Dry Eyes
It burns and waters – so why do we speak of dry and not watery eyes?
“Dry eyes” occur when the conjunctiva and cornea of the eyes are not sufficiently wetted with tear fluid. This can result from a lack of tear film or an incorrect composition.
The film formed by the tear fluid consists of several layers with an aqueous and a fatty phase and keeps the surface of the eye moist. Uniform wetting is a prerequisite for being able to see without discomfort for a long time. If this is not the case, chronic inflammation of the eyelids and the ocular surface occurs.
What can cause dry eyes?
A dry eye can result from a variety of reasons. Tear fluid production decreases with age. Women are more affected than men due to hormonal influences. Especially after menopause, the complaints intensify. General diseases, such as diabetes or rheumatological conditions, as well as many skin diseases, can also lead to dry eyes.
Since the conjunctiva of the eye, which is involved in the production of the tear film, belongs to the complex immune system of our body, many immunological or allergological diseases can cause or worsen dry eyes. Medications – especially psychotropic drugs, sleeping pills, or beta-blockers – as well as alcohol and smoking can intensify side effects in the sense of dry eyes.
Our environment also has a significant effect on the tear film: heating air and air conditioning lead, with too low humidity, to increased evaporation of the tear film. That is why the complaints are often more pronounced in winter than in summer. Drafts, car fans, airplane cabins, or cigarette smoke also promote evaporation of the tear film. In addition, prolonged screen work can lead to a disturbance of tear film formation by reducing the blinking frequency.
Even just two hours daily in front of a screen can irritate the eyes. Normally, a person blinks about 3–4 times per minute. Looking at a screen reduces the blinking frequency, since the eye has to focus on one spot.
Whether smartphone, laptop, or tablet – the size of the screen does not matter at all. The result is eventually painful and reddened eyes that tire more quickly. The consequence is blurred vision as well as headaches, neck, and back pain.
How can dry eyes be recognized?
- Tiredness, heavy eyes
- Red eyes
- Burning and pain in the eyes
- Sensitivity to light
- Sensation of sand / foreign body
- Tearing eyes in wind and air conditioning
- Complaints when opening the eyes in the morning
How is dry eye diagnosed?
If there is suspicion of dry eyes, a quantitative or qualitative tear film disorder should be investigated. For this, the so-called tear film break-up time is measured after instillation of fluorescein into the tear film. One observes under the biomicroscope the time span between a blink and the breaking up of the tear film, which provides information about the stability of the tear film.
Furthermore, within the framework of the so-called Schirmer test, it is possible to measure the amount of tear fluid produced. With a strip of filter paper that is hung for several minutes in the conjunctival sac, one measures the amount of tear fluid. At the slit lamp, a special microscope, a precise examination of the eyelid margin, the conjunctiva, and the cornea is also performed.
How are dry eyes treated?
Treating dry eyes is difficult, but also effective.
The eyes may require additional moisture supply through contact lenses, a PC workplace, as a consequence of an eye herpes disease and rosacea, or due to dry heating air. This is supplied by artificial tears. Treatment of dry eyes is required several times a day. It can prevent late damage to the eye. A temporary closure of the tear ducts with small plugs (so-called punctum plugs) can in many cases also bring relief.
Eyelid margin care and cleaning is another important option for the treatment of dry eyes. Cleaning the eyelid margins is done by moist-warm compresses and subsequent eyelid massage.
The Meibomian glands at the eyelid margin produce a fatty film that stabilizes the tear film and protects it from drying out. If sebum production in the glands is disturbed and these are blocked, this is called Meibomian gland dysfunction (MGD). An eyelid margin inflammation intensifies the symptoms of dry eyes noticeably:
- Burning, itching, and tired eyes
- Increased tearing
- Foreign body sensation
- Red, swollen, and stuck eyelids
If possible, in case of eyelid margin inflammation, you should avoid contact lenses and excessive cosmetics in the area of the eyes.
What can you do yourself?
- Take breaks during screen work and blink deliberately (three times daily, 20 squeezes each)
- Drink enough (at least 2–3 liters of fluid/day)
- Avoid tobacco smoke
- Pay attention to a balanced diet
With appropriate treatment, dry eyes usually show a good course. However, they can be very burdensome for those affected and limit the ability to carry out certain activities.
Do you have dry eyes?
In our Sicca specialized consultation, we analyze your complaints in detail and seek the optimal treatment path for you. Two of these treatment options are briefly presented below. Whether these are suitable for you will be determined after an initial analysis in the Sicca consultation.
Specialized consultation for dry eyes – BlephEx® treatment
With AB Max®, a rotating fine brush soaked in a special cleaning solution is used to mechanically remove deposits on the eyelid margins. This allows the secretion of the Meibomian glands to flow again. In addition, skin flakes and bacterial deposits are removed, which are the main cause of bacterial colonization of the eyelids.
Already shortly after the first application, most patients feel a significant relief of their blepharitis symptoms. The device treats effectively and quickly the condition of itching and burning eyes. Please note that this procedure is not covered by health insurance. Cost per treatment during the introductory period until March 2026: CHF 80.
In preparation for this consultation, we ask you, if possible, to refrain from eye make-up.
Specialized consultation – Blephasteam® warming goggles
The application treats the symptoms of a dysfunction of the Meibomian glands. The device warms the eyelid glands with moist warm air inside the warming goggles. After the steam treatment, the eyelids are hygienically cleaned with a special cleaning solution. A light massage of the upper and lower eyelids activates the secretion of the eyelid glands and improves the stability of the tear film.
The glands are then expressed individually at the slit lamp microscope, which allows the meibum secretion to flow out better again. Please note that this procedure is not covered by health insurance. Cost per treatment during the introductory period until March 2026: CHF 50.
Improvement of the following symptoms:
- Itching
- Dry eyes
- Foreign body sensation
- Discomfort of the eyes
- Tearing eyes
In preparation for this consultation, we ask you, if possible, to refrain from eye make-up.
