily, look for brands that say preservative-free, advises Mitchell H. Friedlaender, M.D., director of corneal services in the Division of Ophthalmology at the Scripps Clinic and Research Foundation in La Jolla, California, and coauthor of 20/20: A Total Guide to Improving Your Vision and Preventing Eye Disease. Preservatives such as thimerosal can build up to toxic concentrations and may damage the surface of the eye, he says. If your eyes do not respond to lubricants after using them for a week, see your doctor.

Make gooey-gooey eyes at night. If you wake up feeling like the Sandman left too much sand in your eyes, inserting a tear-replacement/ moisture-sealing ointment at bedtime can cease your misery, says Dr. Michelson. These extra-thick ocular ointments contain white petrolatum and mineral oil and last longer than drops.

Wear an eye moisture chamber while you sleep. Specially designed moisture shields can be worn at bedtime to help prevent moisture evaporation from your eyes.

Have your tear drains plugged. If your dry eyes do not respond to artificial tears, your doctor can insert a tiny collagen plug in your tear drainage canal, says Dr. Sanborn. The plug remains in place for about six months and helps conserve the tears you do produce and keeps artificial tears in your eyes longer. (Or your doctor can permanently seal the tear duct with surgery.)

Prevent Arid Orbs

If you have borderline dry eye, certain environmental factors can worsen your problem and may cause extreme discomfort. Here's how to keep your eyes' waterworks in working order.

Moisturize the night air. Switching on a humidifier or placing a pan of water on the radiator in the bedroom can keep eyes from drying out while you sleep, says Dr. Friedlaender.

Wear wraparound shades outdoors. Sunglasses with lenses that extend past the sides of your eyes or side shields on your regular glasses help keep out drying sun and wind, says Dr. Michelson.

Aim the air nozzle that-a-way. Hair dryers and home air vents blowing on your eyes can worsen dry eye, says Dr. Friedlaender. It's especially important to aim overhead air nozzles away from eyes on airplanes, where the atmosphere is very drying anyway, he says.