Dry Eyes (Sicca Syndrome)

by Pamela W. Smith, MD, MPH, MS

One of the least discussed but perhaps most irritating symptoms of menopause is dry eyes. Dry eyes, also known as keratoconjunctivitis sicca (KCS), is an eye disorder that is most often caused by decreased tear production, but may also result from increased evaporation of the tear film due to abnormal tear composition. Symptoms can include dryness, burning, the sensation of having sand or grit in the eye, itching, stinging, tired eyes, redness, a pulling sensation, or a sensation of pressure behind the eye. Generally both eyes are affected.

Dry eyes are commonly an age-related disease process. This is especially true when there is an inadequate production of tears. Other causes of dry eyes include:

• use of contact lenses

• eye surgery (including LASIK surgery)

• diabetes

• menopause

• rheumatoid arthritis

• lupus

• Sjögren’s syndrome

• medications

  • sedatives

  • diuretics

  • tricyclic antidepressants

  • oral contraceptives

  • nasal decongestants and antihistamines

• eye injuries including chemical and thermal

Most patients do not suffer any long-term effects from dry eyes. However, since the condition is uncomfortable, and can lead to eye damage if it is left untreated or becomes severe, it is important to eliminate the cause of the condition and relieve symptoms.

Treatments include:

• artificial tears

• EPA/DHA (2000 mg)

• carnosine eyedrops (compounded)

• prescription natural estrogen replacement for women if they are deficient and there is no contraindication (progesterone and other hormones need to be replaced also so that a woman’s hormonal balance is maintained)

• evening primrose oil (3000 mg)

• eye drops that contain vitamin A palmitate

• combinations of therapies that have been found to be helpful

  • evening primrose oil (3000 mg) + pyridoxine (25–50 mg) + vitamin C (2000-3000 mg)

References

Campbell A et al. Treatment of brittle nails and dry eyes. Brit Jour Dermatol. 1981;105:113.

Chandra D et al. Topical vitamin A palmitate in dry eyes. Afro-Asian Jour Ophthalmol. 1988;7:74–80.

Kobayashi T et al. Effect of retinol palmitate as a treatment for dry eye: a cytological evaluation. Ophthalmologica. 1997;211:358–361.

Oxholm P et al. Patients with primary Sjogren’s syndrome treated for two months with evening primrose oil. Scan Jour Rheumatol. 1986;15:103–108.

Quinn P et al. Carnosine: its properties, functions and potential therapeutic applications. Mol Aspects Med. 1992;13(5):379–444.

Rose M et al. Save Your Eyesight. New York: Warner Books; 1998.

Smith P. What You Must Know About Vitamins, Minerals, Herbs, and More. Garden City, NY: Square One Publishing; 2008:260.

Wang A et al. Use of carnosine as a natural anti-senescence drug from human beings. Biochem. 2000;65(7):869–871.

©2013 Pamela W. Smith, MD, MPH, MS

Director, Fellowship in Anti-Aging, Regenerative and Functional Medicine

Codirector, Master’s Program in Medical Sciences with a concentration in Metabolic and Nutritional Medicine, University of South Florida College of Medicine