Ask Your Doctor: What You Need To Know About Dry Eye
Education and Advocacy Mediaplanet had the chance sit down and ask ophthalmologist, Dr. Devesh Varma, the crucial facts regarding dry eye disease.
Mediaplanet What are the main triggers of dry eye in the upcoming spring and summer months?
Dr. Devesh Varma Dry eyes tend to feel worse in dry conditions. Many people have the hardest time during winter when the air is dry both outside (due to cold) and inside (due to indoor heating).
Spring can brings out allergies in some people due to pollen exposure — the itchiness from allergy can exacerbate pre-existing dry eye symptoms. Allergic eye disease can be treated with prescription eye drops. During summer, we often spend time outdoors on hot dry days or indoors in dry air conditioned environments.
Both of these can worsen dry eye symptoms. Additional air flow from wind or air conditioning vents (for example in a car) can amplify the drying effect.
MP Drops vs. Implants – How do each contribute to the treatment of dry eye and what are the differences between the functionality of each?
DV Artificial tear drops work by lubricating the eye surface. Unfortunately, if you waited until your eyes hurt before you put a drop in, you would be too late — at that point, the eye surface has already broken down, becoming rough like sandpaper. It can take days to heal completely and in that time the cycle often recurs.
Tear drops work best when taken regularly to prevent drying out and breakdown of the eye surface. Depending on the severity of a person’s dry eyes, they may need to be taken as frequently as every 1-2 hours. Punctal plugs are implants placed in the ducts that drain tears through the eyelids by your doctor. They can be removed but are often left in place long term.
By blocking outflow, punctal plugs allow tears (both your own and any artificial tears instilled) to stay on the eye surface longer. Artificial tears are the first line of defence for dry eyes. An ophthalmologist can also prescribe drops that increase tear production or reduce inflammation in more severe cases. Punctal plugs are usually introduced later in patients whose symptoms persist despite using artificial tears.
MP How do you know you have dry eye disease?
DV When the eye dries out, its surface becomes rough like sandpaper. It feels like there is something in your eye and the vision may become blurred. The ensuing irritation can also cause redness and reflex tearing. Symptoms tend to fluctuate and worsen with activities where we blink less frequently (reading, watching TV, driving), are exposed to blowing and/or dry air (windy dry days, air conditioning).
"Dry eyes are common and bother some people more than others."
Often symptoms worsen as the day goes on due to progressive damage to the eye surface. Some dry eye sufferers also have symptoms of tired, heavy feeling eyelids in the mornings caused by blocked oil glands in the eyelids. Normal oils seal in the tears and without them, the tears evaporate quickly leading to dry eyes.
MP Who should/can you go see if you have the symptoms of dry eye?
DV Your optometrist can help to diagnose dry eyes and start initial treatments. Additional therapy may require a referral to see an ophthalmologist.
MP What kind of damage can it do if it’s not treated?
DV For most people, dry eyes will cause distressing symptoms but no overall long term damage. Rarely, however, severe dry eyes can lead to ulcers (deeper craters) and infections in the eye surface. These can cause scarring and permanent vision loss. Others can have chronic inflammation that leads to scarring on the eye surface.
MP How does one acquire dry eye? If so is there any way to be proactive to prevent it?
DV Dry eyes are common and bother some people more than others. Most people have no specific cause and tend to develop symptoms as they get older. Dry eyes are more common in women than men. Contact lens wearers are also at higher risk for dry eyes. Some people have other eye conditions (allergy, eyelid lid abnormalities) or systemic diseases (Sjogren’s syndrome, rheumatoid arthritis) that can be linked to dry eyes.