CONDITIONS

Dry Eye

What Is Dry Eye

Dry eye occurs when you don’t produce enough tears or a high enough quality of tears to keep your eyes hydrated. Dry eye is uncomfortable and can cause vision to be impaired. However there are available treatment methods to manage symptoms and maintain accurate vision.

What Causes Dry Eye

Dry eye is caused by an insufficient production of tears. The hormonal changes that come with menopause are the most common cause of this condition, though symptoms of dry eye may also be caused by seasonal allergies or eye irritation.

Risk Factors For Dry Eye

The following are risk factors for dry eye:

  • Age. The risk of dry eye increases with age.The hormonal changes in the aging male and female body can also cause dry eye.
  • Certain chronic conditions. Rheumatoid arthritis, systemic lupus erythematosus, and Sjogren’s syndrome can all cause dry eye.
  • Certain medications (diuretics, beta-blockers, antihistamines)
  • Nutritional deficiencies. A severe vitamin A deficiency can lead to dry eye in rare cases.

Diagnosing Dry Eye

If your doctor suspects you have dry eye, he or she may conduct the following tests:

  • Schirmer test that measures tear production may be used to confirm the diagnosis.  The doctor will put filter paper strip under your lower eyelids and measure your rate of tear production
  • Dye eye drops. After putting the drops in your eyes, the doctor will check for the time it takes for dry spots to show up on your cornea
  • Standard eye exam.A standard eye exam involves a review of your eye medical history in addition to your current state of optic health.

Symptoms of Dry Eye

A main symptom of dry eye is, ironically, watery eyes. Your eyes may also burn itch, and get irritated by smoke or wind. If you’ve always worn contact lenses with no problem, you may now find them uncomfortable.

Prognosis

Dry eye is most often chronic. However, people with mild to moderate cases can typically find relief with treatments such as lubricants and don’t feel that their quality of life is negatively affected.  When dry eyes symptoms are severe, however, people have trouble keeping their eyes open and may be unable to drive, function at work, and perform their activities of daily living. With the exception of the extreme cases of needing to keep the eyes closed, dry eye is not a threat to general vision.

Screening

If you wear prescription glasses and/or contacts, you probably go to an optometrist for an annual check-up to make sure your prescription hasn’t changed and to order a new batch of contacts if you’re running out of them. Optometrists conduct vision tests to check for basic vision impairment, and can prescribe glasses and contact lenses. They can also spot early warning signs and give you a referral to an ophthalmologist, an eye doctor with a medical doctor degree, for a more thorough examination. If you do not wear contact lenses or glasses, chances are you miss out this periodic optometric screening. Many times, family doctors will conduct a visual acuity test, which is a series of letters decreasing in size on a chart that patients are asked to read to the best of their ability. This gives doctors the opportunity to do as the optometrists would.

The standard recommendation for all adults over the age of 40 is to have an eye exam at least every two years, and for adults over 65, to have an eye exam every year.  According to the National Federation of the Blind, prompt detection and treatment can preserve your vision for a lifetime even if you do contract a serious eye condition or disorder. Schedule an eye exam with an optometrist. If he or she spots any problems that may be of concern, you will most likely be referred to an ophthalmologist, a medical doctor specializing in eyes, for further testing. Be sure to make an appointment with the ophthalmologist and follow recommendations regarding the frequency of follow-ups should any diseases or conditions be detected.

People with diabetes or at risk of developing gestational diabetes are recommended to get additional ophthalmic screening. The American Academy of Ophthalmology recommends the eye screening schedule:

  • Type 1 Diabetes: Within five years of being diagnosed and yearly thereafter.
  • Type 2 Diabetes: At the time of diagnosis and yearly thereafter.
  • During pregnancy: During the first trimester and follow-ups if indicated.

Prevention

Medline Plus, a service of the National Library of Medicine, reminds us our best defense is to have regular checkups because eye diseases do not always have symptoms. Early detection and treatment are the keys to preventing vision loss.

Beyond that, a healthy diet that has sufficient vitamin and other nutrients will help keep your eyes lubricated and free of infections.

Also, avoid second hand smoke and if you smoke, kick the habit.

Protect your eyes from injury by wearing plastic eye guards if you’re involved in any activity that poses a risk of flying objects or particles.

Finally, remember that overexposure to the sun is just as bad for your eyes as it is for your skin. Wear sunglasses and stay away from tanning beds.

Medication And Treatment

The following treatments are available for dry eye patients:

  • Eye drops
    • Artificial tears lubricate your eyes and are available without a prescription.
    • Prescription eye drops can provide relief for more severe cases of dry eye.
  • Lubricating ointments are a thicker consistency than eye drops, and can help provide more long-lasting relief for more severe cases of dry eye.
  • Punctal plugs can be placed in the tear drainage ducts on the eyelids to keep tears on the surface of the eye longer and to prevent them from draining out of the eye.

Complementary and Alternative Treatment

A limited number of studies have shown that the following supplements may help decrease the symptoms of dry eye:

  • Omega-fatty 3 acids
  • Gamma-linolenic acid
  • Eicosapentaeonic acid
  • Docosahexaenoic acid (DHA)

Care Guide

A healthy, body, mind and spirit will improve your chances of controlling any eyes diseases and conditions you may have, especially as you age. Here are some guidelines for a lifestyle that will help you live not only long but well and go a long way toward preserving your vision for a lifetime:

  • Protect your eyes from injury Don’t let an accidental injury threaten to rob you of you vision! If you do any type of chores such as carpentry, splitting logs for the fireplace, or even hanging a picture, wear an inexpensive plastic eye guard available at hardware stores.
  • Wear sunglasses UV rays are dangerous. Remember that the rays shine through even on cloudy days.
  • Stop smoking. Smoke particles are irritants for the eyes and can cause inflammation and redness. Try cessation aids or join an online support group.
  • Eat real food Make (and keep!) a resolution to avoid packaged and processed junk food and well as fast food. Opt instead for vegetables and fruits, lean protein from fish and chicken, the occasional serving of red meat, and whole grains. Skip the sugar except for special occasions and go easy on the salt.

When To Contact A Doctor

In addition to your regularly scheduled visits to your eye care professionals, get immediate medical attention if you notice any sudden change in your vision or experience unusual symptoms such as extreme eye pain, burning, itching, redness, or fluid coming out of your eye.

Questions For A Doctor

Before you visit your doctor, write down a list of questions and concerns. Consider bringing a friend or family member along who can help you make sure you get all the information you need. In addition, writing down the doctor’s answers and recommendation for later reference is a good idea. Also come prepared with your medical history, information about any allergies you have, your family medical history, and a complete list of all medications you take including over-the-counter herbs and supplements.

Here are some questions you might pose when you visit your optometrist:

  • I started having trouble reading up close not long after I turned 40, so I bought a pair of readers at the drugstore. Is that OK? And did I pick the right strength?
  • I’ve always been nearsighted. Do I now need bifocals or progressive lenses?
  • I’ve heard about progressive contact lenses and monovision lenses. Would one of those options be right for me?
  • My eyes feel dry even when I blink. Is that a sign of a condition I’ve heard about called dry eye?
  • My eyes tear in cold weather, especially when it’s windy out. Is that a bad sign?
  • I work at a computer all day. Is that a risk for eyestrain?
  • Has my prescription changed in the last year? If so, is that a bad sign?

Here are some questions you might pose if you are referred to an ophthalmologist:

  • Which eye diseases or conditions are you screening me for?
  • If you diagnose an eye disease or condition, how much will medication and/or surgery cost?
  • Will the treatments control my problems so that I retain my vision?
  • How often will I need to come back to you for check-ups?
  • Should my adult children be checked if my condition is hereditary?
  • Are there any lifestyle changes I can make that will help prevent other eye diseases or the progression of the ones I already have?