Dry eye disease is one of the most common eye problems affecting people today. With winter temperatures dropping and indoor heating systems cranked up, those of us who suffer from chronic dry eye find ourselves in desperate search of relief.
Although the actual prevalence of dry eye is difficult to determine, due to varying definitions of the disease, the National Eye Institute, in Facts about Dry Eye, estimates that “… five million Americans 50 years of age and older are estimated to have dry eye. Of these, more than three million are women and more than one and a half million are men. Tens of millions more have less severe symptoms.”
Dealing with chronic dry eye, in conjunction with vision loss, can further complicate matters. Dry Eye Syndrome is a prevalent, chronic problem most often exhibited in older adults and, in particular, older women.
What is Dry Eye Syndrome?
Tears allow all of us to maintain proper eye health and clear vision. Dry Eye Syndrome is an ocular condition in which a person either does not make enough tears or does not create good quality tears to properly lubricate their eyes and keep the cornea hydrated. People with dry eye may experience scratchy, burning, or irritated eyes, excess watering, and blurry vision. According to the National Eye Institute, if left untreated, this condition can lead to pain, ulcers or scars on the cornea, and some loss of vision. However, permanent loss of vision from dry eye is uncommon.
How Eye Doctors Diagnose Dry Eye
A comprehensive eye exam can diagnose Dry Eye Syndrome. Your eye doctor will evaluate the quality and quantity of your tear production. By taking a detailed medical history, your doctor also can determine if any pre-existing medical conditions, environmental factors, or current medications could be causing the dryness. Your eye doctor may also perform an external examination of the eye, evaluating your eyelids, cornea, and observing your blinking patterns.
Talking to My Doctor about Possible Solutions
As someone who has suffered from Dry Eye Syndrome since 2009, having this disease is as annoying as it is painful. My dry eye diagnosis was first linked to the chemotherapy and radiation I received during my battle with breast cancer. However, even after my cancer was in remission, the dry eye persisted. I spoke with my doctor about the chronic burning sensation and ocular pain that I was experiencing. Working collaboratively, we developed several solutions to make living with my Dry Eye Syndrome more manageable.
Taming the discomfort is a delicate balancing act of conserving tears, making tears, and controlling eyelid inflammation. It is important to note that every individual’s case is different and you must consult with your doctor to determine the best course of action for combating your Dry Eye Syndrome.
Treatment of Dry Eye
First you have to uncover the underlying reason for dry eye, such as medications or a medical or ocular condition. After your doctor determines the cause, here are some treatment options to consider:
For mild cases of dry eye, over-the-counter artificial tears may help alleviate some of your symptoms. Preservative-free drops in individual vials are recommended. Artificial tears with chemical preservatives can harm your eyes and actually make your eyes worse! Ask your eye doctor for a recommendation. Currently, I carry lubricating artificial tear drops with me at all times. Whether in my coat pocket or at the bottom of my diaper bag, these drops do offer minor relief for dryness.
Tear Duct or “Punctal” Plugs
Conserving your own natural tears is important when you have dry eye. Blocking your tear drainage ducts with tiny plugs can prevent the tears you have from draining. These very small silicone, collagen, or synthetic polymer plugs, called “punctal plugs,” help tears evaporate naturally from your eyes, which helps the surface of your cornea to retain moisture. Each plug is no larger than a grain of rice.
Your ophthalmologist can conduct this procedure right in the office. In some cases, your doctor will numb your eyes with anesthetic eye drops; in other cases, no anesthetic is required. The doctor will use a tweezer- or forceps-like instrument to insert the sterile plugs into the tear drainage ducts, which are located in the inner corners of your upper and lower eyelids.
There are four drainage ducts in total. Each drainage duct is called a “punctum” (the plural is “puncta”). Punctal plugs can be inserted in the puncta of your lower eyelids, your upper eyelids, or both, depending upon the severity of your dry eye.
My Own Experience with Punctal Plugs
Admittedly, I was fearful when my doctor suggested this method as a way to lessen my dry eye symptoms. I didn’t exactly love the idea of a foreign object being placed into my eye. However, the entire procedure takes less than five minutes per eye to complete. My ophthalmologist compares the plugs to a lollipop because they slowly melt over time within the eye.
While this treatment may not be ideal for everyone, on average the collagen plugs I have been prescribed last approximately three months before dissolving completely and needing to be replaced. Currently, I have four punctal plugs placed into my eyes every eight to twelve weeks, due to the severity of my dry eye symptoms. I have noticed a considerable decrease in pain due to this intervention.*
Prescription Eye Drops: Another Option
Your eye doctor may also suggest treating your dry eye with prescription medicated eye drops to help eyelid or ocular surface inflammation. For the past several years, I have been using a prescription medication called Restasis, which helps with tear production, reduces inflammation, and lubricates the eye. It takes 60-90 days to experience the full benefit of the medication. Currently, I use Restasis twice daily. While it hasn’t completely rid me of my dry eye symptoms, the medication has made it easier to cope with some of the uncomfortable side effects of this condition.
Also, on July 11, 2016, the United States Federal Drug Administration (FDA) approved Xiidra for the treatment of signs and symptoms of dry eye disease.
Implementing Self-Care to Fight Dry Eye
Over the years, I have also found it very beneficial to combine a self-care approach towards coping with dry eye. In addition to my ophthalmologist’s medical recommendations, I also do the following:
- Blink More: It sounds like such a simple thing to do, but reminding yourself to blink when staring at a computer screen or cell phone for a long period of time may help re-moisture your dry eyes.
- Take A Technology Break: We live in an age of technology, but having dry eye sometimes requires us to put down our cell phones and shut down those laptops. Short, incremental breaks help give our eyes the rest they need to retain much-needed moisture. If I am working on a project that requires a lot of computer work, I set an audio timer to remind me when to take a tech break.
- Wear Sunglasses: I always wear wraparound eye protection whenever my family and I are outdoors. This reduces exposure to sunlight and other seasonal elements, like wind, which can increase symptoms of dry eye.
- Dietary Supplements: Increasing your body’s own essential fatty acids may also help fight against Dry Eye Syndrome. Omega-3 fatty acids, in the form of fish, fish oil, or flaxseed oils can assist your body in maintaining its own natural form of hydration. Please note: Always consult your physician and your eye doctor before beginning any dietary supplement regimen.
- Pay Attention to the Weather: My dry eye is always worse when the heat or air conditioning is on inside my home. During those times of the year, I make sure I increase my use of over-the-counter artificial tears to maintain moisture. I also utilize tabletop humidifiers.
- Invest in a Humidifier: Humidifiers add moisture back into the air. These small, often inexpensive home appliances can really help relieve some of the symptoms of dry eye. Humidifiers come in all shapes, sizes and colors to coordinate with your own personal style and home décor.
- Drink Lots of Water: It’s important to keep yourself hydrated by drinking plenty of water every day. If your body has the natural hydration is needs, dry eye symptoms can become more manageable.
- Use Warm Compresses: Placing a warm compress on my eyes has always provided me with a cooling sensation and has alleviated my dry eye pain. When symptoms are really intense, I may even choose to sleep with the warm compress over my eyes.
- Be Careful with Eye Makeup: For women especially, makeup makes a big difference when dealing with dry eye. Always make sure you remove eye shadow, mascara, and liners from your eyes before applying drops. In addition, be proactive in replacing your eye makeup regularly to avoid any bacteria they may collect over time on brushes and applicators.
Dry Eye Syndrome can be managed with over-the-counter remedies, medical interventions, and self-care methods. Maintaining good communication with your eye care professional can help you to learn how to minimize any discomfort and maintain proper eye health.
*Editor’s Note: Punctal plugs can be temporary, extended-duration temporary, or longer-lasting, depending upon the severity of dry eye symptoms and each person’s individual needs. This post originally appeared on the American Federation For the Blind’s (AFB) website, Vision Aware. For more information on dry eye and other ocular conditions, visit www.visionaware.org.