Keratoconjunctivits Sicca(aka Dry Eye Syndrome) occurs when the chemical balance of your naturally produced tears gets altered. This imbalance can occur if your body produces fewer tears or the oily layer that keeps your tears from evaporating diminishes. Environmental factors like wind, sun, and smoke exposure also can affect your tear chemistry.
SYMPTOMS
Many people with dry eyes commonly complain of stinging, burning, or a scratchy feeling of something in the eye. Other less recognized symptoms are WATERY eyes, blurred, and fatigued vision. Difficulty wearing contacts is another common symptom of dry eyes. Even driving at night can be more difficult with dry eyes.
CAUSES
Certain factors increase your risk of developing dry eyes.
– Individuals over the age of 65
-Women are more likely to have dry eyes due to hormonal changes from menopause, pregnancy, and birth control.
-Medications, particularly antihistamines, can decrease the amount of natural tears a person produces daily. Other drugs, including those for blood pressure and depression, can also cause dry eyes.
-Medical conditions, particularly diabetes, thyroid, and auto-immune disease(Rheumatoid arthritis, Lupus, and Sjogren’s), can increase your risk for dry eye.
-Contact lens wear. Specific soft contacts, particularly older brand technology, act like little sponges on the eye. Over time, the contact lens will try to absorb the natural tears you are producing to maintain the integrity of the contact lens, leaving some patients too dry to tolerate wearing contacts.
-Refractive Surgery procedures like LASIK and PRK can interfere with tear production. For some, this is only temporary. For others, as we age, the condition can return and become a permanent issue.
TREATMENT
SELF CARE
Dry eye therapy can start at home with simple adjustments to your routine.
-Blink regularly when on an electronic device. We call this the 20/20/20 rule or ‘blink breaks.’ Every 20 minutes, pick a target 20 feet or more away and look at it for 20 seconds while blinking several times. Studies have shown when we are on a computer, and we physically blink less per minute, this upsets the delicate chemistry of the tears and quickly leads to dry eye symptoms. SO, BLINK, BLINK, BLINK!
-We also recommend getting outside and staying hydrated. We Floridians tend to run our AC because of how hot it is outside, but we don’t realize this is pulling humidity out of the air to keep us refreshed and cool. Lower humidity=dry eyes. Dehydration also causes dry eyes. We recommend drinking 8-10 glasses of water daily.
-Wear good quality polarized sunglasses with a wraparound design. This type of sunglasses gives you excellent crisp vision. It protects from drying sun and wind exposure, which can permanently damage the eyes in the form of pinguecula and pterygium. Both exacerbate dry eyes and sometimes require surgery to remove.
-We recommend a daily supplement of pharmaceutical-grade omega oils to build the natural oil layer back up in the tear film. Dietary foods high in omega oils such as salmon, nuts, and flaxseed also help keep dry eyes at bay. It can take several weeks of consistent use of omegas before you start to feel the results, so be patient.
HEY DOC, I TRIED ALL THOSE THINGS…. NOW, WHAT?
When at home, self-care doesn’t provide enough relief; we now move on to in-office therapy. First, we perform a thorough, specific set of tests to determine what type of dry eye you have.
Treatment options include:
-Prescribed drops. You may have heard of Restasis and Xiidra, which increase your natural tear production. These drops work great for many patients but can be expensive. They are prescribed twice daily everyday…forever… so we usually attempt some other type of treatment first. One such option is Regener-Eyes. Regener-Eyes is a biologic eye drop that calms inflammation and helps your eyes heal, repair, and regenerate. It is prescribed for three months and provides lasting relief for an additional six to nine months. Another option is the autologous serum. This treatment involves taking the patient’s blood and splitting it into a concentrated serum. This is combined with preservative-free artificial teardrops making drops full of the patient’s very own nutrient-rich natural solution.
-Punctal occlusion. This one sounds scary but is the simplest and quickest way to alleviate dry eyes. Conserving one’s natural tears by blocking the flow of tears out through the puncta(that is the tiny hole on the edge of the eyelid in the nasal corner of the eye) is achieved by placing small silicone or gel-like plugs. We currently use an extremely gentle brand to the eyes that dissolve very slowly(over six-nine months). The goal is to keep available tears you naturally produce on the eye longer.
-One other treatment of dry eyes is to reduce inflammation that prevents those good oils from getting into the tear film. Several eye conditions, including blepharitis, ocular rosacea, and Demodex or a combination of all three, can lead to a chronic disease that comes and goes over the years, adding to the patient’s frustration and discomfort. Treatment involves sustained heat therapy, medicated lid wipes, and expression of clogged glands with an in-office procedure.
There can be many causes of dry eyes. The team at Advanced EyeCare is ready to help evaluate your unique case of dry eyes and tailor a specific treatment plan.
Call us to schedule a medical consultation at 407-333-3937.
