Dry Eye Disease

BY OPTOMETRIST PHILIP MILFORD.

Dry Eye Disease

How did I become interested in dry eye disease?

I started suffering from dry eyes, when I turned 40, which gave me an appreciation of just how frustrating and debilitating constant eye discomfort can become. Happily, with treatment I now live with virtually no dry eye symptoms.

What is Dry Eye Disease?

Dry Eye Disease is a very common condition, and symptoms vary from occasional mild grittiness to a severe debilitating disease that can ruin your quality of life.

Many who suffer from Dry Eye Disease experience a gritty sandy feeling in their eyes, possibly accompanied by watery red eyes and blurred vision. Over time this may deteriorate to a severe burning sensation.

As Dry Eye Disease can deteriorate over time it is best to treat it as soon as possible. In serious cases, Dry Eye Disease can cause severe damage to the front surface of your eye, potentially resulting in permanent vision loss.

Fortunately, over recent years, our understanding of Dry Eye Disease, how it develops and how to treat, it has improved dramatically with treatment of the underlying disease now possible in most cases. 

Dry Eye Disease is a chronic condition that needs to be managed and treated correctly. If you think you may be suffering from Dry Eye Disease, speak with your Optometrist at your next appointment.

Causes and Symptoms of Dry Eye Disease:

Dry Eye Disease or Dry Eye has many causes and symptoms, so it is best to have your Optometrist assess and diagnose your individual symptoms. It’s important to note that Dry Eye Disease is not just a lack of watery tears. There are many symptoms and many causes of Dry Eye Disease.

• Dysfunctional Glands: Our eyelids have multiple different tear glands and cells which produce different parts of our tears. Of these, there are two gland types which cause most Dry Eye Disease symptoms: Meibomian tear glands and the Aqueous tear gland.

Meibomian tear glands line your eyelid margins on both the upper and lower eyelids. These glands produce the oily layer in your tears and are critical for comfortable eyes. In fact, up-to 85% of Dry Eye cases are caused at least in part by the Meibomian gland dysfunction. The Aqueous tear gland sits in your upper eyelid and produces the watery part of your tears. This gland can be damaged by autoimmune conditions such as Sjogren’s Disease leading to Dry Eye Disease.

• Not Blinking Correctly: Another cause of Dry Eye Disease is incomplete blinking. Complete blinking is very important. We don’t think much about blinking, but I routinely see people with Dry Eye who only have a half blink. This means the bottom half of the eyes dry out due to exposure to the air. Also, a good complete blink pumps fresh tears into your eye on every blink. If your eye surface is desensitised, this can remove the reflex to blink properly and ultimately the production of fresh tears. Without fresh tears, you will experience Dry Eye.

• Eye Inflammation: Inflammation in your eyes causes Dry Eye symptoms and Dry Eye Dieases causes inflammation. This can be a vicious circle and this circle needs to be broken to resolve dry eyes. Inflamed eyelid margins are very common. We call this Blepharitis and this is one the most common causes of Dry Eye symptoms. Blepharitis can be associated with skin conditions such as Rosacea, Seborrheic Dermatitis and tiny (Demodex) mites that live in the hair follicle of your eye lashes.

• Hormonal Changes & Medication: Hormonal changes to your body ,especially as we age, can create problems to quality tear production resulting in Dry Eye. Similarly, some medications (such as antidepressants and blood pressure medications) can cause unwanted side effects leading to Dry Eye.

• Watery Eyes: People ask me all the time ‘How can I have dry eyes when they are watery all the time?’ The answer is all about poor tear quality. You can have a lot of watery tears that don’t wet your eye properly. Meibum from your tear glands creates a barrier between your tears and the air. So quality tears are essential for resolving Dry Eye Disease.

Treating Dry Eye Disease:

Dry Eye Disease and Dry Eye can have multiple causes and symptoms, so to treat your Dry Eye, you need to start with visiting your Optometrist for an individual assessment of your symptoms.

Some other, day-to-day changes you can make to help reduce your Dry Eye symptoms may include:

• Avoid air-conditioning as this dries the air ,which then dries your eyes.
• Reduce the time you wear contact lenses or stop wearing them completely. Contact lens wear breaks up the tear film on your eye and can make your dry eyes feel worse.
• Take Omega 3 supplements
• Adopt good sleep habits and eat a healthy diet with lots of fresh vegetables and fruit.
• Avoid air pollution and modern day chemicals as these can inflame your eyes.
• Avoid makeup on your eyelids and clean your makeup off very carefully at the end of each day.

Your Optometrist may also recommend:

• Lubricating eye drops or ointment.
• Blinking eye exercises.
• Warm compresses or steam googles to improve the Meibomian tear glands.
• Eyelid wipes to manage inflamed eyelids (Blepharitis).

If you have tried these options and you are still suffering from Dry Eye Disease I recommend more sophisticated treatment options offered in a Dry Eye Clinic, such as my clinic at Optical by National Pharmacies Norwood.

• Intense Pulse Light: Intense Pulse Light (IPL) is a safe and effective way to treat Dry Eye Disease. This procedure involves multiple flashes of very bright visible light across your eyelids. This is performed with your eye closed or covered. IPL has been proven to improve your tear quality, reduce lid inflammation, and provide relief in up to 85% of Dry Eye sufferers.

• LipiFlow:vLipiFlow is a very clever applicator that heats your eyelid and then massages your Meibomian tear glands to express them and stimulate them to function normally.

• Eye Drops: Ciclosporin Eye Drops have been shown to reduce eye inflammation and can be prescribed when other treatments have not worked.

Autologous Serum Eye Drops are manufactured from your own blood sample and while they are difficult and expensive to manufacture, have been shown to help people with severe Dry Eye Disease.

We live in exciting times with new health breakthroughs evolving all the time, so speak with your Optometrist about the latest treatments available to you.

If you are concerned you may be experiencing Dry Eye Disease, book an appointment with your Optometrist or at a dedicated Dry Eye Clinic like mine at Optical by National Pharmacies Norwood.