October 23, 2011
Step 1: Find out what’s causing the problem
It is impossible to deal with eye strain/ dry eyes/ eye allergy without knowing precisely what is the cause. Most eye specialists won't spend time investigating this basic issue.
However, here are a few key steps to determine the cause.
Q: What was happening just before you started experiencing the problem?
In my case I experienced the worst hayfever season of my life and took a very large quantities of oral antihistamines. I started experiencing a major, dull headache centered around my frontal lobe area, and later started experiencing the most shocking pain when reading on a computer screen.
Clue: This indicates that my PRIMARY cause of the eye issue was NOT dry eyes but allergic response. Unfortunately, it is only now, about a year later, that I'm now sure that this was the case. How? Through a simple test: Dip your eyes into water and blink inside the water. If it feels better then its likely an allergy since the allergen and its rubbish is washed away by the water. Of course the problem will come back, but this is the key test, I think.
Q: Did the problem arise slowly or quickly?
If the problem arose quickly (or relatively quickly), it would indicate allergic or bacterial cause, since nutritional deficiency or age-related dry eyes would likely happen slowly.
In my case the onset was very rapid. This would indicate either allergic or bacterial cause.
Q: Apply a drop of honey in each eye. What happens?
If you apply a drop of honey (Manuka, preferably) in each eye, you should experience stinging sensation followed by the release of reflex tears. The tears will tend to wash away allergens and also some of the bacteria (plus, honey kills bacteria anyway). This should give you some relief (albeit temporary) IF you have allergic or bacterial issues.
In my case I have always felt temporary relief immediately after applying honey. That would indicate allergic or bacterial (or both) cause.
Q: Does the pain ease on closing your eyes?
If the pain/soreness is associated primarily with dry eyes then closing the eyes should provide relief as the nerve cells in the cornea are protected by tears which are not allowed to evaporate.
In my case there was NO RELIEF by shutting the eye (except during deep sleep). This would indicate a problem NOT related to evaporative dry eyes.
Q: Do you experience relief by putting preservative-free Theratears?
Theratears reduces tear osmolarity which is typically high in the case of dry eyes, and so if you experience (even temporary) relief, then you probably have dry eyes.
In my case the problem was initially ONLY allergic response and so Optive and other eye drops provided no relief. However, I did develop dry eyes AS A RESULT of the allergy. Today I do get a brief (often very fleeting) relief with Theratears.
Addendum: Medicines that cause dry eyes.