Sarah's Health Notes: Help for dry eyes

Itchy, tired, watery eyes? Maybe blurred vision and light sensitivity? You’re not alone. Dry eyes affect about a third of adults in the UK, as Sarah Stacey knows all too well. In this week’s Health Notes, she explains the problem and offers self-care solutions which work for her and many others.

According to The Aston Dry Eye Study* published in 2023, about one third of adults in the UK suffer from Dry Eye Disease (DED), also called Dry Eye Syndrome (DES). The symptoms of this chronic condition affecting the surface of the eyes commonly include a gritty, burning or itchy feeling, blurred vision, eye fatigue, watery eyes, and light sensitivity.

It’s all down to the film of tears over the surface of our eyes. This keeps eyes moist, lets eyelids move comfortably over them, enables you to see clearly, and protects the cornea from dryness and damage by slooshing away irritants, as well as containing antimicrobial agents to fend off infection.

When the tear film is impaired, however, the result is DED/DES, basically because of a lack of tear production or a poor-quality tear film. Tears may evaporate too quickly due to problems with the lipid (oily) layer of the tear film – known as ‘evaporative dry eye’ – or the lacrimal (tear) glands may not produce enough aqueous (watery) fluid – called ‘aqueous deficient dry eye’. Sufferers can have one or both of these underlying conditions, as well as other contributing factors including nutrient deficiencies (mainly several vitamins), inflamed eyelid glands, autoimmune disease or allergic eye problems.

Age is a big factor, and I’ve experienced the symptoms more as the years passed. Especially if I’m spending long hours at the screen. Women tend to suffer more than men, due to hormonal fluctuations and also cosmetic use: eye make-up, particularly eyeliner (tight lining can be a culprit here) and mascara, can block the vital meibomian (oil) glands at the base of eyelashes, affecting the tear film. Ingredients in make-up can also irritate eyes and disrupt the production of tears.

Another problem you might not think of is spending lots of time outdoors, because of exposure to wind, dry air and airborne irritants, allergens and pollutants, as well as UV rays. Hot weather with low humidity can make eyes dehydrated and reduce tear production. As with working at a screen, being outside apparently tends to make you blink less – and blinking is crucial so tears are evenly spread around the surface of the eye to hydrate the cornea. You should aim to blink every four seconds… (Pause to blink ….)

Other factors are smoking/smoky environments, drinking alcohol, medications e.g. some antidepressants or blood pressure drugs, blepharitis (inflammation of eyelids), and autoimmune conditions including lupus and Sjögrens syndrome.

If you feel the problem is serious and symptoms don't improve with DIY remedies (see below), please do go and see your doctor or an optician. I go to an optician for a sight test every two years who does a battery of eye tests and advises on concerns like DED/DES. So far, I’ve only needed to use lubricating eye drops morning and night (lots of good options but I like preservative-free VisuXL Eyedrops in the liquid format; the formula contains a longer lasting form of hyaluronic acid, plus CoQ10 and vitamin E) and I’m adamant about taking big sunglasses with me everywhere. Plus I try to take screen breaks every hour.

Self care for dry eyes:

• OTC eye drops – ask a pharmacist for recommendations; Victoria Health in house pharmacist Shabir Daya recommends preservative-free Hycosan Shield

• Large wrap around sunglasses – helps protect against environmental invaders and UV light

• Keep hydrated: sip, sip, sip still water through the day; also try a humidifier in dry environments or just keep a bowl of water near your desk

• Clean eyelids thoroughly am/pm: if you find eyelashes get sticky/crusty, it could be a sign of blepharitis (it was with me); try wipes such as Blephaclean, formulated for eyelids

• Keep make-up brushes and other applicators scrupulously clean: obviously eye make-up applicators but also foundation and powder brushes as you really don't want bacteria in or around your eyes and, yes, I know cleaning brushes is a boring chore but it is worth it

• Bin old eye make-up: the rule of thumb is three months for mascara if you use it every day, six months if you use it occasionally. If it gets hard, throw it out immediately. A good tip is to use travel sizes. Replace liquid and gel eyeliners after three to six months, pencils may be safer longer if you sharpen them as you sharpen away the bacteria. (My favourite eyeliner is – help! – years old now and I’m off to bin it the moment I finish writing this…)

And also…

• Consider supplements: nutritional deficiencies, which may lead to dry eyes, can affect even people who eat the best diet so it makes sense to take a good basic supplement like DoSe by VH Daily Multivitamins One-A-Day, (excellent value BTW)

• Omega-3 supplements, once a staple recommendation from eye specialists, haven’t been shown to directly affect DED/DES but since the condition is considered to be an inflammatory disease and omega-3s are anti-inflammatory, it’s still sensible to up your intake of oily fish and possibly take a supplement such as Life Extension Super Omega-3 EPA/DHA Fish Oil. Omega-7s may also help dry eyes, according to Shabir Daya; try SIBU Omega-7 Sea Buckthorn Oil.

More recently, researchers have found that taking a probiotic and prebiotic supplement can help dry eyes. This is because the gut microbiota (microorganisms in the gastrointestinal system including bacteria, fungi and viruses) is important in regulating low-grade inflammation throughout your body including the eyes. Shabir Daya says: ‘Probiotics may help dry eye syndrome by reducing systemic inflammation and improving the gut-eye axis with strains like Lactobacillus casei, Bifidobacterium lactis, and Streptococcus thermophilus showing promise. Mega Probio contains these three probiotic strains.