Don't let dry eyes make you see red

Do your eyes often feel dry and scratchy, particularly in windy or air-conditioned areas? Do your eyes often turn red or feel itchy, and does your vision blur?

All of these are possible symptoms of dry eyes, a common condition that affects 10-30% of the general population.

Dr Louis Tong, a consultant at Singapore National Eye Centre (SNEC) and Singapore Eye Research Institute (SERI), told AsiaOne Health in an e-mail interview that this eye disorder is more prevalent in the elderly, with almost all of them having some extent of mild dry eyes.

Surprisingly, watery eyes can also be a symptom of dry eye syndrome. "Reflex watering is very common," explained Dr Tong. "Other complaints include heaviness of the lids, grittiness, burning, feeling as if there's a foreign body in the eye, or just feeling 'tiredness in the eyes'," he added.

According to Dr Tong, the following are some of the risk factors for developing dry eye disorder:


  •     Perimenopausal or older age
  •     Eyelid inflammation
  •     Contact lens wear
  •     LASIK
  •     Systemic medications such as hormones and anti-depressants (i.e. oral contraceptives, HRT, and antidepressants such as SSRIs)
  •     Thyroid disease
  •     Rheumatologic conditions such as rheumatoid arthritis and Sjogrens syndrome
  •     Poor nutrition or sleep habits
  •     Environmental factors, i.e. air conditioning and use of computer monitors

Dry eyes are usually treated with over-the-counter eye drops. For many sufferers, this usually suffices to alleviate their discomfort. Severe cases can be treated with steroids, punctal occlusion or surgery.

Unfortunately, the condition tends to persist - it is not something that will usually go away on its own unless the symptoms are caused by medication. In such cases, altering or discontinuing the medications* should result in improvement of the symptoms.

While dry eye disorder is usually a permanent condition, "change in environmental conditions or the use of eye drops often makes the condition less noticeable or better tolerated", said Dr Tong.

Dry eyes and LASIK

Dry eyes and LASIK

One of the potential complications of LASIK surgery is the development of dry eyes after the procedure.

"Dry eyes caused by LASIK is still quite a puzzling condition," noted Dr Tong, who pointed out that a large number of patients suffer from the condition for only a few months, while others may experience them for a lot longer.

"However, I don't think that this is due to variables associated with the procedure. Rather, I think that there are some inter-individual factors that we do not understand well at the moment, such as differences in each patient's threshold for feeling the dry sensation, or subtle differences in the ocular surface prior to the procedure," he added.


If left untreated, dry eyes will continue to cause irritation and even pain for the patient.

Fortunately, permanent visual loss is unlikely, said Dr Tong, with the rare exceptions of severe dry eye caused by medical conditions such as Steven Johnson syndrome.


I have dry eyes - do I need to see a doctor about it?

While OTC eyedrops are often sufficient to relieve dry eyes, there may be occasions when it is necessary to go to a doctor, says Dr Tong. These include:

  1. When there is doubt about the diagnosis: eg., whether the cause is ocular allergies or dryness
  2. When the eye dryness is bad enough to affect vision, or when a primary physician notices fluorescein staining of the cornea of the eye
  3. When the dry eye disorder is associated with a systemic condition such as rheumatoid arthritis which is causing symptoms.
  4. When the dry eye may affect the management of another eye condition, for example before LASIK or intraocular surgery.
  5. When there is exposure or a condition called lagophthalmos, when the eyelids cannot close completely.
  6. When previous eyedrops cause redness or side effects and the patient needs advice for further management.

What can I do?

Given the fact that ageing is one of the primary risk factors for dry eyes, everyone must be prepared to experience this disorder sooner or later.

Moreover, given that many buildings and offices in Singapore are fully air-conditioned, and majority of people have to stare at computer screens all day for work or their studies, it is near impossible to avoid the risk factors completely.

Dr Tong agrees that there is "no simple magic cure", but says that there are many lifestyle changes that can be made to reduce one's risk of developing dry eyes, or to reduce the discomfort they experience.

Some of the suggestions Dr Tong gave include:

  •     Routine cleaning
  •     Taking measures to ensure lid hygiene
  •     Use a humidifier
  •     Use moisture occlusion eyewear in windy areas
  •     Avoid driving at night
  •     Find the 'right' air-conditioning unit that does not dry out the room
  •     Avoid smoking
  •     Consume a balanced diet with sufficient Omega-3 fatty acids
  •     Get suitable eyedrops

If you are unsure as to which eyedrops you should use, consult your GP or pharmacist for advice.

*Editor's note: One should never discontinue prescription medication on one's own. Always seek the advice of your doctor before altering or discontinuing your medication.