Treatment for Dry Eye

Dry eye is a term used to describe a group of conditions that result from inadequate wetting and lubrication of the eye. While millions of people worldwide experience dry eye, it is not always easy to diagnose and can easily be mistaken for other conditions such as infections and allergies.

  • It has been estimated that 10 to 20 percent of the U.S. population suffers from dry eye. Nearly six million women and three million men in the U.S. have moderate or severe symptoms of the condition. Scientists estimate that an additional 20 to 30 million people in this country have mild cases of dry eye.1
  • It is estimated that the rate of diagnosis of dry eye is low – at approximately five percent.2 Dry eye can be difficult to diagnose because there are so many possible causes and contributors. Also, not everyone experiences or describes symptoms in the same way.
  • Anyone can experience dry eye, but the condition is more common in femalesthan in males. According to a study by scientists from Schepens Eye Research Institute (SERI) and Brigham and Women’s Hospital, nearly 3.2 million American women age 50 and older suffer from dry eye.3
  • The occurrence of dry eye increases with age. SERI reports that nearly 75 percent of people over age 65 will experience dry eye syndrome,1 and the condition occurs most often in older women after menopause.4
  • Dry eye results from abnormal or insufficient tears. This leads to reduced tear clearance, increased osmolarity, ocular surface irritation and ultimately inflammation. Once inflammation begins, damage can occur to ocular structures. This perpetuates and intensifies a cycle of signs, symptoms and further inflammation.
  • Factors that can contribute to dry eye include smoke, pollution, extreme heat or cold, windy environments, concentrated near work such as reading or staring at a computer screen, hormonal changes, autoimmune diseases such as Sjogren’s Syndrome, Lupus or Rheumatoid Arthritis, and certain types of medications including antihistamines, anti-depressants and hormone replacement.
  • Clinical signs of dry eye include fast tear film break-up time, corneal surface damage, corneal and conjunctival staining, low tear meniscus, tear debris, hyperemia, increased cytokines and abnormal tear osmolarity.
  • Symptoms of dry eye include dryness, scratchiness, burning or stinging, Foreign Body Sensation (FBS), grittiness, fluctuating blurring of vision, tired eyes, general discomfort, sensitivity to light, contact lens intolerance and tear debris.
  • It is important that patients see an eye care professional to determine whether or not they have dry eye and to determine the appropriate therapy for the condition. An eye care professional may recommend an artificial tear.

Dry Eye is a multi-factorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity (concentration of salts) in the tear film and inflammation of the ocular surface. 

Problematic dry eyes are one of the most common problems reported to eye doctors. Dry eyes result from either a decrease in the amount of tear production, or the quality or composition of the tears produced. Common causes may include advancing age, allergies, poor diet, heating/cooling environmental circumstances, hormonal changes, health status such as diabetes, arthritis, lupus, thyroid dysfunction, chemotherapy or radiation treatments, and acne rosacea, contact lens use, computer use, and patients that have a history of LASIK surgery. In addition certain medications can contribute to dry eye symptoms such as antidepressants, antihistamines, decongestants, acne treatments, diuretics, and some blood pressure medications.

Common symptoms of dry eyes may include blurred or variable vision, sensitivity to light, dryness, burning, stinging, gritty or foreign body sensations. Occasionally, the dry eye patient may experience a paradoxical excess or “reflex” tearing caused by the underlying eye surface irritation.

Treatment of this condition may include artificial tears, gels and/or lubricating ointments at bedtime, daily eyelid hygiene scrub procedures, a prescribed medication regimen, omega-3 essential fatty acid nutritional supplements (fish and flaxseed oil), and punctal (tear drainage) occlusion of the eyelid to retain moisture.

As you can see the causes and possible treatments are complex. An individual treatment plan will be formulated for you based on severity and known causes. Please follow my recommendations and outlined treatment plan carefully.

In addition, here are some helpful tips:

  1. Wear sunglasses outside.  This will not only reduce the aggravating glare, but will provide a “windshield” to help block the drying wind effect.
  2. Stay hydrated – drink plenty of water and fluids.
  3. Bedroom – may add a humidifier and turn OFF the fans!
  4. Aim vents in cars away from your face.
  5. Take frequent “blink breaks” when using a computer.
  6. If taking hormone replacement therapy, be sure your doctor knows about your tear problem.
  7. Okay (and desirable) to use over-the-counter lubricants (such as SYSTANE® ULTRA Lubricant Eye Drops) during the day as needed for extra relief.
  8. Supplements such as flaxseed oil and omega-3 could provide extra benefit.
  9. Avoid excessive caffeine.
  10. Smoking aggravates this problem.
  11. Environmental factors can add to your discomfort (smoke, fumes, dust).
  12. Airline travel can increase symptoms

NOTE: For U.S. distribution only.

1Eye Disease Information and Resources: Dry Eye Fact Sheet. The Schepens Eye Research Institute. 2003.

2Lemp MA, on behalf of Alcon Laboratories. Systane®: A Therapeutic Option for Dry Eye.

3Schaumberg DA, et al. Prevalence of Dry Eye Syndrome Among U.S. Women. Am J Ophthalmol 2003;136(2):318-26.

4©2000 National Womens’ Health Resource Centers, Inc. (NWHRC). iVillage Health, Dry Eye Syndrome: Overview.

http://health.ivillage.com/eye/eyedry/0,,nwhrc_75hlv2nv,00.html

5Torkildsen G. et al. Poster accepted at ARVO, May 2009, Ft. Lauderdale, FL.

6Survey of Dry Eye Patients, November 2008, Data on file, Alcon Laboratories, Inc.