By Jenny Livanos, Holistic Optometrist
Longer hours spent on digital devices have increased dry eye issues – I am seeing this in the practice much more frequently. As a holistic optometrist, I am interested in addressing the root causes of dry eyes and treating naturally for long-term benefits.
Tears provide lubrication and they wash away foreign material in the eyes, reduce the risk of eye infection and keep the eye surface smooth and clear for optimal vision.
Dry eye syndrome is a common condition in up to 50 percent of the population. Tear production in the eyes may be insufficient, tears might be of poor quality or the meibomian glands along the bottom eyelids that produce the fatty tear layer may become blocked. Chronic dryness can create inflammation and damage the surface of the eye.
There are 3 layers in tears. The top layer is made of oils produced by the meibomian glands and helps prevent evaporation of the tears. Dysfunction in these glands (known as MGD) is a significant cause of dry eye symptoms and is present in more than 80% of dry eye issues. The middle layer is an aqueous component produced by the lacrimal glands in the upper lids. The bottom layer is mucin produced by goblet cells in the conjunctiva and helps spread the tears evenly on the surface of the eye.
Dry eyes can feel gritty, stingy, burning, itchy, heavy and sore. There may also be redness, blurry vision, sensitivity to light and difficulty in opening the eyes in the morning. The eyes may also water due to this irritation.
Health issues and medications can cause dry eyes
Eyelid issues like blepharitis, seen as inflammation and discharge along the lid margin and lashes; structural lid issues, for example, turning in or out that can affect the blinking motion that spreads the tear film evenly across the eyes; demodex mites that live on the eyelashes.
Previous history of eye surgery, for example, laser corrective surgery or cataract surgery.
Ageing – tear production decreases with age.
Allergies and the use of antihistamines.
Health conditions affecting tear quality, quantity and blinking – for example, autoimmune diseases like rheumatoid arthritis, Sjogren’s syndrome; skin conditions like rosacea and dermatitis; Parkinson’s disease; thyroid issues; diabetes.
Hormonal changes in women – pregnancy, oral contraceptive use and menopause can exacerbate dry eye issues.
Preservatives in eye drops.
Medications including decongestants, nasal sprays, blood pressure medication, diuretics, acne medication and antidepressants can reduce tear production.
Dry eye syndrome is multifactorial
Identify and minimise your risk factors, then try a natural approach. This could lead to less dependence on artificial tears and better comfort and vision.
Consider these risk factors:
Inadequate water intake – aim for around two litres per day.
Insufficient sleep or poor sleep (I recommend 7 – 9 hours and retiring to bed early).
Low intake of omega-3 fats and vitamin A in the diet.
Environmental factors – exposure to air-conditioning and fans at home, work and in the car can trigger dry eye issues. Very cold or hot or windy weather could trigger dry eye symptoms.
Excessive close work on computer or mobile phone – when we concentrate on a task we blink less.
MADE (mask-associated dry eye) – wearing a facial mask can dry the eyes by forcing air out of the top of the mask and over the surface of the eyes.
Smoking.
Blue light exposure – minimise your exposure by adjusting your computer settings and wearing blue-light blocking glasses when using digital devices.
Wearing contact lens – try the healthier daily lenses and wear glasses as an occasional alternative and at the end of the day.
Makeup – wear less and remove at the end of the day.
Better nutrition
Better nutrition can help increase tear production and quality in the long-term. Pro-vitamin A from carrots, sweet potatoes, green leafy vegies, pumpkin, tomatoes and capsicums can help.
Similarly helpful can be healthy fats (omega-3’s) from chia seeds, hemp seeds, flaxseed, walnuts, seaweed and algae. There are also modified omega-3 supplements to assist dry eyes.
Standard treatments
Treatments aim to increase tear production and tear volume and prevent the loss of tears.
Standard treatment includes:
Non-preserved lubricant drops – preservatives can cause irritation especially if used often. There are many lubricants available which supplement the different layers of the tears. An optometrist can assist in the best type of drop for your dry eyes. In more severe cases gels and ointments can be used before bedtime.
Immuno-modulatory drops prescribed by an eye specialist reduce inflammation and trigger increased production of tears. These need to be used long-term to gain benefits, but can have systemic side-effects.
Antibiotics taken orally or as eye drops in severe cases.
Steroid eye drops.
Punctal plugs block tear ducts where tears drain away, so tears can remain on the surface of the eyes longer.
Natural treatments
Natural eye drops add to the tear layers and help with inflammation and infection. They contain ingredients like Manuka honey, aloe vera, coconut oil, chamomile, propolis, castor oil and vitamin A.
Cleaning your eyelids every day with dilute baby shampoo or special lid wipes or foam with coconut oil and tea tree oil.
Warm compresses or eye masks with gel or silicon beads that can be heated. Follow this with a gentle lid massage and squeezing the meibomian glands to unblock them in the direction of the lid margin.
IPL (intense-pulsed light) therapy for blocked meibomian glands. IPL has been used for many years in beauty and skin treatments. This in-office treatment helps rejuvenate the meibomian glands and their functioning. A hand-held device flashes the bright light onto the upper cheeks and lower lids and is a specific wavelength that can be absorbed by dilated blood vessels.
A humidifier will add moisture to dry indoor air. Try a bowl of water in the room to help hydrate the air
Eye masks can be worn during sleep to prevent dryness overnight.
Wrap-around protective eyewear can be worn when outdoors, especially in windy/hot/cold weather.
Improving your visual habits
It is important to have regular visual breaks during prolonged close work. Use the 20/20/20 rule: every 20 minutes look at least 20 feet (6 metres) away for 20 seconds.
Keep your computer below eye level, so that your eyes are less exposed to the environment.
Concentrating on close work will slow your blinking rate and may contribute to dryness. Remember to blink!
Try some blinking drills: lightly blink 10 – 15 times every 20 minutes as a vision break.
Full blinking by periodically squeezing eyelids together can spread tears more evenly.
Treat dry eyes early
Dry eyes can be debilitating, causing discomfort, pain, anxiety and difficulty functioning in daily life. It is best to treat dry eye symptoms early by assessing your risk factors and improving lifestyle, diet and visual habits.
Jenny Livanos is a Holistic Optometrist
Dr Livanos conducted a webinar with us on natural eye care, where she teaches a group of exercises for healthy eyes as well as goes through nutrition for healthy eyes. The recordings of these 2 sessions are available for purchase here.
