Dry Eye

Every time you blink, a thin layer of tears spreads over the front of your eye (the cornea). This tear film keeps the eye moist, smooth and comfortable, and helps you see clearly [1][2].

Dry eye (also called dry eye disease) happens when [2][3]:

• your eyes do not make enough tears, or
• your tears are poor quality and evaporate too fast. This is the most common type, and is often caused by blocked oil glands in the eyelids (meibomian gland dysfunction).

Dry eye is very common and usually long-term. It is rarely serious, but it can be uncomfortable and annoying. With the right care, most people feel much better [1].

Image to add

Simple drawing of an eye showing a thin tear film over the front surface, with small oil glands along the eyelid edge. Alt text: "Drawing of an eye with a thin layer of tears over the cornea and tiny oil glands along the eyelid edge that help stop tears drying out."

Anyone can get dry eye. It is more likely if you [1][2][3]:

• are older, especially over 50
• spend long hours on screens, because you blink less
• sit in air-conditioning, or in front of a fan or air vent
• wear contact lenses
• have blepharitis or blocked eyelid oil glands
• are a woman, especially after the menopause
• take certain medicines, such as antihistamines (allergy medicine), some antidepressants, and some glaucoma eye drops
• have an autoimmune condition, such as Sjögren's syndrome or rheumatoid arthritis
• have thyroid eye disease
• have had laser eye surgery (such as LASIK)

Dry eye usually affects both eyes. You may notice [1][2]:

• eyes that feel gritty, sandy, or like something is in the eye
• burning, stinging or tired eyes
• watery eyes: when the eye is dry and irritated, it can make extra tears to protect itself (reflex tearing)
• blurred vision that clears when you blink
• redness
• discomfort that is worse with screens, reading, wind or air-conditioning, or later in the day
• trouble wearing contact lenses

An eye doctor can check your tears and the surface of your eye with a microscope (slit lamp), often using a yellow dye (fluorescein).

Dry eye on its own does not usually cause severe pain or loss of vision. These symptoms suggest something else, such as an infection or inflammation, and need checking the same day:

• a painful red eye
• sensitivity to light
• reduced vision that does not clear when you blink
• eye pain in a contact lens wearer

There is often no quick cure, but dry eye can usually be well controlled [1][3][4].

Things you can do yourself:

• Lubricating eye drops (artificial tears) from the pharmacy. If you use them more than 4 to 6 times a day, choose preservative-free drops, which are gentler on the eye.
• Eye gel or ointment at night. These are thicker and may blur your vision for a while, so they are best used before sleep.
• Warm compresses and lid hygiene every day if you have blepharitis or blocked oil glands: a warm compress for a few minutes, then gently clean the lid edges.
• Take screen breaks. Follow the 20-20-20 rule: every 20 minutes, look at something 6 metres (20 feet) away for 20 seconds, and blink fully.
• Avoid air blowing at your eyes from air-conditioning, fans or car vents.
• Drink enough water and stay hydrated.
• Ask your doctor or pharmacist if any of your medicines might be making your eyes dry. Do not stop prescribed medicine without advice.

Treatments your doctor may offer:

• Anti-inflammatory eye drops, such as a short course of steroid drops or cyclosporine drops. Steroid drops should only be used when a doctor is checking your eye.
• Punctal plugs: tiny plugs placed in the tear drainage holes in the eyelids, so your tears stay on the eye for longer.
• Treatment of any underlying condition, such as blepharitis or thyroid eye disease.

Where to get help in Brunei

If your symptoms do not improve with the tips above, you can walk in to any Community Eye Clinic at your health centre. No referral is needed.