Dry Eye Season - It's That Time of Year
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This is probably the best time of the year for a dry eye column: the temperature is down, the humidity is way down, and forced air heating systems are common in our homes and offices. These are some of the factors that can contribute to ocular discomfort in the form of dry eyes.
Typical symptoms of dry eyes are a dry feeling in which one may have to blink more frequently to minimize the discomfort (re-distributing the tears), or a sandy/gritty feeling, or a burning feeling. Sometimes patients have marginal dry eye in that the symptoms are more prevalent this time of year.
The causes of dry eye are many:
Tear production - some of us don't make enough tears to keep the eyes' surface hydrated properly. Make sure you drink enough water!
Tear chemistry - we may produce an adequate volume of tears, but perhaps in the wrong proportion. Our tears are three layers thick: a protein layer that keeps them adherent to the eyes, a watery layer that contains most of the volume of the tears, and an oily layer on the surface that prevents evaporation. A deficiency in the oily layer, for example, can cause the tears to evaporate faster than they should when a normal tear consistency is present.
Eye and eyelid hygiene - some of us have too much debris building up in our eyelashes. This can contribute to an elevated bacteria population, which in turn can irritate and dry our ocular surface. In other cases, the oil glands that line our eyelids may become inflamed/clogged and may cause an imbalance in tear chemistry.
Mechanical factors - some patients have eyelids that do not conform properly to the eyes; thus, maintaining proper tear consistency is difficult. Others have eyelids that do not close completely, especially during sleep, and this can obviously be detrimental to normal surface hydration.
Contact lenses - Some patients do not have any dryness issues until contact lenses are introduced to the eyes. Fortunately, newer contact lens materials and dry eye treatments are usually successful in minimizing discomfort. However, the newer wettable and breathable materials are not a panacea for dry eye.
Medications - Many medications may decrease tear production - the most common/notable ones are antihistamines, birth control medications, and some mood-altering drugs.
Systemic conditions - diabetes, menopause, and Sjogren's syndrome are a few of the conditions that are associated with dry eye.
There are certainly more causes for dry eye, but these are some of the most common.
Treatments for dry eye - The goal is to modify all the factors that can be easily manipulated, such as preventing a forced air heating register to blow directly on you as you sit in front of a computer all day long. In this case, redirect the air flow laterally or have your employer contact their HVAC person.
Make sure you are consuming a reasonable amount of water daily.
Make sure your diet is fairly well-balanced.
Make sure your eye and eyelid hygiene are good/if in doubt, ask your eye doctor for specific instructions for improvement.
Over the counter tear supplements are sometimes useful. I personally advise avoiding any that are preserved. If you used a preserved formulation four or more times per day, the preservative may build up to irritating levels in your tears - The "disappearing preservative" types are generally adequate - as are the non-preserved variety. There are many OTC supplements that are not good, so ask your eye doctor about this as well. You generally need a higher level of treatment if you have to use them more than 4 times per day, or if your eyes feel dry again 5 minutes after use.
There is a prescription medication that may help your tear glands produce more tears and well as reduce some inflammation and discomfort caused by a lack of tears. I find that this is very beneficial in 8 or 9 patients out of 10 in which I feel it may help.
For patients with moderate or severe dry eye, punctual occlusion may be beneficial. The puncta are the individual drainage openings through which tears leave the surface of the eye. There are two for each eye, one on the upper and lower lid in the nasal corner. About 80% of tears drain through the lower orifice. Occluding these with a silicone or collagen material makes tears longer lasting and generally helps comfort. I avoid these as first line treatment as sometimes the quality of tears needs to be improved before increasing the quantity.
Recent studies have shown that Omega 3- and 6- fatty acids are helpful for patients with dry eye. The key is to obtain them in the correct ratio, so don't just go out and purchase a bottle of them. (For more information, email me privately). Our body changes one of them into the other - this is why the proper ratio is important.
Other treatments are available for dry eye patients as necessary - humidifiers, moisture chamber spectacles, and prescription medications. Dry eye can be a difficult and painful condition, and may cause loss of vision in its severe forms. For more information please contact me via email, at my office, or ask your eye doctor.
I invite your questions and feedback
Or Contact Dr. Lee Newton at:
3720 E. Wilder Road, Bay City, MI
(989) 667-9393
3720 E. Wilder Road, Bay City, MI
(989) 667-9393
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Dr. Lee Newton, Eye Care |
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