Dry Eye: Symptoms, Causes and Treatment in Menorca

Dry eye syndrome develops when your tears no longer lubricate the surface of the eye properly — either because you produce too few or because their quality isn't right. The most common symptoms are a gritty sensation, burning, redness, watering and blurry vision that gets worse as the day goes on. It's neither a minor nor a passing problem: it's estimated to affect around one in five adults, and it becomes more common with age and screen use. In this guide we explain why it happens and how we approach it at the dry eye unit of Óptica Carreras in Maó.

What exactly is dry eye?

Tears aren't just water. They form a film with three layers that work together: an outer lipid layer that stops the tears evaporating, a middle aqueous layer that cleans and nourishes the cornea, and an inner mucin layer that keeps everything anchored to the surface of the eye. When any of these layers fails, the tear film becomes unstable and the eye is left unprotected.

That's why we call it a multifactorial problem: there's no single cause and no single treatment. Every case of dry eye is different, and that's the key to treating it well.

The two main types of dry eye

Put simply, there are two main mechanisms:

• Evaporative dry eye: the most common. Tears evaporate too quickly, almost always because of a dysfunction of the Meibomian glands — glands along the edge of the eyelids that produce the lipid layer. When they become blocked, the tears lose their protective "lid".
• Aqueous-deficient dry eye: the lacrimal gland simply produces too little tear fluid. It's linked to age, hormonal changes and some autoimmune conditions.

In many patients both mechanisms coexist, which makes an accurate diagnosis essential before any treatment.

Why do I have dry eye? Risk factors

Some factors that trigger it or make it worse:

• Screens: when we concentrate on a phone or computer we blink up to 60% less — and every blink is what renews the tear film.
• Age and menopause: hormonal changes reduce tear production and alter its quality, which is why it's more common in women over 50.
• Contact lenses: prolonged wear can dry out the ocular surface.
• Environmental factors: wind, air conditioning, heating and dry environments all speed up evaporation. In Menorca, the tramuntana wind and air conditioning during the hot season are frequent triggers.
• Certain medications: antihistamines, some antidepressants and contraceptives, among others.
• Previous eye surgery: a tear-film assessment is advisable before any procedure.

The watering that misleads

It may sound contradictory, but many people with dry eye come in precisely because their eyes water. It's a reflex: the irritated surface signals the lacrimal gland, which releases a flood of poor-quality tears that never quite lubricate. If your eyes water for no obvious reason — especially in wind or cold — it could be a sign of dryness.

How we diagnose dry eye at Óptica Carreras

Treating dry eye "blindly" with the first artificial tears from the pharmacy rarely works in the long run. That's why, at our dry eye unit, we carry out a complete assessment of the tear film using dedicated technology:

• OSDI questionnaire: measures how symptoms affect your daily life and grades their severity.
• Meibography: produces an image of the Meibomian glands so we can see their condition and detect blockages or gland loss.
• Tear stability and volume assessment: we measure how quickly the tear film breaks up and how much tear fluid is available.
• Analysis of redness and the lipid layer.

With this data we identify the type of dry eye you have and design a treatment tailored to you, rather than applying the same solution to everyone.

Available treatments

Dry eye doesn't always have a definitive cure, but it can be managed very well with the right approach. Depending on the case, the options range from the simplest to the most specific:

• Preservative-free artificial tears and daily eyelid hygiene as the foundation of treatment.
• Meibomian gland treatment: we apply controlled heat and massage that liquefy and release the built-up oil, restoring the lipid layer of the tears. It's a quick, painless procedure.
• Intense pulsed light (IPL): a technology that acts on inflammation at the eyelid margin and improves gland function.
• Punctal plugs: these block the tear ducts so that tears stay on the eye longer.
• Omega-3 supplements and advice on habits and environment.

What you can do starting today

While you consider an examination, these measures help ease the symptoms:

• Follow the 20-20-20 rule with screens: every 20 minutes, look at something 20 feet (about 6 metres) away for 20 seconds, and blink consciously.
• Never point air conditioning or heating at your face.
• Stay well hydrated and eat a diet rich in omega-3 (oily fish, nuts).
• Shield your eyes from the wind with wraparound sunglasses.
• Use preservative-free artificial tears if you feel occasional dryness.

Frequently asked questions about dry eye

Can dry eye be cured?

In most cases it's a chronic condition that can't be cured completely, but it can be managed very well. With the right treatment, symptoms can be reduced significantly and damage to the ocular surface can be prevented.

Do supermarket artificial tears work?

They can bring occasional relief, but not all are the same, and they don't suit every type of dry eye. Those containing preservatives, used continuously, can cause more irritation. Ideally, a professional should tell you which one you need.

Can I wear contact lenses if I have dry eye?

In many cases yes, but it's worth reviewing the lens type, the material and the hours of wear. Sometimes adjusting these factors or treating the dryness is enough to wear them comfortably again.

When should I be concerned?

If the discomfort is constant, affects your vision or doesn't improve with artificial tears, a tear-film assessment is advisable. Severe pain, marked light sensitivity or loss of vision require prompt attention.

If these symptoms sound familiar, don't just put up with them. At Óptica Carreras (Costa de sa Plaça, 16, Maó) we have been caring for Menorca's vision since 1928, with a dedicated unit for assessing and treating dry eye. Book an appointment or call us on (+34) 971 363 560 and we'll look at your case in depth.

Written by Mª Gracia Carreras, optometrist.
Collegiate number: 5.232