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The Doctors Book of Home Remedies II: Dry Eyes

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Dry Eyes

Every time you blink, a film of tears spreads over your eyes. For the wet-eyed crowd, that film can turn to an eye bath when you're watching a classic weeper like, say, Old Yeller. But if you suffer from dry eyes, even the tear jerkingest flick can leave your hanky dry.

But another thing happens when you have dry eyes: They actually ache. Lacking the ability to cover or coat the cornea (the clear front surface of the eye) with a thin, protective coating of tears, your eyes start burning and stinging. At worst, it may feel as though a grain of sand is permanently embedded in your parched peepers. And because of this ongoing problem, your vision may be mildly blurred, or your eyes may become sensitive to light.

There are many causes: Medicines such as decongestants, tranquilizers and antihistamines, as well as drugs for high blood pressure, may all cause dry eyes. You can also get dry eyes if you have an allergy to contact lens products. Winter winds, air-conditioning and indoor heating are all potential culprits as well. Chronic cases often result from menopause, rheumatoid arthritis or Sjšgren's syndrome, a gland condition that also causes dry mouth and vaginal dryness. Sometimes dry eyes occur for no apparent reason. But whatever the cause, here are some ways to get your peepers dewy again--and to give you a chance to shed a tear the next time you hear a sob story.

Oil your eyes with a washcloth compress. "Place a warm washcloth on your closed eyelids for five to ten minutes several times a day to help open the clogged oil glands in the eyelids," says Eric Donnenfeld, M.D., associate professor of ophthalmology at North Shore University Hospital/Cornell Medical College in Manhasset, New York.

Here's why it works. Tears are made up of three components: water, oil and mucus. Artificial tears, the kind sold in eyedropper form in drugstores, can replace the water component of your tears. But those drops don't replace the oil: Only your own eyes can do that. So the warm compress helps your eyes do the work they're supposed to, according to Dr. Donnenfeld.

Using a compress is especially helpful if you have "crusty" eyes when you wake up or at other times of the day, says Dr. Donnenfeld. (About 50 percent of dry-eye sufferers get this crusty condition-called blepharitis-in the morning or during the day.)

Choose the right artificial tears. Over-the-counter artificial tears are a mixture of saline and some type of film-forming substance, such as polyvinyl alcohol or synthetic cellulose. This solution can be used several times a day, because it mimics real tears and provides a soothing balm whenever your eyes feel dry.

When choosing a brand, keep in mind that thicker formulas remain in the eyes longer, so you'll need to use them less frequently. But the thicker kind can blur vision and leave a gooey residue on your eyelashes. Thinner drops, on the other hand, need to be used more frequently. "You'll need to experiment to see what drops work for your condition," says Paul Michelson, M.D., senior staff ophthalmologist at the Mericos Eye Institute in La Jolla, California.

"But only use commercially prepared, preservative-free products," warns Donald Doughman, M.D., professor of ophthalmology at the University of Minnesota in Minneapolis. "If it doesn't say 'nonpreserved' or 'preservative-free' on the label or box, don't buy it. Preservatives can damage your eyes."

Nighttime Is the Right Time for Treatment

Even when your lids are closed, eyes can dry out, which is why your doctor will probably suggest that you use either a combination tear-replacement/moisture-sealing ointment or a "moisture chamber" at night.

These over-the-counter superthick ointments, which contain petroleum and mineral oil, last longer than drops, says Paul Vinger, M.D., assistant clinical professor of ophthalmology at Harvard University in Cambridge, Massachusetts. To insert, pull the lower lid down, look up, and squeeze a dab of ointment in the trough between your lid and eye. Blink to spread the ointment around. Keep in mind that ointments can blur your vision for a while, so be sure you don't use them before driving.

Your eye doctor can supply you with ready-made moisture chamber glasses to wear during sleep, but a pair of ordinary watertight swim goggles will also do fine. In a pinch, says Mitchell H. Friedlaender, M.D., director of the Cornea Service at the Scripps Clinic and Research Foundation in La Jolla, California, you can even make your own chamber by taking a piece of plastic food wrap and securing it with petroleum jelly around your eyes. As tears evaporate, the air inside the chamber becomes slightly more humid, preventing further tear evaporation and creating a comfortable, moist atmosphere. To boost the moisture content, use ocular ointments along with your moisture chamber.

Turn heating and cooling vents away. A blast of heat or air-conditioning may be what your body craves, but it's no good for your eyes. "When you're driving, keep air vents pointed down, away from your face," according to Dr. Donnenfeld. "And when you're home, do the same: Point heating and cooling ducts away from areas where you spend a lot of time. This is really important if your home has forced hot-air heating, because that can dry out your eyes very quickly."

Dress for the slopes. The Great Outdoors can deliver a one-two punch to dry eyes: The sun's brightness makes them supersensitive, and the wind and low humidity dry them out. That's why many experts suggest that you wear eye-protecting sunglasses or goggles for any outdoor activity. "Wraparound sunglasses are very helpful because they protect the sides of the eyes, which are vulnerable to the wind," says Dr. Donnenfeld. "But if you have very dry eyes, the best thing you can do is wear ski goggles when you're outside. They create a moist chamber for the eyes."

Take a blink break. Doing close work--typing at a video display terminal, driving, sewing, even watching television--can exacerbate even mild cases of eye dryness, says Dr. Michelson. "People doing tasks that require concentration tend to stare and not blink as much." And when you don't blink very often, eye moisture evaporates rapidly. So if you're doing concentrated work and notice dry eyes, look away and take a blink break whenever possible. Blinking helps restore the tear film over your eyes.

Humidify your surroundings. Moisturizing the air can keep mucous membranes from drying out during sleep, especially in the winter, doctors suggest. "When moisture is low, your eyes dry up fast," says Dr. Donnenfeld. "If you can, get a humidifier for your bedroom or other places where you spend a lot of time." And when you're using a hair dryer, don't run it any longer than necessary.

Moisten up and fly right. If you know you'll be in the arid environment of an airplane cabin, be extra vigilant in using artificial tears. And be sure the overhead air vents are pointed away from your eyes, says Dr. Donnenfeld.

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