Dry Eye Disease
Dry eye sounds like a pretty minor condition, right? Just use some eye drops! Surprisingly, dry eye is actually an extremely complicated condition caused by a number of factors, including things like environment, oral medications, inflammatory conditions (like skin conditions, inflammatory arthritis, etc.), thyroid disease, environment, and many more.
What is Dry Eye Disease?
Don’t be fooled by the name: most patients coming in with dry eye issues are not telling us, “My eyes feel dry.”
In fact, most people come in saying things like, “My eyes feel tired” or “My vision is a bit blurry.”
These are just some of the minor examples that we hear when patients are coming in for an updated prescription for their glasses thinking that a new prescription is all they need. But if you’re noticing more symptoms like intermittent blurred vision (especially if blinking makes it better for a few moments), burning, stinging, watery eyes, discomfort, sandy/gritty sensation, tired eyes, itching, or any other physical symptoms, you should bring that up to your doctor at your visit.
That list of symptoms can be just some of the early warning signs. As dry eye progresses it can become debilitating for some patients. We have heard patients are considering leaving careers they love because their eyes are so uncomfortable.
While it may not sound like it, having discomfort and pain from dry eye is better than the alternative. If someone goes from painful to no longer having eye pain, that can be a bad sign that things have progressed to the point where the eye no longer can feel itself and can lead to major complications including vision loss.
Understanding Dry Eye Disease
Dry eye can not only be mildly uncomfortable, it can be downright debilitating! With the digital worlds that we live in, most patients work with a computer or their phones and then spend the evening catching up with friends via their devices, watching TV, playing video games, etc. Screen time can lead to certain types of dry eye and can really cause patients a lot of discomfort with their eyes.
Risk Factors for Dry Eye Disease
There are so many risk factors involved in dry eye. In 2017, the Dry Eye Workshop Study (DEWS) report wrote an entire chapter about all the risk factors in their reports. Dry eye is so complicated that these groups effectively wrote an entire book on the condition with 2 chapters dedicated to some of the risk factors involved in dry eye. Here’s just a few of the contributing factors:
- Eye Disease
- Contact Lens Wear
- Systemic Conditions (diabetes, thyroid disease)
- Skin conditions (eczema, psoriasis, rosacea, etc)
- Oral Medications (like antihistamines, antidepressants, etc)
- Topical Medications (glaucoma medications, other eye medications)
- Gender (women more so than men)
- Screen time (with any type of device, computer, phone, TV, etc.)
- Age
- Hormone changes or imbalances
- Diet
- Environment
So based on that list, I’m sure many readers can look at that and think, “Wait, I have several of those categories. Will I develop dry eye?” The answer is an unsatisfying, “Maybe!”
Thankfully, there are many treatment options available and you can talk to your eye doctor about them.
Treatments for Dry Eye Disease
Often we’ll start the treatment process with lubricating artificial tears like BioTrue, Refresh, Systane, Blink, etc. We tend to recommend branded artificial tears rather than generic due to concerns of manufacturing practices. 95%+ of the time we receive notifications from the FDA on recalls for eye drops, they are pretty much always generic drops with concerns for contamination.
Oral supplements like a quality Omega-3 fish oil can be beneficial along with hot, moist compresses and eyelid hygiene products.
Medications
Beyond the more basic things, we can also prescribe patients medications to help with their dry eye. Depending on the type of dry eye, there are topical eye drops like Restasis, Xiidra, Cequa, Vevye, Miebo, and likely a few more in the coming years. We even now have a nasal spray (Tyrvaya) available that can really help improve dry eye signs and symptoms.
In some cases of oil gland issues, we will prescribe oral medications that can help to reduce the inflammation and help produce better quality oil tears.
And in some more severe cases, we can even order patients to have eye drops made from their own blood plasma! Don’t worry, it’s very safe and works quite nicely.
Passive Therapy
We also offer for many of our patients something called punctal plugs. Punctal plugs are small collagen inserts we can place in the lower eyelid’s drainage structure, called the puncta. These plugs act like putting a plug in a drain. Instead of the tears draining and evaporating, they’re kept on the eye longer to improve someone’s tear film right away. These can be a huge benefit for patients, are quick to place, and are not painful to have in.
Contact Lenses
You might say,“Wait, didn’t contact lenses show up as a risk factor for dry eye? What gives?!”
Yes, it’s true. Contact lenses can cause dry eye. Especially in patients who are over wearing and abusing their lenses. But even if you’re the model patient who always follows all the instructions, you may still end up with dry eye. Discomfort is one of the leading causes of patients dropping out of contact lens wear.
If you’re in a monthly disposable contact lens, switching to a daily disposable can be one of the best options to improve your comfort.
But what about patients who already have dry eye? How can a contact lens treat that? Well, we have scleral contact lenses! These are lenses that are larger in size and made of a rigid material. They land on the white part of your eye (the sclera) and vault over the cornea, keeping it covered in fluid all day. While they may sound uncomfortable, you’d be surprised just how comfortable a well fitting set of lenses can be! Dr. Nick actually wears a pair of these himself most days.
Additional Therapies
While we offer a wide variety of dry eye therapies at Mt. View EyeCare, not every treatment is available at this time. The world of dry eye treatments has rapidly been expanding in the last 10-15 years and now includes treatments like Lipiflow, Intense Pulsed Light (IPL), Radiofrequency (RF), and several other options that are becoming more readily available.
While we do not offer these treatments at this time, that doesn’t mean you can’t ask our doctors about them. If your dry eye is the type that would benefit from it, we have colleagues in the area we can refer you to for your treatments!
Disclosures: Dr. Nick has no financial interests or disclosures with any companies or medications listed. While he mentions brand names specifically, he does this as some patients may recognize these names of medications.
Our Commitment to Dry Eye Disease Care
Mt. View EyeCare is dedicated to providing comprehensive care for patients with Dry Eye Disease. Our experienced eye care professionals are committed to early detection, diagnosis, and treatment to help you maintain your vision.
Ready to Schedule Your Dry Eye Disease Screening?
Don’t wait for symptoms to appear. Schedule a regular eye exam to assess your risk of Dry Eye Disease and receive the care you need.