Dry eye symptoms occur when either your eyes don’t produce enough tears or if the tears that they do produce are of poor quality. Common symptoms of dry eye include burning, “tired” eyes, scratchiness, grittiness, fluctuating vision, the feeling of something in the eye and tearing.  Tearing often misleads patients to believe that they are “watery,” not dry.  However, with poor quality/deficient tears the brain reflexively compensates by increased tearing in an effort to keep the eye well lubricated. Certain activities and situations can exacerbate dry eye symptoms.  Below are tips on things to avoid/do to hopefully reduce your symptoms.

Avoid air blowing in your eyes.

• Don’t direct hair dryers, car heaters, air conditioners or fans toward your eyes.
• Wear wraparound glasses to protect from moving air.

Wear goggles while swimming.

Stop smoking and/or avoid smoke.

Add moisture to the air. In winter, consider a room humidifier in addition to the furnace humidifier.

Take eye breaks during long, concentrated visual tasks. When you read, watch TV, do computer work, sew, drive, etc., you blink less often.  This causes your baseline tear-film to evaporate which leads to dry eye symptoms. If safely possible, close your eyes for a few minutes or blink repeatedly for a few seconds to help spread your tears evenly over your eye. When participating in up close tasks utilize the 20/20/20 rule—Every 20min, look 20 feet away for 20 seconds.

Computer/Screens

• Reduce screentime if possible
• Utilize the 20/20/20 rule (see above)
• If your computer screen is above eye level, you’ll open your eyes wider to view the screen. Position your computer screen below eye level so that you won’t open your eyes as wide. This may help slow the evaporation of tears between blinks.
• Some studies show that blue light contributes to a decrease in blink rate, consider glasses with blue light filters.

Many medications contribute to dry eye. Common ones are listed here.

• Antihistamines and decongestants.
• Pain relievers. Ibuprofen and naproxen may contribute to dry eye
• Birth control pills.
• Miscellaneous drugs. Some drugs used to treat high blood pressure, diuretics, some antidepressants and isotretinoin-type drugs for treatment of acne.

Use over-the-counter artificial tears.  Artificial tears are wetting agents that afford short term relief; they do not increase tear production. How often you need to put them in will depend on your symptoms.

• Drops with preservative. Preservatives are added to some eyedrops to prolong shelf life. You can use eyedrops with preservatives up to 4 times a day. Using the preserved drops more often than 4 times daily can cause eye irritation.
• Preservative-free tears. They come in packages of single-use vials and special bottles.  They can be used as often as needed. If you need drops more than four times a day, non-preserved drops are a better choice than drops with preservatives.
• Consider over-the-counter lubricating liquid gels, gels and ointments.Lubricating eye gels and ointments coat your eyes and provide longer lasting relief than drops. They are thicker than drops and can cloud your vision so they may best be used just before bedtime (especially ointments).
• Tears with extra oil content.If you have been diagnosed with blepharitis or meibomian gland dysfunction, tears with increased oil content may work best for you.  (Examples of these include Systane Complete, Systane Balance, Retaine MGD, Refresh Mega-3).

Control lid inflammation (Blepharitis). Inflammation along the edge of your eyelids (blepharitis, rosacea, meibomian gland dysfunction) causes poor quality tears. Controlling this improves tear quality.

• Apply warm compresses.  These can be a warm wet wash cloth or a warming mask.
• Cleanse the eyelashes and eyelid margin. Commercial lid scrubs, as well as sprays and foams are available over-the-counter.  (Brands include Optase, Ocusoft, Ivizia and Theratears among others)
• Do the above actions at least daily, even when you don’t have dry eyes symptoms. Stopping this daily routine may cause your dry eyes to return.

Dietary support. Good nutrition, hydration and supplements help to produce good quality tears.

• Eating foods rich in Omega-3 fatty acids and may relieve dry eye symptoms. (They are also good for your arteries heart, brain, etc).
• Omega-3 supplements like flax and fish oil may help.  The dose should be is at least 2000mg but 3600mg is recommended daily.  There is a supplement specific for dry eye called Theratears Nutrition for Dry Eye.
• NOTE: If you are pregnant, have congestive heart failure or are on blood thinners consult your doctor before using flaxseed or Omega-3 supplements.
• Make sure to have enough vitamin A in your diet as Vitamin A deficiency can cause dry eye.  Be careful with supplementation of Vitamin A as it is possible to overdose.