Dry eyes • What to do about Sicca syndrome?

One symptom that one is often confronted with in everyday life is eyes that are too dry, the so-called Sicca syndrome. Especially women between 50 and 70 complain of the annoying accompanying symptoms such as foreign body and pressure feelings, burning pain, red swollen eyelids and copious tear flow.

About every third patient in an ophthalmological practice suffers from dry eyes (Sicca syndrome, keratoconjunctivitis sicca or dry eye syndrome). It is believed that around ten million people in Germany are affected by Sicca syndrome of various degrees, including more women than men, which is mainly due to the hormonal changes in menopause.

Symptoms: the most common complaints with dry eyes

Dry eyes appear when not enough tear fluid is produced or its composition is disturbed. This causes the tear film on the surface of the eye to tear open too soon (i.e. before the next blink of an eye), which creates dry spots.

Visual disturbances and what they mean

As a result, the eyelids can no longer slide smoothly over the eyes when blinking. They scratch the surface of the eye, which not only leads to unpleasant sensations, but also Inflammation and Infections favor and lead to damage to the outer layer of the surface of the eye, the cornea.

The following symptoms are the most common signs of Sicca syndrome:

  • itching
  • Burning eyes
  • Eye pain, pressure
  • Foreign body sensation (“grain of sand”)
  • Eyelid blinking is perceived as uncomfortable
  • reddened conjunctiva
  • glued eyelids after waking up
  • excessive tears in the eyes
  • tired eyes
  • Sensitivity to light

In many cases, however, the complaints are considered by those affected as not requiring treatment and there is no or only one inadequate therapy. But the dry eye is not a harmless condition, it is the most common cause of corneal perforation and can lead to vision impairment and even blindness.

Healthy eyes with pleasure

Causes of dry eyes

To protect it, the eye covers a thin one Tear film, which is composed of lipids, aqueous and mucous (viscous, slimy) components. Continuous blinking ensures that the tear fluid produced in various glands of the eye is evenly distributed over the front area of ​​the cornea and conjunctiva and that the protective film does not tear. If this does not work, there will be wetting disorders on the surface of the eye. The lack of humidification leads to Sicca syndrome.

Often you can no clear triggers Find. Usually, internal and external causes are responsible for the Sicca syndrome.

To the external factors for dry eyes count:

  • long stay in rooms with air conditioning
  • Drafts or overheated rooms (low humidity)
  • Blower in the car
  • Ozone (also from copiers, printers)
  • Cigarette smoke
  • long-lasting and concentrated screen work (due to too low blinking frequency (winking) the tear film evaporates more)
  • insufficient lighting of the workplace
  • Intolerance of contact lenses
  • insufficient glasses
  • Preservatives (such as benzalkonium chloride) in eye drops that are used against other eye diseases (for example, against glaucoma)

To the “inner” factors counting:

  • age-related changes in the mucous membranes
  • hormonal changes in the lacrimal fluid during pregnancy or menopause
  • Lacrimal gland disorders (such as inflammation)
  • Narrowing (stenoses) in the laxative tear ducts
  • insufficient sleep
  • Vitamin-A-Mangel
  • certain diseases that are associated with reduced production of lacrimal fluid (Parkinson’s disease, rheumatism, neurodermatitis, diabetes, thyroid diseases)
  • Sjörgen syndrome (immune system disorder that is also associated with dry mouth)
  • Misalignment of the eyelids

In addition, numerous Medication lead to reduced tear production. These include:

  • oral contraceptives (“pill”)
  • High blood pressure (beta-blockers)
  • Antiallergy (antihistamines)
  • Eye drops against reddened eyes (“whitener”)
  • Sedative
  • Antidepressants
  • diuretics

Diagnosis of Sicca syndrome at the ophthalmologist

The ophthalmologist has the various examination options and tests to determine whether the symptoms actually result from a wetting disorder on the surface of the eye or if there is another reason. For example, sensation of tension and redness can also be caused by conjunctivitis.

The doctor does not only look at the surface of the eye. The folds on the edge of the lid also show the expert whether the eyes are dry. The height of the tear film on the lower edge of the lid also plays a role. The Composition of the tear film the ophthalmologist examines it with a special slit lamp. This examination is important so that the patient receives the right eye drops for treatment, for example with a particularly high lipid content if his tear fluid contains too little of it.

Schirmer test for dry eyes

With the Schirmer test, the doctor can check the production of the tear fluid. To do this, he carefully leads a small paper strip made of specially absorbent material into the lower conjunctival sac. Depending on the dampening of the examination material, the doctor recognizes whether the eyes are actually dry.

If the ophthalmologist has only found a slightly or moderately pronounced dry eye, the person affected can continue to treat the symptoms on their own. Check-ups at the ophthalmologist (once or twice a year) are recommended.

Eye drops and gels: what helps with dry eyes?

The most common treatment for Sicca syndrome is the use of Eye pots, gels or ointments. With dry eyes, this either replaces the insufficient tear fluid (“artificial tears”) or improves the consistency of the tear film. If necessary, the preparations are dripped into the conjunctival sac several times a day. The goal of the therapy is a better wetting of the eye surface and thereby one Relief of symptoms.

The preparations for the treatment of Sicca syndrome are usually of a viscous consistency so that they remain on the surface of the eye for as long as possible. The disadvantage is that vision can sometimes be limited shortly after use (blurred vision).

Use special eye drops

Preservative-free preparations are particularly recommended. Because preservatives such as the commonly used benzalkonium chloride can damage the cornea of ​​the eye and negatively affect the composition of the tear film.

If there is a very severe lack of tear fluid, the doctor can recommend one Desolation the teardrops (these are the drainage points of the tear fluid) or a closure of them using small silicone seals (punctum plugs).

What else helps with Sicca syndrome

Often, simple protective measures can contribute a lot to maintaining your own eye health. For example, sufferers of Sicca syndrome should Avoid drafts and smoky rooms. To protect against the wind, it is advisable to wear sunglasses or cycling glasses.

Also a damp indoor climate and plenty of liquid drunk throughout the day (at least 1.5 liters) relieve the symptoms. Provide sufficient breaks when working on the monitor for long periods. In the case of acute symptoms, cool compresses can be applied.

Prevent dry eyes: the best tips

Today’s living and working conditions favor the development of dry eyes (Sicca syndrome) to a much greater extent than at times when there were no computers and air conditioning systems.

Dry eyes can be prevented with the following measures:

  • Avoid overheated and smoky rooms
  • Protect eyes from drafts
  • if possible, no longer stay in rooms with air conditioning
  • wear glasses instead of contact lenses
  • enough sleep to regenerate the eye
  • Use cosmetics sparingly around the eyes
  • regular check-ups at the ophthalmologist

If the screen work is prolonged, the Sicca syndrome is prevented by the following procedure:

  • ensure that the workplace is adequately lit.

  • Take a five minute break every hour

  • often wink (the tear film is renewed by blinking)

  • pay attention to the correct distance between eye and screen (50 to 80 centimeters)

  • Screen must be set up glare-free (at right angles to the window)

Visual disturbances and what they mean