What is Dry Eye?
Dry eye symptoms vary quite a bit. Some of the most common dry eye symptoms are burning, stinging, redness, and a sandy, gritty type of sensation in the eye. A lot of patients will say “I feel like I have a foreign body or something in my eye.” Some folks even complain of excessive tearing, even though they have dry eye syndrome.
The prognosis of dry eye can vary from person to person. Dry eyes can be a simple thing for some patients, and it can be a chronic, ongoing disease for others. Some patients have very mild symptoms, while other patients are debilitated by them. We recommend that when they notice that their eyes are uncomfortable, regardless of what they think it is, they need to get an appointment with their eye care professional to see their best because it could be something else entirely. Eye discomfort could indicate an allergic response, an infection or, quite commonly, it is dry eye. They need to be seen so some type of treatment program can be initiated.
There are different types of dry eye syndrome. There can be an actual lack of tear production, a deficient amount of tears on the ocular surface; or there may be an adequate amount of tears produced, but they are not adhering to the ocular surface. This can happen if the composition of tear layers is unbalanced, which makes them evaporate too quickly and therefore less effective.
Daily environmental conditions can make dry eye worse. This can include a simple side effect of medications the patient is taking, exposure to chemicals in the environment, or heaters/air conditioners.
During a dry eye - eye exam, we look at the eye under magnification with a slit lamp. Using this 3D microscope, we can examine the different parts of the eye, including the corneal surface, blood vessels at the side of the eye, eyelids, oil glands on the eyelid right where the lashes go into the skin, as well as looking at the volume of moisture that the eye produces. For enhanced views of these and other structures and tears, we may use fluorescein eye drops. There are also little testing strips for measuring the volume of the patient’s tears, called a Schirmer’s test. One of the newer dry eye tests that we do at our office is the TearLab® Osmolarity Test, using instrumentation at the corner of the eye to determine the volume and quality of the tears.
Dry Eye Treatment in Tupelo, MS
There is no perfect treatment that cures all dry eye syndrome. We start simply with an over the counter dry eye treatment, but a lot of patients have already been down that path by the time they see us. Some of the over the counter treatments for dry eye are lubricating artificial tears, as well as thicker tear gel-type lubricating ointments for bedtime. One other readily available dry eye treatment is nutritional supplements that are good for the oil glands of the eye; specifically, omega 3 fatty acids, typically including fish oil. With chronic dry eye, or a very acute dry eye situation, we will often recommend prescription medication such as Restasis® – which is heavily advertised right now – as well as steroid drops to reduce the initial inflammation. Another treatment, which is a bit more invasive but requires less patient compliance, is punctual occlusion. In this painless outpatient procedure, the tear ducts that usually drain the eye are gently closed off, kind of like putting a stopper in the bathtub to keep the water in the tub. Those are some of the more popular treatments we recommend.
Who is at risk for developing dry eye?
Women tend to have more difficulties with dry eye than men do. Our Tupelo, MS eye care practice treats a lot of men for it, but women with more hormonal fluctuations – especially those patients who have had a hysterectomy – are more prone to dry eye. Any patient – male or female – taking systemic medications, like antihistamines for treating allergies or beta-blockers for high blood may experience dry eye symptoms as a side effect. That encompasses a wide patient population.
Environmental factors also play a role in causing dry eye. One of the initial things a person can try, other than over the counter dry eye therapies, is to increase the humidity in the home. From about November until March, during the winter especially, we get a lot of patients with dry eye complaints. Simply adding a cold air humidifier can add more moisture to the rooms and help improve dry eye symptoms.
Dry eye is often misdiagnosed by people trying to self-treat. A lot of patients do not really realize that dry eye may be causing their eye issues. Many patients come in and tell us “I have allergies - my eyes burn and sting”. They are so intent on calling it an allergy, even though the allergy medications they have tried are not effectively managing their eye symptoms. Dry eye is very common, and people just think, “My eyes are dry and that’s normal. I’ll just get some artificial tears and get on it.” For some, eye drops for dry eyes are all that is needed, but for others, artificial tears are not enough.
The earlier you start treatment for dry eye, the better outcome will be for the patient four, five or ten years down the road, which is significant because dry eye is usually chronic. Like any medical condition, we want to see it as early as we can and start treatment off appropriately so if you think you suffer from dry eye schedule an eye exam as soon as possible.