By Shomace Fallah-Loer, D.O., ophthalmology & eye services
Every time you look at a screen, you blink about one-third as often as you normally would, and even then, you’re probably not closing your eyes all the way. Multiply that by every scroll, swipe, email and episode of your favorite show and it makes sense why so many of us are walking around with chronically dry eyes.
Not blinking enough is just one of many things we do that affect our eyes. The eye is a small, sensitive system that depends on the precise balance of water, oil and mucin; bad habits repeated daily for years are enough to tip the balance.
Here’s what’s happening in your eye
The tear film is a thin layer of fluid that coats the surface of your eye, protecting it and keeping it moist. It’s made up of two layers: a thin layer (0.2 millimeters) of water, topped by a layer of oil and mucin. The water comes from the lacrimal gland, which is under the eyebrow, and the oil and mucin come from the little glands along the lid margin. Mucin holds the whole tear film together, while the oil acts as a shield, sealing the water to prevent it from evaporating. Without the layer of oil, the water on your eyes would evaporate almost as soon as you opened them.
Causes of dry eye
There are two main categories of dry eyes: evaporative dry eyes, where the tear film evaporates faster than it should, and aqueous deficiency, which happens when the lacrimal gland doesn’t produce enough water.
Most cases of dry eye are the evaporative kind and that’s mostly related to the tiny oil glands lining your lids. As you age, or as bacteria, dead skin and debris builds long the lash line, these glands can become blocked. If they remain blocked for months or years, the oil glands can atrophy, which is why eye experts recommend catching the problem early, before the damage is permanent.
A number of factors can cause blockage of the oil glands or interrupt the balance of the tear film. These include:
- Age (gland function and tear production decline over time)
- Autoimmune conditions such as Sjögren’s syndrome (affects moisture-producing glands)
- Certain medications (antihistamines, antidepressants, acne medications and hormone therapy)
- Demodex mites (microscopic organisms that live at the base of the lashes and can inflame the lid margin)
- Diabetes
- Environmental irritants and seasonal allergies
- Incomplete blinking Rosacea
- Screen time
- Thyroid eye disease
Daily habits that make a difference
It may seem simple, but blinking fully as much as every six seconds can help alleviate dry eye. When you close your eyelid, the action squeezes oil onto the tear film. Other daily habits that help maintain healthy eyes include:
- Avoiding direct airflow when you’re in your car or in front of a fan
- Eating omega-3 rich foods like salmon, sardines or fish oil
- Using a humidifier, especially during the summer or in your office where you look at a screen for long periods of time
- Washing eyelids daily (use eyelid cleaning solution or even baby shampoo)
- Wearing sunglasses during the day
- Apply a warm compress and massage the eyes with the soft, fleshy area at the base of the thumb
Applying artificial tears can help add moisture, but it should be used as a temporary fix, not a solution to the problem. Choose a preservative-free brand, as the chemicals in some brands can make the condition worse.
A warm compress does wonders
A warm compress over the eyes is one of the best and most soothing things you can do to relieve dry eye. The heat from the compress melts blocked oil in the meibomian glands along the lid margins. Once it’s liquified, massaging the eyes with the fleshy area at the base of the thumb helps squeeze it out. Without that step, the melted oil just sits there instead of flowing to the tear film.
For the heat to work, it has to be hot enough and applied long enough — about 10 minutes. The right temperature is around 110 degrees Fahrenheit. If you don’t have a thermometer, the water shouldn’t feel lukewarm, but it shouldn’t feel scalding, either.
Although there are many types of compresses available for purchase, you can simply soak a washcloth or rag in a bowl of warm water or fill a sock with uncooked rice and heat it in the microwave for a minute or two. Always test it first for heat spots before placing it on your face.
After 10 minutes, spend about 30 seconds massaging the eyelids in a pattern: 10 strokes left and right, 10 strokes up and down, then circles both clockwise and counterclockwise. Not only does this squeeze out the liquified oil, but over time it encourages the glands to produce more.
Why contact lens hygiene matters
Contact lenses can cause problems when they’re overused or when the fit isn’t right. It’s important to not wear them longer than they’re meant to be worn — about 10 to 12 hours — to properly clean them, use the right solution and follow the instructions. Tap water or river water should never be used. Hands should be clean before putting lenses in or taking them out; and never sleep in contact lenses. Good contact lens habits matter in helping to keep your eyes in balance, and so does getting the right fit.
Protect your eye health
Like brushing and flossing your teeth, minimizing your risk of dry eye only takes small, consistent habits. It’s also important to get regular exams. The Portland Clinic Eye Clinic provides comprehensive eye-care services, from routine exams and glasses/contact lens prescriptions to complex medical and surgical eye treatment.
Dr. Fallah-Loer is a comprehensive ophthalmologist, providing a full range of medical and surgical eye care at The Portland Clinic south location and the Ambulatory Surgical Center.
