One of the most common complaints in the field of eye health is a sensation of sand or dust in the eyes. The sensation can be accompanied by a range of further complaints such as itching, discomfort, pain, blurred vision, watering and more. The severity of the complaints varies and can range from mild discomfort to severe pain. The causes of a sensation of sand in the eyes are varied and numerous; we will focus here on the most common ones: dry eye syndrome, blepharitis, a foreign body, allergy.
It is important to note that there are many other causes of a sensation of sand in the eyes, among them the use of medications and ocular or non-ocular diseases, and you should consult an ophthalmologist in order to receive the most appropriate diagnosis and treatment.
Dry eye syndrome
The most common cause of a sensation of sand in the eyes.
Dry eyes occur when there is a problem in the production or secretion of the tear layer that covers the outer layer of the eye (the conjunctiva and the cornea). The purpose of the tears is to provide continuous moisture to the eyes and also to protect them from foreign bodies and infections. Tears are made up of an aqueous part secreted by the lacrimal gland, and a lipid part secreted by sebaceous glands; when at least one of these is lacking, dry eye syndrome can develop.
The symptoms of dry eyes are varied and differ between people and include a sensation of sand or dust in the eyes, discomfort, burning, redness, a desire to rub the eyes, blurred vision. There may also be watering, as a mechanism to compensate for the dryness or in response to irritation.
There are several risk factors for dry eye – more common in women, older age, diabetes, eyelid diseases, use of certain medications, wearing lenses, working in a dry environment and more.
The treatment of dry eyes is the use of tear substitutes. There are many types of tear substitutes, most of them without the need for a doctor's prescription. If there is significant dryness that does not improve with tear substitutes, there are further treatments such as ointments, medications and surgical solutions.
Inflammation of the eyelid margin (blepharitis)
The most common form of blepharitis occurs when there is inflammation of the sebaceous glands (called meibomian glands) located at the eyelid margin.
The common manifestations of blepharitis include itching, a sensation of a foreign body/sand in the eyes, a sensation of stickiness (mainly in the morning), redness of the eye and/or the eyelid margins, scaling on the lashes, sticky discharge, irritation of the conjunctiva and the cornea and more.
Risk factors – older age, failure to maintain eye hygiene, skin diseases, smoking, exposure to environmental pollution.
The cause of the inflammation is linked to a problem in the function of the meibomian glands, exposure to infections, allergies.
The treatment of inflammation of the eyelid margin is based first on hygiene of the eye and the area around the eye (among other things the use of dedicated wipes and the application of compresses to soften the skin and dissolve the oil, cleaning the hands, use of tear substitutes). In cases of a flare-up of the inflammation it can be treated with eye ointments combining an antibiotic and steroids. In cases of stubborn inflammation that does not respond properly to the above treatments there is the option of a deep cleaning of the eyelid margin (expression of the glands) at an ophthalmologist.
A foreign body on the conjunctiva / cornea
A sensation of sand or dust in one eye can be caused by the entry of a foreign body into the eye. Foreign bodies can be small like sand/dust, which pose a low risk, or large such as metal/glass, which pose a higher risk.
The foreign body can be located on the conjunctiva (the layer that covers the white of the eye), on the cornea (the outer layer through which the light rays pass and which has heightened sensitivity because of the abundant presence of nerves) or enter beneath the eyelid.
The symptoms include burning, discomfort, pain, blurred vision, glare, difficulty opening the eye, redness.
In situations where a small, superficial foreign body is involved, an attempt can be made to remove it from the eye by rapid blinking and rinsing the eye with lukewarm water. The eye should not be rubbed, since this may worsen the injury.
When the foreign body cannot be removed alone, or when the complaints are more severe (intense pain, glare), there is a concern about damage to the cornea and it is therefore necessary to seek medical treatment urgently.
As part of the treatment, the ophthalmologist will remove the foreign body and carry out an examination in order to see whether there is damage to the cornea. In accordance with the findings of the examinations, he will give instructions for continued treatment which may include, among other things, covering the eye and various eye drops, in order to prevent infections or to ease the symptoms in the days following the injury.
Allergy
An eye allergy is an allergic reaction that causes irritation and inflammation of the conjunctiva. The allergic reaction causes the cells of the body's immune system to produce substances that cause swelling of the blood vessels in the eyes. In an allergic reaction, the immune system over-responds to substances that are usually not harmful, such as house dust mites, animal fur, plant pollen and more. The allergy can appear in certain seasons of the year (for example in spring) or appear throughout the year.
Symptoms of allergic conjunctivitis can include irritation in the eyes, a sensation of sand, redness, watering, itching, burning, eyelid swelling. Sometimes there will also be non-ocular symptoms such as sneezing and nasal congestion.
The treatment of allergic conjunctivitis includes rinsing the eyes, avoiding exposure to allergens as far as possible. Drug treatment includes drops containing antihistamines (against the active component of the immune system), drops containing steroids or drops containing other anti-inflammatory substances. There are also drops for the relief of symptoms (tear substitutes, blood-vessel constrictors).
Adjustment of the drug treatment should be carried out by a doctor.
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