Disclaimer: I am not a paid spokesperson for any of the products listed in this post. If I mention a particular product or treatment, it is only because I prescribe them, my patients use them, and I have seen real results with them. This post, as well as future blog posts, are for educational purposes. As you will see, dry eye is a very complicated ailment and this is not meant to take the place of your doctor’s advice.
Let’s jump right in with one of the most common problems that my patients ask me about. Dry Eye Disease is something that over 30 million Americans suffer from. Unfortunately, only about 16 million of those people have actually been clinically diagnosed with dry eye, and only 1.5 million of those diagnosed are using anything more than simple artificial tears. Dry eye is rarely vision threatening, however, it is always quality of life compromising. Getting a handle on dry eyes takes a diligent and consistent treatment regime, which can often lead to frustration from the patient and the doctor as well. Today, we’ll dive into what dry eye disease is, some external factors that exasperate it, and how to take the fight to dry eyes so you can go about your day without thinking about your gritty, irritated eyes.
Dry eye is commonly thought of as a problem that involves the patient not making enough tears to lubricate the eye, but this is just one of many causes. When you don’t have a healthy tear volume, this is called aqueous-deficient dry eye disease. The makeup of your tears also plays a role. Healthy tears contain fluid, mucus, and oil, and dryness can occur when any of these layers are disrupted. If your glands that produce the oil are blocked, the tears lack a protective layer and evaporate too quickly. This is called evaporative dry eye or Meibomian gland dysfunction. Blepharitis, or lid margin disease, is another common problem that causes dry eyes. With blepharitis, inflammation in the lids is the root cause of the tear film disturbance. Lastly, lagophthamos, or an incomplete blink, can cause issues with dryness. Your lids act as windshield wipers for your eyes, spreading the tears out evenly over your cornea (the “windshield” of your eye). If the eyelid does not fully close when you blink, the bottom portion of the cornea does not get the tears it needs to protect it, causing pain and irritation. These are the most common forms of dry eye but this is not all inclusive. In future posts, we will cover how diseases like Sjögren’s syndrome, certain medications, computer use and even being a contact lens wearer can have an impact on a healthy tear film.
It’s great that we can categorize dry eye into neat little boxes with definitions, but often times, in the real world, patients can exhibit signs of multiple types of dry eye. The first line of treatment should always include a combination of artificial tears, lid hygiene, warm compresses, and omega fatty acids. Specifically, I recommend Systane Ultra or Systane Complete for artificial tears, OcuSoft scrubs for lid hygiene, Bruder masks for warm compresses, and HydroEye as a nutraceutical. This sounds like a hassle but if done on a consistent basis, most of my patients show vast improvement within 6 weeks. For patients that still aren’t getting the desired results, punctal plugs, steroid drops, and prescription drops like Restasis and Xiidra are the next line of treatment. Scleral contact lenses and intense-pulse light therapy (Lipiflow) are also options in severe cases.
Today we have covered the common forms of dry eye and what can be done to help alleviate it. I hope that after reading this post that you have learned a little more about this disorder and can take these tips and implement them in your own daily routine or share them with a friend or family member who needs it. Thank you for reading and feel free to comment or share. If you feel so inclined, check out our Facebook and Instagram accounts and give us a like!