Dry Eye

DRY EYE

When doctors address what is commonly referred to as "dry eyes they are really talking about ocular surface disease. Generally, it's a result of our eyes not producing enough tears. When our tear glands are functioning properly they create a healthy tear film that protects and nourishes the eye. Think of tear film like a skin for the eye. When our tear glands are not functioning properly, this negatively affects the tear film, and it can break down rapidly. The result can be itching, burning, redness, grittiness, discomfort and/or light sensitivity, any and all of which can lead to more serious problems.

Dry eye disease affects approximately 20 million Americans. Unfortunately, many of them remain undiagnosed. It can be tricky even for a seasoned professional to make the correct diagnosis, which is one of the reasons why we opened the Dry Eye Center of Excellence in the Fall of 2010 at Cool Springs EyeCare and Donelson EyeCare. This "clinic within a clinic specializes in addressing dry eye and the conditions that cause it. Dry eye can be difficult to diagnose for a variety of reasons.

Do I have dry eye?

The first judge of your symptoms will be you. Are your eyes itchy, burning, red? Are these conditions becoming more common? If you can sit at a computer screen for eight hours a day five days a week and you don't notice any problems with your eyes you probably don't need any treatment. But if you're rubbing your eyes, if they're persistently itchy or aching whether you're in front of a computer or not, you may have dry eyes.

Given the number of people suffering from Chronic Dry Eye who don't even know it, well, it made us recognize the need for the Dry Eye Center of Excellence. We can provide relief, real relief. The good news is that once detected early, the condition of Chronic Dry Eye is controllable and painlessly treatable. There are a number of excellent options for treatment, and it's an area of rapid growth in the eyecare industry. We now can manage Chronic Dry Eye to the point that it doesn't cause you any symptoms or any problems with your vision or quality of life.

Who is most likely to develop dry eye?

Yes, some groups of the population may be more prone to dry eye, but the fact is patients of all ages can have it. It is more prevalent in women from their mid-30s to their mid-50s because of natural hormonal changes. But we've seen children in our office who have Chronic Dry Eye.

Contact-lens wearers are more susceptible to Chronic Dry Eye, too. They often believe their contacts are drying out and don't realize it's a medical condition that can be treated. The vision of contact wearers sometimes fluctuates, and if they blink and that makes their vision get better or worse that's a probable sign of Chronic Dry Eye.

Older patients also are more susceptible to Chronic Dry Eye. We gradually produce fewer tears as we mature. Our baseline is less deep, and there is less coating on the front of the eye. Also, as we get older we tend to take more medications. One of the most common side effects related to drug interactions is dry eye.

What can I do when I notice trouble?

Take note of your symptoms and where and when they occur. This will be helpful information to pass along to your eye doctor. Factors to consider include the amount of time you spend at a computer, whether you use ceiling fans, sleep patterns, caffeine intake, exposure to smoke and whether you wear contacts.

There are some easy ways you may be able to give your aching eyes some relief:

  • Take breaks during extended computer time
  • Make sure your computer monitor is at or below eye level
  • Discontinue ceiling fan use or decrease the speed
  • Consider a humidifier instead of a fan
  • Try to increase sleep time
  • Reduce or stop smoking
  • Decrease caffeine intake to four or less beverages per day
  • Talk to your eye doctor about contact lens wearing time, type of lens, etc.

How concerned should I be about a diagnosis of Chronic Dry Eye?

It depends on the severity. Chronic Dry Eye gets progressively worse. Left untreated it can get to a point where it becomes much more difficult to manage and provide relief, and it even can result in damage to your cornea.
Tear film is one of natural barriers to disease problems or irritants on the front of the eye. People who have Chronic Dry Eye are less able to fight off bacteria, particularly for contact-lens wearers. It's not a condition that's completely curable, but in the majority of cases, it is controllable.

Are over-the-counter drops the answer?

OTC eye drops can help moisten your eyes, but they cannot help increase tear production and provide only temporary relief. Restasis Ophthalmic Emulsion is a prescription eye drop that actually increases tear production. It is one of the most common treatments for Dry Eye. A group of 17 international dry-eye experts, the Delphi Panel, recently defined dry-eye severity by frequency of symptoms and impact on quality of life. The panel developed four levels of severity, each with corresponding treatment options.

The resulting chart has made it easier for eye-care professionals not only to diagnose and treat Chronic Dry Eye more confidently but to determine whether a patient will benefit from OTC treatment or prescription therapy. The panel categorized diagnosis and treatment recommendations by disease severity (mild, 1-2; moderate, 3-4; and severe, greater than 4). Restasis is recommended as a treatment beginning with level 2 (or mild) patients and continuing through level 3 (moderate). Symptoms for level 2 patients include: tear film signs, mild punctate staining, conjunctival staining and visual signs.

Why should I visit the Dry Eye Center of Excellence?

Too often patients with dry eyes or other signs of Ocular Surface Disease are dismissed by doctors and told to get some OTC drops. Our doctors have been trained specifically to look for possible signs and symptoms of Chronic Dry Eye. If a patient comes in looking for sunglasses that may be a sign that there is a scattering of light on the eye, and that could mean Chronic Dry Eye. If a patient is concerned about eye strain from computer use we may recommend reflection-free treatment, but we also may follow up and look at the tear film on that patient's eyes.

We approach Ocular Surface Disease collaboratively with our patients. Communication and education are critical. We want patients to know this is a common and progressive disorder, but it's one we can treat and control so it doesn't affect the quality of your life or vision. For more information about dry eyes, go to http://www.allaboutdryeye.com.

 

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