Dry Eyes

“Dry eyes” doesn’t sound very serious, however doctors recognize the condition as a medical diagnosis.  Patients who have severe dry eyes will certainly agree it is an undesirable problem. For others it may be a nuisance that comes and goes and often doesn’t even require treatment.

Some background information: Several glands in and around the eye and eyelids produce the “normal” tears which are composed of 3 layers – an oily layer, a watery layer, and a mucous layer.  Together these layers evenly coat the surface of the eye between blinks. When all three are in balance, the eye has a smooth, moist surface for clear vision and comfort.  The tear film also can wash away and rid the surface of the eye of allergens and bacteria (with special enzymes).

Most often dry eyes are the result of not enough of the oily component of the tear film. This problem can affect men, but is more common in women, especially over the age of fifty. Certain medications (antihistamines, birth control, and diuretics) can create dry eyes or worsen a pre- existing case.

Symptoms of dry eyes vary quite a bit. They often come and go to some extent but never cease totally, as the condition tends to be chronic once it starts.  Dry eyes do seem to become more symptomatic toward the end of the day for many people.  Common symptoms are:

– A feeling that something is in the eye.

– Blurred vision that comes and goes and seems to be sometimes affected by blinking.

– A gritty sensation

– A dry sensation

– Watery eyes! (This happens when the dry eye surface sends a message to the brain that there’s something wrong.  The brain responds by sending back a signal to flood the eye with tears to fix the problem.  The trouble is that these tears are not the “normal” tears described previously.  These are merely reflex tears from the “crying gland” and do not have the good properties of normal tears)

During the eye examination the doctor will rule out other causes of eye irritation, which might be causing the symptoms.  These might be allergies, foreign bodies, eyelid inflammations, eyelid abnormalities, or eye infections – viral or bacterial.  Some patients will actually have dry spots on the front surface of the eye (cornea), which can be seen through the doctor’s examining microscope.  Sometimes the doctor will do extra testing to quantify the tears being produced.

Once the diagnosis is established, treatment typically is designed to manage the symptoms.  Mild symptoms would receive less aggressive treatment.  If the symptoms are only occasional and other problems have been ruled out, the best course is to not treat at all and see how things go – essentially just be aware of the problem and watch for increasing symptoms.

If treatment is indicated, lubricating eye drops are usually the initial choice.  Several things are important with respect to artificial tear preparations:

1.  They are not all the same. Most are formulated to match the eye’s normal tears and do not contain a component that, “Gets the red out” … this is a blood vessel constrictor and in the long run it is often best to avoid.  What works well for one person may not be good for another.  The preservatives used in some formulations may actually cause a reaction in some patients so our doctors tend to favor the ones that are preservative-free.  We try to keep samples available so we can find what’s best in each individual case.

2.  The dosing is very important.  It is not possible to over-treat dry eyes, but it can be easily under-treated.  If artificial tears are not used until you are aware of “dryness”, they typically will work only for a very short time.  The “dry feeling” will quickly return. Usually the doctor will recommend a minimum of 4 drops over the course of a day at regular intervals.  It’s often better to start with too much, and then taper back to the least amount needed to reduce the symptoms of discomfort.

Sometimes drops alone are not enough and the doctor will recommend an ointment or gel form of eye lubricant.  Ointments and gels are soothing and tend to stay in the eye for quite a while before washing out.  They do tend to temporarily blur the vision a bit due to their thick, viscous nature.  Oftentimes the ointment or gel will be used at bedtime only.

Another alternative treatment for difficult and more severe cases involves blocking the drainage canal between the eye and the nasal passages with a plug that is easily inserted by the doctor in the office.  This effectively pools tears in the eye by reducing the outflow.  Temporary plugs that dissolve in a few days can be inserted first.  If the result is satisfactory, longer lasting plugs or permanent plugs can be inserted.

Prescription eye drops are a new development in treating dry eyes.  The medicine is called Restasis.  It is used twice a day for dry eyes and used in cases for which relief from symptoms has been difficult by other means.  It is not guaranteed that it will work equally well for all patients.

Another new development in dry eye treatment involves the use of nutritional supplements and can actually help many patients.  The following is an article we prepared for our patients concerning flaxseed oil.

Some eye care researchers are now recommending taking flaxseed oil by mouth for chronic dry eye problems.

If you want to try flaxseed oil, try to find it in liquid form or 1000 mg. gel capsules. Current studies have been done by having patients take at least 2 capsules/day for 1 month, then at least 1 capsule/day from then on.  Other sources recommend as much as a tablespoon per day, which would equal about fourteen 1000 mg. capsules.  Flaxseed oil is rich in Omega-3 type fatty acids and linoleic acid and researchers are finding that a lack of these oils in our diets can cause a number of health problems, particularly autoimmune/inflammatory type problems.  You should be able to purchase flaxseed oil over the counter at the drugstore or health food store or on the internet.  It is very important that it be fresh because any type of oil becomes oxidized over time. Oxidation is caused by heat, light and air and affects every type of oil we consume.  If you can find fresh oil or capsules that do not have a disagreeable odor (from oxidation), try to keep them in the refrigerator or freezer in an airtight container.  Should the oil develop a powerful odor, discard it.

For best absorption, take flaxseed oil with food.  It is easily mixed into juices and other drinks, and it has a nutty, buttery flavor that complements cottage cheese, yogurt and many other foods.  You can also use it instead of olive oil in salad dressing.  Don’t cook with it, however, as this will deplete the nutrient content of the oil.

Here are a couple of websites that can offer more information.


Whole Health MD



Print Friendly

Connect with us on Facebook

Come See Us

2205 S. Seneca
Wichita, KS 67213

M-F: 9:00 a.m. to 5:30 p.m.


General Optometric Services

Contact Lenses

Full Service Dispensary with in-house Laboratory

Sports Eyewear and Sunglasses

Cataract Surgery Co-management

Refractive Surgery Co-management

Diagnosis and Management of Non-Surgical Eye Disease

Foreign Body Removal

Dry Eye Treatment and Therapy

Low Vision Services