Dry eyes cause pain

What really helps against dry eyes

Those who do not experience it themselves probably hardly understand the suffering. It also sounds so banal: dry eye. "To call it a pure disorder of wellbeing belittles the problem too much," says Professor Claus Cursiefen, Director of the Center for Ophthalmology at the University Clinic in Cologne. "Fortunately, dry eyes rarely have serious consequences."

In certain cases you should see a doctor: Among other things, if the eye turns red, hurts or loses visual acuity. The symptoms can usually be easily alleviated - also because medical professionals understand the causes better and better. For example, they have recognized that it is usually not the tear glands that fail, but that the composition of the fluid is incorrect (see graphic).

In the majority of patients, the protective layer of fat in the tears is too thin or full of holes. This promotes the evaporation of the tear film, it tears up more quickly. The so-called meibomian glands form the fat and excrete it on the edges of the eyelids. They can catch fire, produce too much or too little fat, or the wrong mixture. Then the secretion often clogs the exits.

Therapy of the meibomian glands

The focus of the treatment is therefore on the edge of the eyelid. Warm, moist compresses help to soften the secretion, while an eyelid massage supports the glands. The technique is best shown by an ophthalmologist.

There are also special drops and gels in the pharmacy that contain fat and thus stabilize the tear layer. If pathogens cause inflammation of the glands, the doctor will prescribe antibiotics. In stubborn cases he can widen the exit corridors with mini probes.

If the treatment of the meibomian glands does not help, eye drops form the basic therapy. If used regularly, they should not contain any preservatives. The patient has to pay for the drops himself. The following applies: try it out and gain experience. In general, you start with thin solutions. If they are not enough or if you have to drip too often, switching to thicker preparations can help.

However, these can impair the clear view. For this reason, some patients put the drops in their eyes during the day and put a special gel or ointment into the conjunctival sac at night. Others, on the other hand, prefer a spray that is sprayed onto the closed eyelids and - color tests prove it - actually gets into the eye via the eyelid rims.

Therapy of the inflamed surface of the eye

New findings show that an inflamed lacrimal gland or an inflamed surface of the eye is an important factor in the development and deterioration of dry eyes. "There are many things in common with an autoimmune disease, an attack by the immune system on the body's own structures," explains Professor Elisabeth Messmer, senior physician at the University Eye Clinic in Munich.

Anti-inflammatory ciclosporin-A eye drops for dry eyes with surface defects are approved as a therapy. Anti-inflammatory cortisone eye drops are suitable for short-term use. However, they increase the risk of cataracts and glaucoma and must therefore not be used for long-term therapy.