New Perspective on Dry Eye Syndrome
News Suffered by one in three Canadian adults, dry eye disease is characterized by a chronic inflammation of the surface of the eye, which includes the cornea and conjunctiva, as well as the eyelids and their surfaces.
Be on the lookout. The early manifestations of the disease can be misleading: it can simply be experienced in the form of a watery eye, fluctuating vision when blinking or a discomfort with your contact lenses.
Don’t ignore these symptoms or wait for them to go away; book an appointment with your Doctor of Optometry. If left untreated, dry eye disease can cause scarring of the cornea, the conjunctiva or both, which can, in the long-term, lead to a loss of vision. Living with dry eye disease can severely impact the quality of your life.
Up to 86 percent of dry eye patients suffer with the evaporative type of the disease, which is caused by oil gland (meibomian) dysfunction.
“I’ve found that in more than 60 percent of these cases the problems stem from exposure, meaning the eyelids are not blinking or closing properly,” explained Dr. Richard Maharaj, Clinical Director at eyeLABS Optometry and Center for Ocular Surface Disease.
"Preventative care in the form of eyelid cleaning is the most effective tool in the fight against dry eye disease."
Blinking draws oil out of the glands in our eyelids and into our tear film. When our eyes are unable to blink properly, we’re more likely to produce unstable tears, which will be less effective at nourishing and lubricating our eyes.
Copious use of eye make up, which covers the glands on the eyelid, is another common cause of the disease. “Sufferers of thyroid disorder, diabetes and other inflammatory conditions are also more likely to suffer with dry eye,” said Dr. Maharaj.
“There’s also a large amount of data that suggests that improper contact lens care can exacerbate any underlying dry eye condition.”
Ways to combat
Eat as much oily fish as possible and try to get hold of some triglyceride form omega 3 supplement. “It’s more highly absorbed by the body than most over the counter ethyl ester form omega 3 products and therefore has a more significant impact on oil secretion and tear production,” said Dr. Maharaj. “I recommend 2.5 grams per day at a minimum of 3 months in order to be effective.”
Be mindful of your blinks. “I suggest doing forceful, purposeful blinks, making sure that the eyelids are closed, and squeezing those glands,” said Dr. Maharaj. “Glands are like every other part of the body: if you don’t use them, you lose them.”
Proper hydration is imperative; “For all of us that get up early and down two cups of coffee, which is going to dehydrate you significantly, replenishing liquids and fluids is extremely important,” explained Dr. Maharaj.
“I suggest doing forceful, purposeful blinks, making sure that the eyelids are closed, and squeezing those glands. Glands are like every other part of the body: if you don’t use it, you lose it.”
Preventative care in the form of eyelid cleaning is the most effective tool in the fight against dry eye disease. “Clinical cleaning or ‘debriding’ of your eyelids is a new technique that clears the pathway to your glands,” said Dr. Maharaj. “It’s the best thing that you can do because it reduces the inflammatory burden and increases the glands’ performance.”
In the early stages of dry eye disease topical drops recommended by your eye doctor are usually the most effective and suitable treatment of symptoms. “I would favour non-preserved eye drops and stay away from the ‘red free drops’, which can actually cause longer term damage,” said Dr. Maharaj “Hyaluronate drops in a multi dose bottle offers superior comfort and stability to the tears. They are definitely best for the ocular surface in the early and advanced stages.”
For more advanced stages of the disease there are in-office specialized heated pressure treatments for the glands (FDA approved for dry eye), as well as prescribed oral and topical drugs that can decrease inflammation and stimulate the gland to start producing the necessary oils.