With each passing year since the advent of the computer, dry eye symptoms have multiplied significantly across the broad spectrum of society. And as device use spreads to younger and younger ages, symptoms of eye irritation associated with dryness is also drifting towards younger and younger ages.
Thankfully, there has also been an explosion of treatments for these issues, and a better understanding of what the underlying root causes are…
Understanding the Causes
There are many potential causes in our daily routines which can contribute to Dry Eye Symptoms. Understanding these risk factors can help your eye doctor begin the diagnosis process.
- Aging: The eye is no stranger to new issues associated with aging. The average patient is best educated about the risk factors associated with cataracts and aging, but dry eyes can also have a grounding in this. Our eyes have meibomian glands which secrete meibum. Meibum is a lipid based component to our tears which act as a lubrication and also a protective barrier against irritants or infectious agents damaging the eye. As we age, the meibomian glands can clog to the point of not secreting any meibum. As we lose the meibum, the dry, burning, irritation symptoms multiply.
- Gender: While the full cause of the gender split on dry eye symptoms are not fully understood it is suspected that the compounding factors of hormone release changes as we age, as well as lifetime use of eye makeup can significantly increase the risk factors of dry eye disease for women.
- Allergies: Use of antihistamines can help to reduce allergy symptoms, but their ability to “dry out” your sinuses can also contribute to a loss of meibum flow, and more eye irritations associated with dry eye disease.
- LASIK: The laser correction of your prescription can dramatically increase risk of dry eye disease. If you’ve had LASIK in the past, you may want to be evaluated for potential dry eye treatments.
- Reading: If you already have one or more of these risk factors AND you enjoy to read a lot, the prolonged use of your near vision can put additional strain on your dry eye disease. We tend to blink less when focusing on something close, like the words on a page. The less we blink, the less opportunity for the meibomium glands to do what they need to do.
- Cold/Dry/Low Humidity: Cold, dry, windy, or low humidity environments mean that you need to blink much more frequently to keep your eye properly lubricated with meibum. While more frequent blinking can help, in extreme environments that just not enough. If you enjoy the winter sports frequently, you may have dry eye disease.
- Prolonged Computer/Screen Time: Similar to the issues associated with reading, when we look at a screen our blink rate can reduce by as much as half. Less blinking, means less tear film, means less meibum to keep your eye lubricated and comfortable. You may have heard me mention the 20-20-20 rule before (for every 20 minutes of screen time, take a 20 second break looking 20 feet away), and while this can help, if you are on a screen a significant amount of time, you may need a treatment to restore your meibum flow.
- Contact Lens Wear: Any contact lens wearer will tell you that the lenses can be super convenient for many aspects of our lifestyle, and can really change your look, but they also tend to make our eyes much drier. The extra work the eye has to do to keep the eye lubricated may need assistance from a dry eye treatment.
So, How Can My Problem Be Treated?
As you might expect there are many forms of treatment available for Dry Eye Disease. From simply over the counter solutions, to prescription medications and in-office treatments. The answers are plentiful enough that it can be challenging to navigate without some guidance. My goal here is not to tell you the best treatment. How to handle your Dry Eye needs really should come down to a discussion with your Eye Doctor to find the most appropriate treatment for you. I hope to help establish the variety of ways your situation can be handled. If you have had a failure with one of these treatments, it does not mean you just need to suffer. There may be other paths for your relief.
Over The Counter (OTC)
There are literally hundreds of Over The Counter (OTC) eye drops on the market. And many of them can actually be harmful to your eyes. Some products, such as Visine or ClearEyes only mask a problem by reducing the appearance of symptoms without addressing the underlying dry eye condition, allowing your eyes to become even more problematic.
Don’t worry, though, there are many which can actually help your eyes by replenishing the type of tears you need. Specifically the tears with the lipid content to maintain tear film and reduce irritation. Some of these products include Systane, Refresh, and Blink–just to name a few.
If you wear contact lenses, it’s also important to make sure any eye drops you use are compatible with contact wear. Some can actually become dangerously painful if used when wearing contacts. It’s important to look for the term “Rewetting drop” if you are looking for a eye drop designed to work with contact lenses.
In addition there are drops specifically designed to assist with allergy issues. These work well for mild to moderate eye allergy symptoms. They don’t necessarily help well for severe issues. These products aren’t designed to treat dry eye symptoms, other than the fact that allergy problems can increase dry eye symptoms. Chief among this category are Zaditor and Alaway
Several excellent prescription medications have recently been created to help treat dry eye syndrome, and its symptoms. You’ve probably seen commercials for some of these products over the past 10-15 years. While each tries to tackle the issue from slightly different angles, their goal is to improve your eyes’ natural ability to produce and maintain a quality tear film.
Restasis was first approved by the FDA for treatment of dry eye syndrome in 2002. It’s designed to treat the meibomium gland dysfunction, as well as Sjögren syndrome. It’s had excellent efficacy for many patients, but some have had issue with either the side effects (including eye irritation, burning, itchiness, etc.). As with so many prescription medications, side effects can mimic the disease symptoms you’re trying to prevent.
For those who don’t find comfort in the treatment from Restasis, there is treatment available visa Xiidra as well. Xiidra is targeting the inflammation associated with dry eye disease by blocking T cell interaction with irritants in the eye. The most common side effect is a bit of a bitter aftertaste draining through the sinuses.
Avenova takes an entirely different approach to eye irritation concerns. They are focused on addressing the proliferation of mites on the eyelid. It’s natural for us to have fauna growing on our skin, but if they overproduce there can be problems with the disruption of tear flow. These natural biome mites are called Demodex. Avenova is a way of cleaning the lid surface and reducing the proliferation of these mites. Common causes of the growth of mites can be a buildup of eye makeup which can clog the pores which produce the meibomium tear film.
As with all prescription medications, consult your optometrist or physician to find if they are the best course of action for yourself.
There is a common first step in the treatment of dry eye issues. It’s the warm compress. The simplest form of this therapy is to run a wash cloth under a hot tap, and, after wringing it out, place it on your eyes. The heat, combined with moisture can clear clogged ducts and pores around the eyes.
If you are suffering from dry eyes syndrome, then you may need a more intensive version of this treatment. The first step up would be using a Bruder Mask. These are relatively heavy beaded masks which, after microwaving, release a steady and moist heat to clear your meibomium ducts.
If this isn’t sufficient to address your symptoms, then taking the next step up may be right for you. MiBoFlo is an intensive, office visit version of this treatment. With MiBoFlo your doctor will run a heated sterling silver pallet across your lids, after applying a small amount of ultrasonic gel to it. This reaches a temperature and duration you cannot achieve at home. Typical treatment is 4 visits, spread across a month. After the intensive, month-long treatment, then a routine follow up ever 6 months or so can maintain the improvements.
Many Ways to Help
As you can see there are many ways your Eye Care Professional can help address your particular case of Dry Eyes. Which solution is best, will depend on your symptoms and what is causing those symptoms. This is best addressed with a visit to your Eye Doctor.
What’s most important is to realize you don’t have to suffer in silence! Talk it over with your doctor and find some relief to this all-too-common problem!