Are your eyes too dry? Understanding the surprising effects on vision

• Dry eye occurs when the eyes don’t produce enough tears or when tears evaporate too quickly, and leads to symptoms which can affect vision and daily activities.
• Lifestyle habits, the surrounding environment, eye conditions, and systemic health issues can worsen or increase the likelihood of dry eye.
• Treatments for dry eye involve modifying the surrounding environment, lubricating eye drops, warm compresses, and a diet rich in vitamin A and omega-3.

The tear film is the layer of moisture that covers the surface of the eye, and is produced by our glands.

It consists of three main layers, which need to be kept in balance for optimal function:

• Lipid layer – top layer of tear which to help aqueous layer does not evaporate rapidly
• Aqueous layer – the middle layer of the tear that consists of nutrient and antibacterial component to keep the eyes healthy
• Mucous layer – the bottom layer of the tear that act like glue to stick tears onto eyes

Dry eye occurs when there is an imbalance in the tear film (for example, the eyes do not produce enough tears), which can lead to symptoms that can noticeably impact vision and eye comfort.

An imbalance in the tear film in dry eye can noticeably impact vision and eye comfort.

Think of the tear film as a mirror. When the mirror’s surface is smooth, the reflection is clear. But when the surface is scratched or uneven—like in dry eye disease—the image becomes distorted. Each time you blink, the tear film is refreshed. A healthy tear film keeps vision clear between blinks, while a poor-quality tear film causes blurred vision due to instability.

The tear film has other important roles too. It minimizes eye irritation and discomfort by washing away debris and acting as a protective buffer between the eyeball and eyelids when we blink. In addition, the tear film allows the passage of nutrients to the eye and has antibacterial properties to fight against germs. Without a healthy tear film, comfort may compromised.

• Blurred or fluctuating vision
• Increased sensitivity to bright lights
• Eye fatigue 
• Red eyes
• Watery eyes 
• Foreign body sensation
• Grittiness 

• Living environment 
  Temperature, wind exposure, humidity, and air pollution create conditions that can cause the eye to dry more rapidly.
• Digital device use 
  One tends to blink less during continuous smartphone and computer use, causing the eye to become dry. Besides, prolonged screen time can worsen myopia.
• Contact lens wear
  Contact lens wear can affect lipid layer spread, tear film stability and tear evaporation which make the tear film less stable and cause dry eye.

• Meibomian gland dysfunction 
  Meibomian gland dysfunction (MGD) is a chronic disorder of the meibomian glands – the oily glands that help supply the tears with oils to keep the eyes moist. Blocked or poorly functioning glands lead to reduced oil production and poor-quality oils that contribute to dry eye disease.
• Ocular allergy
  Ocular allergy and dry eye are common eye disorders that often occur together and share similar symptoms. Ocular allergy can lead to dry eye, and dry eye can worsen allergic reactions.
• Diabetes and insulin resistance 
  Obese children, particularly those with insulin resistance, have reduced tear film production and stability compared with normal children.
• Inflammatory and autoimmune diseases
  Autoimmune conditions – especially Sjögren’s syndrome, can promote dry eye and lead to ongoing and more severe symptoms. 
• Systemic medication
  Many systemic medications, such as antihistamines, blood pressure medication, diuretic and more are associated with dry eye as a side effect.

• Modification of environment
  Avoid the face from being directly exposed to air blowing from a fan, air conditioner or heater. Add an air humidifier and purifier to improve humidity and air quality.
• Diet and Nutrition
  Foods rich in vitamin A and omega-3 fatty acids are beneficial for dry eye. Carrots, pumpkins, spinach, and sweet potatoes are rich in Vitamin A, whereas fish, seeds and nuts are a good source of omega-3 fatty acids.
• Lubricating eye drops
  Lubricating eye drops, also called ‘artificial tears’, can temporarily help relieve dryness and discomfort. Over-the-counter moisturizing gels and ointments may also soothe your child’s eyes. Consult your optometrist for most suitable option for your child.
• Lid hygiene
  Dilute a gentle shampoo (e.g. baby shampoo) with water to form a soapy mixture. While the eyes are closed, gently scrub the eyelids along the lash margins, and thoroughly rinse with water afterwards. 
• Warm Compression
  Applying warmth can help unblock the oil glands and improve tear quality. Place a warm towel, microwavable eye mask, or self-heating eye mask on the closed eyes for at least 10 minutes.