1) What are the common symptoms of Dry Eye, and when would you recommend that a patient come into the practice for these symptoms for an exam?
Some common symptoms of Dry Eye besides dryness include burning, foreign body sensation, watering, and redness. If someone experiences any of these symptoms, even intermittently, he/she has some form of Dry Eye. Dry Eye is a chronic, progressive disease. Today may be the best your eyes feel without treatment. I would recommend an exam to evaluate the severity of Dry Eye in any one with any of these symptoms.
2) Many people seem to consider Dry Eye to mean that they are experiencing discomfort in their eyes. How is Dry Eye really categorized, is it considered to be an actual medical disease?
Dry Eye is considered a disease which is chronic and progressive in nature. One or more of the 3 tear layers are disrupted or lacking to cause our tear film to deteriorate. Since our tears have visual and protective purposes, dry eye can lead to decreased vision and increased risk for infection. Dry Eye is common in those with autoimmune conditions, women over 40, those taking multiple medications, contact lens wearers, and those post-LASIK patients. We have no cure for Dry Eye but it can be successfully managed with eye drops and lifestyle changes.
3) Why should a patient come into the office as opposed to treating themselves by purchasing over the counter artificial drops?
There are so many eye drops in the pharmacy, it would be difficult to know which is best for you. Some even contain harsh chemicals which may cause more irritation to your eyes.
4) What types of tests or examination is conducted in the office when checking for Dry Eye?
During an exam, we evaluate the amount and quality of a patient's tears with a slit-lamp biomicroscope. We also look for signs a patient has had dry eye for some time. These include redness on the conjunctiva and lid margins and uneven (or scalloped) lid margins. Tiny oil droplets visible on the lid margin (meibomian stasis) are a sign that the oil produced by the eyes isn't being incorporated into the tear film with blinking. A tear film without oil evaporates quickly. We also used lissamine green staining to show de-vitalized or damaged cells on the eyes, due to dryness. We will take a photograph of these signs and when seen, patients more easily understand the severity of this disease.
5) What treatments are available and most commonly used to treat Dry Eye?
- Do you recommend fish oil to patients?
- Do you use punctal plugs, and in what scenarios?
There are treatments that manage dry eye successfully such as artificial tears, punctal plugs and prescription eye drops. Artificial tears can be found over the counter to add moisture to the eyes. Prescription drops such as Restasis work to reduce the inflammation in the eyes caused by dryness. The benefits of Restasis increase over time. Fish oil supplements can help build up the oily layer of your tears over time. Drinking water helps to hydrate the entire body, including your eyes. Punctal plugs are beneficial to act as a "stopper" for your tears' natural drainage. Those with anatomically larger puncta will have more drainage of tears naturally. Punctal plugs are extremely easy to insert in the office and take only five minutes of your time. Anesthetic drops are given, only to keep you from blinking during the procedure. The punctum is dilated with a probe and the plug is dropped into its place. There are no side affects and no "down time". We recommended plugs on a six month basis as they do dissolve over time.
6) Are there certain people, whether it be because of profession or gender, that are more prone to have Dry Eye issues?
Those who work outside are more prone to dry eye due to wind, temperature changes or dusty conditions. Also, computer users rarely blink while working which causes the tears to evaporate more quickly. Women, especially those over forty are more prone to dry eyes due to hormone changes. Men or women with autoimmune conditions or those taking medications will experience dry eyes as a side effect of those meds.
7) What recommendations can you give people in order to enhance their surrounding environment and avoid Dry Eye issues?
A lot of patients sleep with a fan on and are surprised this can cause their dry eyes. If the fan is for noise, try to find a radio or other white noise that will allow you to sleep. Circulating air is horrible for dry eye sufferers. A warm air humidifier may allow you the noise needed to sleep as well as hydrate the air. Some people don't close their eyes completely while sleeping. Wearing a sleeping mask can reduce your exposure to the night air. Also, those using a c-pap for sleep apnea run the risk of severe dry eyes due to the circulating air near their face. Warm compresses on the eyes twice daily can help to release the oil in your glands to allow for better quality tears.
8) What are the most common misconceptions that people have about Dry Eye?
Most people don't think Dry Eye is bad enough to be considered a disease in the early stages. When they see their eyes during an exam and see the signs we as doctors see, they better understand the chronic and progressive nature of this condition.
9) Any further comments or take home messages about Dry Eye?
Once patients realize there are successful treatments for dry eyes, they are more apt to be compliant. When your eyes feel good, (or don't feel at all!) you feel good too!
For more on dry eye treatments visit your eye doctors in Georgetown KY at Advanced Eye Care Center P.S.C.